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Home My WebLink AboutBuilding Permit #121 - 538 OSGOOD STREET 8/14/2008 BUILDING PERMIT p10RTF� o`tt��D ,°gtio TOWN OF NORTH ANDOVER 02 APPLICATION FOR PLAN EXAMINATION 9 q. # Permit NO: �i' Date Received /j, "tea 4DRATED rPa`(y S`SACHU`+E Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 3g SG)DDd Print PROPERTY OWNERY� Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building. One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: V -h^pd- de-ckl'q? arid raily'na a# endh ° ' e i Yl S 5�m on Identification lease Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: Address: 8nd, /1 Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Gate: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00PER .F. Total Project Cost: $ 3 Ate, , e FEE: $ 012- i Check No.: �� Receipt No.: 02(��G NOTE: Persons contracting ith unregistered contractors do not have access to the guaranty fund Signature of Agent/Own ignature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools d Well Tobacco Sales Food Packaging/Salts,'; r Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS v - I a HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA- (For department use ❑ Notified for pickup - Date ...............----.._.._..........---._..........................._..._........_....---....._._..--..-......._._ ......................_-._................... _.._ _......-----._.._....---._..__..............----......._......_.._.._ Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo CoPY Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 1 �ORTiy Town of No. / 2,1 - - - o o dover, Mass.,LAK _ COCHICHEWICK �� 7�S RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING.INSPECTOR , ooze' l THIS CERTIFIES THAT............ .�? . . . ................................. ............................................................................. Foundation has permission to erect........................................ buildings on ..6_30�......As.�..D..A!FK.. ......................... Rough to be occupied as........ ��......G!..- . <1 ........ .........D. 1 ..... Chimney . . . .. .. provided that the person accepting this permit shall in every respect conform to the s of th. e. ..app. -a. ion. ...o.n...file. .. in.. Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final v PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UN LESS CONSTR STARTS Rough ............... ............................................................. Service BUILDING R Final Occupancy Pemift Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 08:'1.4,` ,` /142008 10:11 FAIL 7814361360 PINELLI & PATALANO 12001 �3*!rt'It 901fitti At!L"i i Insurance Agency FaxlD! Tw Attn:Jue Sterner Date: '216P007 03:45 PNI Papa:2 o M.". CERTIFICATE OF LIABILITY INSURANCEOP ID UVITE-1 12/06/07 T1,11i"CiRTIFICATE 19 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS,NO RIGHTS UPON THE CERTIFICATE LJIA lnz;iizance Ardency, rnc. HOLDER.'ANIS C9P'nF9C.ATF DOES NOT AMEND,EXTEND OR S27 linior, Avenue ALTER THE COVERAGE AFFORDFD SYTHE POLICIES BELOW. Framinglx= RX 01702 Phonc- 508-872-0662 FaY:508-879-5299 INSURERS APFC)RDING COVERAGE INSI.REP A Ohio Casualty GrOR-- United Haudyrpan lwc. 30 CaleWrive- Methum 01844 N;,LlP.ANrE LIS'rED 5ZOVI NAVE EE---N ISSLED 7C 7I1E:NGVR(K)NAP0E,AiIQvE tOR TE aPQUCY PER OC;0011;,M-D 1pla.?,tNT."Ealy!017 CoNn 74)N CF:WY CONTRACT Or OINER 0000WEN-W11-1 RTSPl-wC'TCl CERT!F'CAT=A4AY SC:31SURO OP f,'w PuiTAIK, i?y i HF,4EiN IFals,ci.7-0 ALL 7HE TMAMS,CXCL--4ijC;N':�AND CONClTIONS Or'SLICK ;Wclpa 1,C3krzNT,.lmrm.lHOWN MAY MTHAVE REEN RrOL CED Ell U. --I. PQ Cv:NJAi�tER DATE(MM!ODM1 1 rATE:N E"J>1 0=4�*(Er4E -,,-d0Mt 7REN7M.-n— COMMSPC AL C;lrfX:RA;.JA;0LITY i 09/14/0'7 O�i/14 '08 PREM13 jEa,5wvunt;,, � 100 0 00 0 AIMS MADE -uF;. YE]EXP rAr,v r,r.w p?mjn 1 GE!ERAL AfrAlCW. 1 11 AGGREGATELVT A-rL,ES PE;;: PRODUCTI;-11:0KIlp"Or A�61�� 000 000 rOUCY -IkOp I -A.L,00001L,A 61A6161TY C:7ivRIN50 F-M-LE UN117 ANY AUTO ALL 04NEC AU70S 90)I-Y IN iIt SCm5IXILE.)ALITOS r"Orsol H:RELJ A!.TC6 POW Y IN PROPIR14"-,AMAGI! F-'O* _!3A ,,,34 UAElI.ITY QKL(-LAACCiDENT EA k.170 0111I.Y. Atari j S; 1.0.61417Y xcuc: MAIX OF-0 KlIBLE 1 1 r,M- "-T O.N NORKERI COMPFNII.A-PION AND I ErAFLOYERS'LLUILITY i PAPTkE3,EYECUl Vc v=5003854012006 12/3,1/ 1,2 111/07 E 4 EACH,ACODENT 'Tic)0&IF-)0 9' DI&aA,;E FA ."s 20 600 0 Spccl,-J.rAOviV=q,l bon. 1 X-L.DI36:155•POLICY L 1017 !sSoo0ou OPF-4A--111N3 I LOCATIONS i VEHZM I EXCLO?iONS A Days GL/20 DAyz Wr CIEWTIFICATE HOLDER CANCELI-ATION SHOULANY OF T-S A2,0VE Dr-svZo r—7icn EE-CANT.-E—"9-D'BEFORE TN@ EkPIRATl014 OAXF.-'HEREOF,-nqe ISWING INCUMA WILL ENDAAVOR T4,Mi. * tA'1u wk?'EN N Store mairitenance OTIC S 1*0 THE EIRTIFICA115 HULOIER t4kMED 10 TNE LEFT,faLer PA&URE.TO 00 Z-0 SHALI. ,;',O. box 2002 IMPOSE NDOfWQATION OR UA&LITY OF ANY KINE UPON THC llqtI-4IkE �' R ITS AOGNTS OR AUTHORI RE$ ACQR9 7,5(ZQ01?08) 4rAC0RUO4R ORA' I014 1388 f NORTH TOWN OF NORTH ANDOVER OFFICE OF p BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 rev North Andover,Massachusetts 01845 SSACMtlstt Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 81h, D ff JOB LOCATION: 1<38 O's,aoj OV, Number StiaAd Address Map/Lot HOMEOWNER Sa Vidra H/W r R 7L Wl Name Home Phone Work Phone PRESENT MAILING ADDRESS I 1/ f"�Q�� TOnACI I G � Nt Andover A4 D g City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that helshe understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Hornemvms Exemption 110ARDOF \PPEAls(R$9541 CU.\SFR\'.YrtoN, ,gg-9530 1IF...\L;1'II6R8-95.30 PLANNNG688-9535 4 ec Location No. & Date ' d MORTh TOWN OF NORTH ANDOVER F: • • 09 JL a Certificate of Occupancy $ — �'�s'•°•E<� Building/Frame Permit Fee $ ncMus i Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 1 4 L 0 Building Inspector