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HomeMy WebLinkAboutBuilding Permit #663 - 6 Berkley Road 6/2/2009Permit NO: Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION T h P O Date Received 5 _'a �q�ogAre0 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne famil Ad iti—on Two or more family Industrial Alteratio No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic; `1lVellfloodplain Wetlands Watershed District WaWater/Sewer �'- DESCRIPTION OF WORK TO BE PREFORMED: OWNER: Name: Address: 6 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED/ON $125.00 PER S.F. Total Project Cost: $ .� iJ(� r� FEE: -063y Check No.: 6�, Receipt No.: NOTE: Persons contracting with unreg",ercontractors do not have access to the guaranty fund +C�nn��aira n�':�lnonilrl�e�norL''4 w�,.. _ +r.r'Z�f�'r.r�ra+�.,:.fr.r "`",�''0�•-�•• Location 7f ec le-- C/ Date No. —4 .or &ORTPI TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ CHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �_UC 22 U 60- 4 4& B6115ing Inspector Plans Submitted � I Plans Waived Certified Plot Plan . Stamped Plans TYPE OF SEWERAGE DISPOSAL Water & Sewer Connection/Signature & Date 'Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site :Located at 924 Mainwtraet.. THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION { COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature 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 jDPW Town Engineer: Signature: - Located 384 Osgood Street FIRE ;DEPARTMENT - Temp Dumpster on site yes �'`' no :Located at 924 Mainwtraet.. Fire Department signature/date r ,Lcb IMENTS 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 I 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 All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application V Certified Surveyed Plot Plan Workers Comp Affidavit `t' .8 1 hA eF ❑ 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) j f a 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 "WU 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 m�i�t be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 x w m o w° i aEl V) I- U W � z w or co w° a�' E U cz w O 04 a" a w a ow w W w x o a w�' cis w w d w r CO z cn Q o. cn Ui K1 U O CD O C cs Z co 0. Q .. y C CD Cm CO)CD ff m m L- H0 CD CL *-p CD CD Q cvv o C' a �Q y CD ccc = Cc C.2CL a .C.0 Z ts co 0 CL C) d! c C C_ C c CO)CL D c� �m 0 C o ` O N w, C Cl i v C.') CL. C m cc O C :Z O CD EQ D c ca CD . E c o0 �[ m rr Z m C �m O.•. a O �N N E, CD 3 t .. � C O N =_m s Go E o Cl �v o0 0 A CLC.3 CS CD o +.�•� cm _ C O a' p, O C co �'Z O o ti . oao Of C Q o H o a .o = m :m 3 a 0 N H .' . 1- N O S o W O z e'p t Z .� Aug* L= c W .E co Z CS C.3 m o FE � N_ = O' .3-.00 O.0 CD40 CCL typ L- cc zoo K1 U O CD O C cs Z co 0. Q .. y C CD Cm CO)CD ff m m L- H0 CD CL *-p CD CD Q cvv o C' a �Q y CD ccc = Cc C.2CL a .C.0 Z ts co 0 CL C) d! c C C_ C c CO)CL D Date: 5/29/2009 Time: 5:00 PM To: @ 9,978-975-0012 Tobey Merrill Ins Page: 1 ACORQ, CERTIFICATE OF LIABILITY INSURANCE DATE {M lrtlDDIVYYY) 05/29/2009 PRODUCER 603.926. 7655 FAX 603. 926. 213 5 Tobey & Merrill, Inc. 20 High Street Hampton, NH 03842-2214 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ROB ROY MACGREGOR BUILDER 28 HAMPTON TOWNE ESTATES HAMPTON, NH 03842 INSURER A: Peerless Insurance 24198 INSURER B. INSURER C: INSURER D' INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN; THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ------------------------------------------ --------------------------------------------------------- ---------------------------------------- ------------------- ----------------------------------•-------------------------------- IL�TR N RL TYPE OF INSURANCE POLICY NUMBER I DATEI MM�DlC1'T'rYYY GATE YM M/G6MY(ON LIMITS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL GENERAL LIABILITY CCP9238741; 06/18; 2009 06/18/2010 EACH GCCURRENCE S 500,000 No., Andover, MA Tamie Rhodes `TLA X COMMERCIAL GENERAL LIABI-;TV I.........,,. - ? CzAMALw- fiii-:iF'f.(TiSG- � �•.... PREMISES Ea occtrrence ............................... .S 5O OOO Cf_.416.15 WtADFFXJ OCi:UR NSD EXP IAiw one S 5,000 PERSONAL & ADV ?NJURY S SOD, 000 A GL•NER.AL AGGR1 GATE 1,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODLY'TS - COMP,'OP A.GG S 1,000,00() X f'GLIr;', I FF.4 LOC I JECT AUTOMOBILE LIABILITY COMBINED SiNGLL• i.IM1-, A:TV AUTO (Ea accident) BODILY INJURY (Far person) A_L O`iVrrED AUTOS SCHEDULED AUTOS f5RED AUTOS PION-)WNED AUTi •:, f BODILY INJURY (Pnr arcident) PR.^.FERTY DAIAAG4 ..... ....................•------------------------ I (Per accident) GARAGE LIABILITY I AUTO ONLY . EA A''CIDENT OTHEP, THAN EA ACC AUTO ONLY. AOG S ANY AUTO 5 EXCESS I UMBRELLA LIABILITY �j EACH OCCURRENCE S AGGREGATE 4 OCCUR CLABNS M, -DE --------------------------------------- V ---------------------------------- ..__. I DEDUCT IBLE s $ RETErdFION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANY P=tiPRIETORIPAP.T:-iERIE?'EGL!-VEa OFFICER/MEMBER EXCLUDED? CT - WC STATU- I CTR - ------ TOFY-LI1fTS-:------ -- E.L. EACH ACCIDENT . { E.L. DISEASE - EA EMPLOYE S (Mwdabory in NH) Nabs• descril vp under S ECIAL PROVISIONS below i --------------------------------------- E.L. DISEASE - POLi^.Y LK IT --•---•--._........... ............ £ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ACORD25(2009/01) FAX: 978.975.0012 ©1988-2009ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1.0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Louise Perry REPRESENTATIVES. 6 Berkeley Rd AUTHORIZED REPRESENTATIVE No., Andover, MA Tamie Rhodes `TLA ACORD25(2009/01) FAX: 978.975.0012 ©1988-2009ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Date: 5/29/2009 Tobey Merrill Time: 5:00 PM Ins Page: To: a 9,978-975-0012 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. )tk%'V cu'eatzuuaiul "�^'•'•-•�• ^���� nttuHSlt'lS,D/PRETI 10002/002 MORTGAGE INSPECTION PLAN C. 401 SOUTH BROADWAY,LNAWRE cE MAA..o 8 3-ASSOCIATES,2 837N 335 FAX:(978) 837-3336 MORTGAGOR: LOU15E PERRY LOCATION: G BERKELEY ., CITY,STATE: N. ANDOVER, MA DATE: 5/8/09 PARCEL A 1 1 ,2375F 101.94' 122.80' BERKELEY ROAD CERTIFIED TO: .BLUE WATER MORTGAGE CORP Plood hezard mosu hos been dateranimed by 'w le and is not neC"Mr8y accu'mtaVntil definitive ptans i¢s�tsstted by HUD and/or a 'uetticot comt'ro1 sunigy Pe'r1t+ d, precise elevations a¢nnot be detea tned NOT& 7Ab mertwae fnce.eeu,_...__ ��__, DEED REF: .404G/ 147 PLAN REF: 7447 SCALE: 1"-20' JOB #: 209.01 505 Pen om a< rood or It - -ro ✓"i tis" ""'A°°° °"ry ^pApo*ty sva°yh •.d fir onssng, PR9Dfy deed �i tna teariv.�simp'O�'•a in °ee°rdaneo I >� Nortyoye 1mn pttmae, lf� eor+ara�iesnr ppra reeet°d °a„d JOHN f P-�d by w - teo.d f ttW fNR e'' and vnd he=e3 a J%oaa Ar aon desorm hasten 're. tO.;,"Qti J. + um / Jb't7er .toss tMt cn n g meA+�tonot *.a ! mk tdtoerd te..i ot�ta " MUSSEL! y 717 mete nq-ah en. et�„w�ol�em�en..aew'., °. a "'d`r pYdVLS1O^r f xcc cs 40—A"fh ee�r �u and ewr tlwmn of +scold eed ' ether Northern •aaootot la�wptssm P fit I. fhvis+sY/No+cw 4 vee cn ftaui Nasa+d. o f ty 16 r.epeame�au�y s1orvin to lard o+mer eamupoid ro day _ po'aatnauy A. m+aosoe +=+.decn ueie.vt°ara,`•nyona °error that. w :d 3Vp✓�y/- O9' ten ie cn». Rced Hmaearc 11SOent to — 11 need Haaad detaerntswd Jrom tatert pd." need mmte°yas°orid. m edtA iso Droscsed anoatyaga !e'�a^^++�e t° td taenpeeer_ f1i9i^�m !baro Wp lh�ut Z= �c•f g. o G�� I — -•- - �� ivuninatul Aaauqa - HRUMSIEB,D/PRETI Q002/002 MORTGAGE INSPECTION PLAN 401 SOUTH BROADWAY, LAWOREN CE MAA..018 3 35222CEA� 78 '837N 335 FAX:(978) 837-3336 MORTGAGOR: LOU15E PERRY LOCATION: G BERKELEY . M CITY,5TATE: N. ANDOVER, MA DATE: 5/8/09 PARCEL A i 1,237 5F 101 .94' NL" R /v5•C�% 122.80' BERKELEY ROAD CERTIFIED TO: BLUE WATER MORTGAGE CORP Plood hazard -one has been determined by scale and is not ne"mray accuntteaUla n2il definitive Pns are issued by BUD and/or a vertical control stsntey '+s Perforrned,Pmcise elevations cannot be determined. NOT& This moft ¢ Jaetaen. -.-- to ot v Zo by reitod sspen o sys4y, vel 1Er temdu9. P-P*n deed aeG sng�No oo.rwr were a"sem roun "V toasted eu gd and poetfvvy Ar coning detormfeati°r. !!a e.¢}yAv6Y° net to 6e used to eat.M.% prolwty dtmt-Jure sl.ovi„ heavoa as° amod on to l�othor mte; takv♦gr, aoo ¢nd a Jt oI eny, ¢rid otter rnauera of record and preeerpti or other rights Northam A=-W,Itrt; natrstoes t1.9yheroin to I-Ad otttrwr or °°°t+Porrt. retcnr.or 6y onyo etuyr thaT --a - +mutt{n9 Ir' in rotttwdfor. !I B n+ovdgnyve u.ttt� its Froyoead rmrtg¢gv Jstra<mi, DEED REF: .404G/ 147 PLAN REF: 7447 SCALE: 1 "=20' JOB #- 209.01 505 to with thert7lecl�rnie°f SYandm�s- KP Wd in occro+darae 1 -1 --tion air 1br ortgago. 1mn Rvgiahvtion of Ptof sionol x rOt' w" and land of E60 CYR etx:. tit atrvcttaea aheurts eon b If. -Un" optnton that diaynstonal aet6mk eta '°uh the Wd eontng h°rtaoneci are esenpt carder P -Wo -of jlc•Lt Ca I0 d S— 7 ar gE F. Pmyrrty/9ouro to not fn plod /fasard, O 9. fou twa n stow; Rosard A— to' t IiZZ to d.1--j-Rood >anaaetot Rood lldaard dctenntrud Item latest Federal Ffeed fun.n — Rate Lap Attu! ZS�o'9 la^Goo Z.�G lto o(-ii7-Aa gay I ;r- Si 0 ,y (i' (� ({!gill Jpy { Mi . 4m 0