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Home My WebLink AboutBuilding Permit #143-15 - 6-8 Johnson Street 8/11/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 7��5 Date Received Date Issued: �/�� IMPORTANT: A licant must complete all items on this age I ^ nn LOC AT fe �. �KSon Na r��otJP�2. Print. PROPERTY QWNE Print 100 Year Old Structure yes no MAP NO: PARCEL: ZONING DISTRICT: Historic District no Machine Shop Village yes no TYPE OF IMPROVEMEWT. - PROPOSED USE Residential Non- Residential ❑ New Building 0family 11Addition wo or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: i ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer OSCRIPTION OF WORK TO BE PERFORMED"01101/41r_ BA Gowl &g.1 19-C.L I .c.w �is�}��2t3s fc I T,dentific�tion Pleased eo Print Clearly) OWNER: Name: Phone: Address: 49-CO-7/ S�Le.� S'Ceee �- .D } Phone: CONTRACTOR Name: r/ � Address: (0 9 (OLI C o ��c60yeC. E Su ervisor's Construction License:GS-D7�3 Exp. Date: /on p Home Improvement Licenser Exp. Date: ARCHITECT/ENGINEER Phone: � Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. FEE: $ Total Project Cost: $ ----- Check No.: g7 9� Receipt No.: a 7F �3 NOTE: Persons contracting with unregistered contracto s do not have access to the guaranty fund j Signature of AgentJOwn C /l �ignaturoe' of contract Plans Submitted LJ _ Ins Waive Certified Plot Plan ❑ mped Plans ❑ l -'Plans Submitted ❑ 'Plans Waived ❑. ;7.Certified Plot Plan ❑ . Stamped Plans ❑ TYPE_OF SEWERAGE_DISP.OSAL Public Sewer Tanning/MassageBodyArt ❑. . Swimming Pools ❑ Well ❑ Tobacco-Sales Food Packaging/Sales ❑ :._ Private(septic tanit etc._, -P* eimaneftt D rapster 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 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/Si_gnature Date Driveway Permit DPW Tow-i2 Engineer: Signature: -- Located 384 Osgood Street FIRE MPARTME-INI Temp Dumps,ter on'sile yes no Located-at 124 Mair Street Fire Departure►it 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,'niast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: -Yes No MGL.Ch6pterI66.Section 21A-F and G min.$100=$1000..fine NOTES and DATA— (For department use LI Notified for pickup - Date t Doc.Building Permit Revised 2010 Building Department The foli-.awing is'a list of the required.forms to be filled out forAhe appropriate.permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ B,cailding Permit Application ❑ Workers Comp Affidavit La Photo Copy Of H.I.C. And-/0r C.S.L Licenses o Copy of Contract o 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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations If Applicable) o Copy of Contract ❑ Mass check Energy p p 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 cascs if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apwal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application lication Doc: Doc.Bui?ding Permit Revised 2012 Location e<, V)i_J /7 Date f. /i /G{ • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ �— Foundation Permit Fee $ Other Permit Fee $ TOTAL $ f t Check# I L; J '3 Building Inspector C x Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost 0,000.00 m $ - $ 120.00 Plumbing Fee $ 15.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 15.00 Total fees collected $ 250.00 6-8 Johnson Street 143-15 on 8/11/15 Bathroom Remodels on 1st and 2nd floors Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers isor- License: CS-075302 BENJAMIN C OS60OD 69 OLD V][LLAGE LANE NO ANDOVER MA Oli145 - t£ 'r! a` �� S l� ill t'• Expiration Commissioner 12/04/2014 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F3/2/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: M P ROBERTS INS AGCY INC PA//CQ,"o,Ext): (978) 683-8073 FAX o):(978)683-3147 1060 Osgood Street ADDRESS:mike@mprobertsinsurance.com North Andover, MA 01845 INSURER(S) AFFORDING COVERAGE MAIC# INSURER A: INSURED CENTER REALTY TRUST INSURER B: INSURER C: P.O. BOR 876 INSURER D: ZURICH NORTH ANDOVER, MA 01845 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL NSR ,V POUCY NUMBER (MM/DD/YYYY) (MWDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ __JCLAIMS-MADE CI OCCUR MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ POUCY PRO- Ll LOC $ AUTOMOBILE LIABIUTY Ea accident $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ CPROPERTY DAMAGE I )NON-OWNED HIRED AUTOS AUTOS (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION �� /,S X WC STATU- OTH- AND EMPLOYERS'UABIUTY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNERIEXECUTIVE N/A WC00509510612 E.LEACHACCIDENT $ 500,000 D ; r , NORTH - ve.- No. 9_- tii , >�h , ver, Mass, ACoc"Ic"a WICK N, - S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .......&..'I::... �'.`.t.�f�?....7... ..d. .............................................. BUILDING INSPECTOR has permission to erect .......................... buildings on ... fie.. .�!�.- 4�^..�. ..................... Foundation Rough to be occupied as ........................... ... ' ..C.�r.�;�..:. ........................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service .......... ..... .6.Z1(i« .4 ...... '............................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det.