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Home My WebLink AboutBuilding Permit #155 - 600 FOSTER STREET 8/1/2012 BUILDING PERMIT o� $O DTH TOWN OF NORTH ANDOVER 3� h`�s' -J'6'` oL APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received 7ppDRATED r4P` c5 �SSACH�15�� Date Issued: IMPORTANT:Applicant must complete all items on this page ••. _� . -•, � ' �, .r-'� -•, a ,.. t y srt'-r/ �+e—e "y`. t est y,•� � } r i .. - , - _ Qt w 1 = t r PROP. IVER� Pring - MAPJNO� PARCEL _ZONING DISTRICT.t � Histonc Distract; r yesr _tno'- } Y _ , _ lage ye's� n Macli :Sh TYPE OF IMPROVEMENT PROPOSED USE Reside Non- Residential Ne uilding One la nil Addition I wo or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well:a 17.1-6- lain Wetlantls 'WatershedjDistrict WaterlSewers 1DES RIPTION IF WOR T9 BF PREFORMED: f -. j u'l - J� S h'I � 02 Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRAC-TORI tName 01. aAdtlressIJC/Z SS �C_ - P�'i07 W-1 G Supervisor!slConstructNicense ,_2d_ Ho metlmprovemeritljicense ,.� ;_ f .,, _ Exp. Date ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ox, moi`/ FEE: $ 61 Check No.:. Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access o th a and 0 Signature of, gent/Owner 'Signature of contract 155 Date..�1 / z' ..... .. MpRTM1TOWN OF NORTH ANDOVER pf t��to ti0 OF PERMIT FOR MECHANICAL INSTALLATION � a i1.11O!il• �y i 9SSACHUSE� y This certifies that . ..!. .4. . . . .Ac a!`! . . . . . . . . . . has permission for mechanical installation . . . in the buildings of .��o / a s fr S�- at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee.��-.�!9. Lic. No70.6.`l. . . . . . . . . . . . . . . . . . . . . . . . . . . . . C 1�#3y� GAS INSPECTOR �� WHITE:Applicant CANARY:Building Dept. PINK:Treasurer Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales 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 HEALTH Reviewed on Signature i 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 eyes ,no Locbted at 124 MainStreet Fire Department signature/date COMMENTS I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. I land area, . ft.:q i ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No i MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) i ® 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 g, 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 �I ❑ 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 MOTE: 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 y 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 i COMMONWEALTH OF MASSACHUSETTS SHEET METAL WORKERS' ASA MASTER-UNRESTRICTED ISSUES THE ABOVE LICENSE TO: i6 MIKE A DELONG3- 4 FOURS:EASONS LANE $ MtRRIMACK NH 03054=2940 jpbq 09/28/12 982988 i' I' A CERTIFICATE OF LIAR DATE(MMIDD/YYW) LIABILITY INSURANCE 8/1/2012 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 policyYes)must be endorsed. If 51,08ROGATION 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), PRODUCER CONTACT L dsa Lee NAME: Yn Y The McBriarty Insurance Agency PHONE (603)672-1133 PO BOX AAC No:(603)673-9$05 638 Elm Street Lyndsay@HPMInsurance.com MilfordINSURERISIAFFORDING COVERAGE NAIC; NH 03055-0009 INSURED INSURERA• n Street America Assurance 9939 INsuREReNC7Ht Insurance Co 47e$ 4 SS easons Lase SheetmLaneetal LLC INSURER C;TraVelers CasualtyInsurance 9046 4 INSURER D: INSURER E Merrimack NH 03054 1INSURER F: COVERAGES CERTIFICATE NUMBER:11-12 Certs 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 KD—DL W-6-19 LTR TYPE OF INSURANCE POLICY NUMBERFOLIC YCFF MMlIY YP LIMITS GENERAL LIABILITY rn('1I00MJPRrN(`r I 1,000,000 X C•UMMtNC•L4LUtNtItALLULLiILIIY PRrMIRrthtortaurrru:r. $ 5DD,000 A CLAIW-MAUI IX QCCUR 4PK7954D O/10/2011 O/10/2012 Mtu tw'IAny one person) S 10,000 PrPfi0N1M A AM IN,A)PY 1,000,000 GtlJtitAL AGGNtGAIt $ 2,000,000 r;tN'L AGUI2tGAl t LAvtl I Al'I'LItJ rth: I'uouur; 6-u)mi vol'AUU 2,000,000 X Poi I(Y 142U- AUTOMOBILE LIABILRY CUMd tU;IN'Lt LIMI I r;t,taa�:r l 300.000 B AN1- 80L)ILY INJUI tY rer person) Al I owNrn X ^,rl IrnUI rn 1K7954DUAMAGt 0/10/2011 0/10/2012 /lITt7.^, /�II -O 8001LY INJUItY(I'ere(a;idem) $ HIIttUAUIUS NUN-C^VtitdtU 1'I.UI'tItIY � " Fur,t:citkxii $ UMBRELLA UAB Mtxlua'I r math $ 5,000 ULAJWXUR rA('IIOCY.11RRrNC.,r 6 EXCESS LIAB C,L,gIM'MAUt At�(:IttC%Alt $ nrn RrTrNTi0N S Q WORKERSCOMPENSATION AND EMPLOYERS'LIABILITYVX I AI U- U I H- X T(SRY I IMIT,";AW PR0FRIr-r0R/PARTNrRjrrR Ul1I(;hIUMtY•4LlUJtLY MbA:U E �t�ITIVr I N/A t.L.tA(;HAQQ1L)tNI $ 100,000 IManOdsoInB-5A893408 /23/2011 /23/2012 It Vas.desCflbN under t.L.UtitA't-totMl'LUYt $ 100,000 under Ut LNII'1 K)N OF 011LUAl IUN;;below r I nlsrA>r P01 U^.Y I IMiT s 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Work performed during the policy period: HVAC. Michael DeLong is excluded from the Workers' Compensation policy. Workers' Compensation applies in NH & MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Taws Of North Andover f ACCORDANCE WITH THE POLICY PROVISIONS. NOrt11 Andover, MA 01845 AUTHORIZED REPRESENTATIVE Lyndsay Lee/LL ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025 pmnn=,)nl The ACORD name and logo are registered marks of ACORD FROM 6036734825 OF mike delong 8/1/2012 11:38 AM Page 1