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HomeMy WebLinkAboutBuilding Permit #286 - 67 FOSTER STREET 10/6/2009 ORT BUILDING PERMIT'' o�",�o bAti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date Received ��SSACHUS t Date Issued: IMPORTANT:Applicant must complete all items on this page x LOCATION Pant.:: - , �P OPERTY.OIUNE Print MAP NO PARCEL: ZONING,DISTRICT. Historic District . .� � fi yes 7T77 .Machine Shap Village eyes o . Y 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 , Flaodplairi Wetlands Watershed ,strict � Water/Sewer, f : . . DESCRIPTION OF WORK TO BE PREFORMED: pe" a Ide tification Pkase Type or Print Clearly) OWNER: Name: //,- Phone: Address: �,,J w CONTRACTOR rp Nae `: �°'S'` Plione� Address Supervisor's Construction L�cense Z g2o- -Exp, late. C �.ft w4T Horne Improvement license: .Exp Date; 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: $ FEE: $ �- Check No.: f D Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to th g aranty fu 5igrature of Agent/Ovunery_ , = Signature of contractor " i Location a No. �� _ Date NORTPI TOWN OF NORTH ANDOVER IO- y •� • i � Certificate of Occupancy $ sCMUs� Building/Frame Permit Fee $ Foundation Permit Fee $ i Other Permit Fee $ TOTAL $ Check # { 225'1 1 r Building Inspector 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 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`Dumster ori site yes no. y° r Located F re DeepalUaai treety. 4 mentsionAture/date COMMENTS 'I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: j 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 I NOTES and DATA— For department use) i f 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, 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 � NORTiy TONM of And 0 No. c;2.6q� _ Q LAKdover, Mass., T E' COC MIC HE WICK V AORATE D PPS` �C`� �`s BOARD OF HEALTH ERM T T D Food/Kitchen Septic System v` BUILDING INSPECTOR THIS CERTIFIES THAT ........ .. .................................................................. . .................................... Foundation has permission to erect........................................ buildings on ..... p g ��........... ........ ..�..�...................... ....... Rough to be occupied as...... �...: ......................................................................................... Chimney . provided that the person accepting this permit shall in every respect conform to the terms of the application on 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 jdl� PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSN ARTS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to. 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. Massachusetts-Department of Public Safety Board of Building Re.`ulations and Standards ponstruction.Supervisor License License: cS 72173 Restricted to: 00' " CHRISTOPHER F RIVET �{ 207 WINTER ST- N T•N ANDOVER,MA 01845. F Expiration: 6P2F2010 ('ommissioner Tr#: 25403 R� ;l�te (�omvinaitused o� ae�iuQe/�6 Office of Consumer Affairs&Business Regulation. lugHOME IMPROVEMENT CONTRACTOR h: Registration:. ° ,.:,.g39962 Expiration_�9lOWI1 Tr# 700076- Type„ lndroidual 4-k _ CHRISTOPHER F_RIVET CHRISTOPHER,RIVET°'1�=_:_ 207 WINTER ST.: - ,• �------�--- N.ANDOVER,MA 01845: - Undersecretary Bo il,ICA#22,7 7 Workers'Com hwarsawAffidaift A►DDUcwt -Pime Prkt tAib* Name( . �/.S� —`-- Git3►n► Zap a� /�ivi�or/�s .P a ys *. Arerm an em# yee.Cho&Se bo= L❑ Imnaemploywt ft . ' 4. Q I M a gust anm�ac�amdI TRW Gf*���°�j (inIl and/or s have W dtie f]N[aw o PRAIDYM Z IamasWepnoa•aa Fisledaathes 7:fff - *jp amdhave no T se -o Ise L [ Decor - wading firmeas viLy - amdlavewoado'.rs' [No*admW comp.' 3.0 Went-a m medib laommacarRonarawdWns 3.❑ I mn a bmmmawnea doing al wad< a Neve _ 12.Q Plmu�terms ar nWscK tNo warms'amIqLt?ar I1riGI, I2Q$ -1 c. §1(4).adwehaveno • 9�P1�c8mc uoz#lmntabos0oatmcmcwLaua► tbc& Poft7► . t asap o¢rms �j►meaomgaltsa a�8uahiQeo a cabamiRIVA& samums glatdeedrS�boor amstated so �xtsbowm�6sa£�aa�osoda�tasa�t6�oae tyre crapbymm ff8x ,t]�r ptovi�et�eir s' po$tyamt Pots#or sell ice.vac.#:`- �e ©�ZO S'"70 l 09'� sabSite Aa Attack a copy of fhe wins' poNey awn -( dw9 m d date} FaOnie W=me ooven4e,as wquim&=Ww Sec fi=25 A cfMGL m-132 can lead ia&e mapodtim o£cdwimd prof a fine op to SI,SW.00 and/or ame-year impdsomnud,as WOR w cavil penabies in the fomn orf a 9rW WORK ODDER sat a fine of up to$23000 a day a 8tviotalm Be advised a0 a�arfJVM maybef+a v to emOffim of afthe DIA for . I do hoe6j► prrjury:t t5e ! asrd carnert Phow OffWW ause OJ*6 .tet � maq m be ray arl�ii CWarc TUNM- # Imft y(cwde mx L Dowd of EWd& 2 RaWn Deputmek 3. 't�rrmmc� o 4.Ebwb at &p _ - co>na�ron: Pbouey: 6�is i�� o st��c bio PROPOSAL Matt&Pam Rivet 67 Foster Street North Andover, MA 01845 (H) 978-258-2580 October 6, 2009 Install three new windows in garage. TOTAL LABOR AND MATERIALS $ 1,100.00 Submitted By: Chris Rivet MA Lic#CS072173 HIC#139962 207 Winter Street (C) 508-265-3115 (H) 978-794-1165 North Andover,MA 01845 ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby right You are authorized to do the work as specified. Payments will be made s outlined above. Date 0'� Signature Date Signature ACORD,,, CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDD/YYYY) 10/07/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MacDonald & Pangione Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 428 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 104 Main Street North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# INSURED Christopher Rivet INSURERA: PREFERRED MUTUAL INS CO ' 207 Winter St. INSURER B: N Andover, MA 01845 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. INSR ADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD F INSURANCE DATE MM/DD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY CPP 0160 57 01 05 09/26/2009 09/26/2010 EACH OCCURRENCE $ 1,000,000 DAMAGE T(5RENTE X COMMERCIAL GENERAL LIABILITY PREMISES Ea occcurence $ 100,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5 000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 RO X POLICY F1 ECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ _ OCCUR F1 CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC SLIMIT OTH- EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS certificate holder as listed below CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 120 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL No Andover, MA 01845 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) y���/©ACORD CORPORATION 1988