The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #180-13 - 69 HERRICK ROAD 5/1/2018 NORTH BUILDING PERMIT °F�t�Eo b�tio TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * _ _ ea Permit N0: Date Received AC US Date Issued: IMPORTANT:Applicant must complete all items on this page I L0CATION4 Act Pint? PRORERTWOWNER,1�-�' lr` nJ t. Print, 100 Year-:Structure yes-) WAR 2;1 P--ARCEL'DOZONINGQISTRIUT. Historic0istrict yes n ' i Machine.Shop Village yes o' TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building VOne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ),Repair, replacement ❑Assessor Bid g ❑ Others: ❑ Demolition Other ❑:Septicr ❑Well` q,Floodplain Wetlands: ❑ water shed,Disfrict; ? �!1%Vater/,S:ewer ' DESCRIPTION OF WORK TO BE PREFORMED: cm a cJ f! "n 5 �`o�� &/1 cl J Lae!f. Identification Please Type or Print Clearly) OWNER: Name:rA ftA ?/N�'p Phone: Eek , Address: I�C- A l +C:ONTRAC1TQR, Name:; {Qw ��'y�ctsl/ ._ Phone:�"3) 3 Address: /h2 WL7 Dr. i I S°tapervisoris3Construction License:. _ Exp: Date: Hom'eslmprovement;License;. __. . _ .. Exp:. Dater a ARCHITECT/ENGINEER /r�� i'r--,a,17— Phone( �v3J -213 41, Address: qu `�//�7 Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $Alo7Q0. 6,co FEE: $ . Check No.: Raw L)o Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ;'S" iof_Agent/Owner� Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools El Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS I ' 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'bb" pster on. site_, yes. rio ' Lo_cated;atd1241Main�Str_eetl F fde�Deparfinentfsignature/date I 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 2010 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 I ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products NOTE: All dumpster I permits require sign off from Fire Department prior to Issuance of Bldg Permit Addition Or Decks o Building Permit Application ❑ Certified Surveyed Plot Plan o, Workers Comp Affidavit ❑ Photo Co of H.IC Copy . . 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 pp 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) o Copy of Contract r ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products t TOTE: 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:Building Permit Revised 2008 Location �� L P,3. No. —`� Date e • - TOWN OF NORTH ANDOVER � ��,t1`t�t�n in4� • • P Certificate of Occupancy $ Building/Frame Permit Fee $ 7M=-Z�b • x r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ QQ�� Check#��V3�5� �2 Z� 7 f 25676 Building Inspector •' µaeTy {aEt?4�o TOWN OF NORTH ANDOVER d>f'.- OFFICE OF BUILDING DEPARTMENT Osgood Street Buil ding 20,-Suite 2-36 sSa�Has�c� North Andover,Massachusetts 01845 Gerald A.Brown Inspector of Buildings Telephone(978)688-9545 HONMOWNER-LICENSE XEMPTION Fax (978)688-9542 E BULDING PERMIT APPLICATION Please print DATE: g —JZ / 1 ,1L ---------------- JOB LOCATION: 61 f4e Vk�c.� Number . Street Address Map/Lot . ' IIOMEOWNER M es ,G/�"4�•�v .. Name Home Phone • Work Phone PRESENT MAILING ADDRESS Cit;Town S*w+.e' Zip Code The current exemption for thomeowners"was extended to include owner-occupied dwellings to two units-or less a r to allow such homeowners to engage an irdividual.for hire who does not possess a license,provided that the ownerr_1 acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who awns 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 which there Orio*d shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for Applicable codes,by-lawsrules and regulations. compliances with the State Building Code and other , The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building minimum inspection procedures and requirements and that he/she will comply with said Department requirements, procedures sand HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFF Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541R • CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688.9535 Cunningham Lindsey U.S.,Inc. CU�ir11�1 �1a,rrl. P.O.Box 703689 Dallas,TX 75370-3689 LndSey Telephone(888)738-8714 Facsimile(214)488-6766 CLCAT@CL-NA.COM ***********************AUTO**3-DIGIT 018 801 T3 P1 95000058991 Building Commissioner or Inspector of Buildings 120 MAIN STREET North Andover,MA 01845 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS Ch. 139, Sec 3B Claim Number: 3047196 01 Policy Number: 3047196 01 co Company Name: MERRIMACK MUTUAL FIRE INS 0) Cause of Loss: ICE DAM U') Date of Loss: 2/9/2015 0 Insured: James & Karen Robertson Property Location: 69 Herrick Rd Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 313 is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Section 313. No insurer shall pay any claims (1) covering the loss, damage, or destructions to a building or other structure, amounting to the one thousand dollars or more, or (2) covering any loss;;damage or destruction of any amount, which causes the condition of a building or other structure to render section six of chapter one hundred and forty-three applicable, without having at least ten days previouslygiven written notice to the building commissioner or inspector of buildings appointed pursuant to the state building code, to the fire department or arson squad of the city or town and to the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to the payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said proceedings are pending; provided, however,that said proceedings are initiated within thirty days of receipt of such notification. Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or town against any casualty insurance policy or policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect the lien were initiated. No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the provisions of this section. On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. Cunningham Lindsey Catastrophe Department cicat@cl-na.com 800-867-3885