The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #865-12 - 88 HAY MEADOW ROAD 5/1/2018 NORTH BUILDING PERMIT OF neo 'q ,t 6 ti r4b. ._. , •6 oop TOWN OF NORTH ANDOVER F APPLICATION FOR PLAN EXAMINATION w r Permit NO: 0 Date ReceivedAreo �SSgCHUs�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 'S 6' 15; f, Print PROPERTY-OWNER AJ/C'IZ{� �- 'C�f / /�i�✓ ;�Z',� y .Print MAP NO: PARCEL: `ay ZONING•DISTRICT: Historic District yes- no Machine Shop Village yes no 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 Floodplain Wetlands Watershed District Water/Sewer DESCTPTIOM f1F WORK TO BE PREFORMED: Identification Please Type or Print Cle rly) i OWNER: Name: Phone: Address: 'W CONTRACTOR Name: U/�`T C/ A.E- Phone: �C 2 Address: � �5 Imo / «�T b 4/�= C/� Supervisor's Construction License: J?� � Exp. Date: Home Improvement License: _ l Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.,BOLDING PERMIT.,$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:-$ O FEE: $ 4 Check No.: %�� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund _ _ c Signature of Agent/Owner Signature of contractors�� e�� i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools i 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 i I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Si nature COMMENTS TS �S o 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 - Tem p;Dumpster on site yes no Located!af 124'Main Street y Fire Departinent;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, 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 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 o 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 r Location tel",e No. Date L--- • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee -$i--?0-7-- Foundation T?0-7--Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 2� r: 25363 B U'l I d i'n-g-A nspector NORTH Town of over . 0 No. 0 o , �` dover, Mass.,0 LAKE COCMICNEWICK wry. ORATED v BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System 1°r� 0 BUILDING INSPECTOR THIS CERTIFIES THAT.... ..............................Y....ZgS ................................................................................................... Foundation C has permission to erect........................................ buildion .. . .. 1..ec.6.(..o.. W. ................................ Rough r w Chimney to be occupied as ��;,d�c cup s f fFG. .................................................................... y . . . . .. . . . . 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 Zonino or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC STARTS Rough Service ........ .......... ........................ -...... BUILDING�'Il�PECTOR 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. �cywuauvu. �GiVVr Type: DBA Expiration: 5/24/2014 Tr# 223332 QUINN'S CONSTRUCTION THOMAS QUINN 868 MAMMOTH RD. DRACUT, MA 01826 Update Address and return card.Mark reason for change. {� SCA t .^• 20M-05/11 Address 0 Renewal (r] Employment E] Lost Card j ��e. Crasir,nrnxcacrclf�.n/.'Gfla.;�rre�rxse �. Office of Consumer Affairs&Busi►Sess Regulation License or registration valid for individul use only before the expiration date. If found return to: fiil�' kiOME IMPROVEMENT CONTRACTOR P `' ' a istration: Office of Consumer Affairs and Business Regulation is � 9 121604 Type: g ;7, expiration 5/24/2014 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 QUINN'S CONSTRUCTION THOMAS QUINN 868 MAMMOTH RD. DRACUT,MA 01826 Undersecretary Not valid without signature - Massachusetts- Department of Politic Safet% Bo.ird of Buildim, Regulations and Standards Reed to: 00 I Construction Supervisor License 00- Unrestricted License: CS 39732 1G-1 2 Family Homes Restricted to: 00 THOMAS J .QUINN Failure to possess a current edition of the 868 MA MAMMOTH RD Massachusetts State Building Code DRACUT,MAOi82S g is cause fo r rev ocatton of this license. { ��- Expiration: 3/2Sf2012 Refer to: WWW.Mass.Gov/DPS ('nnunissi�ncr Tr#: 18330 QC- OP ID: JP �.--- CERTIFICATE OF LIABILITY INSURANCE13ATE(MMIDDrfYYY} x3112112 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: COVERAGt; AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE 01= INSURANCE DOE'S NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCE;,AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INS1JRED, 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. A statement on this certificate does not confer rights a the Certificate holder in lieu of Such entlorsemeR s. PRODUCER 978-975-1300ONTAGT Se revs&Hall Insur,Assoc.lne NAME: 30north Maim St. 978-975-7596 PHONE FAX Andover,MA 01810 ADEIC Edward Ramirez DRESS: cu MER ID N:THOMA-3 INSURERS AFFORDING COVERAGE I NAICtr! INSURED Thomas Quinn INSURER A:Distel Group dba Quinn's Construction INSURER B:Hartford Ins Co. 868 Mammoth Road Dracut,MA 01826 rNSVRER0: INSURER D: INSURER E: N$URER 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 DE=SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUpH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IMS EFF TYPE OF INSURANCE POLICY NUMBER MlDD MMIDo LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERALLIABIUTY M021000227 01115112 01115/13 PREMI (Eaaceurronce} 8 1QQ,01s CLAIMS-MADE �OCCUR MED EXP(Any One perao-n) S S,QQ — PERSONAL R ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGRECATELIMIT APPLIES PER: PRODVGTS-COMPIOPAGG $ 2,000,00 POLICY PRO- Lac AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Es accld6ni) $ ALL OWNED AUTOS BODILY INJURY(Por peraan) S BODILY INJURY(Per sccidhflS) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accidcn() $ NON.OVANED AUTOS $ E UMBRELLA LIAR OCCUR EACH OCCURRENCE. S EXCESS LIAR CLAIMS-MAD= AGGREGATE $ DEDUCTIBLE 3 RETENTION If $ WORKERS COMPENSATION WC$TATU- OTH= AND EMPLOYERS'LIABILITY �,/N X ATLj B ANY PROPRIETORIPARTNERIEXECUTIVE 4116P704 01/15112 01/15113 OFFICERIME ER XCLUDP 1 N!A E.L.EACH AC I - 1QQ QO M3 E p. C1 C 4ENT $ , (Mandatory In NH) E.L.DISEASE•Eq EMPLOYEE $ 100 QQ Ify o^deecnbo unCer , DE f±- ION OF OPERATIONS below EL.DISEASE•POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATlQNS f VEHICLES(Atutah ACORD 101,Additional Romgrk2$ahodulo,If more apace In mquired) Sale Proprietor Thomas Quinn is Excluded under Workers Comp CERTIFICATIER HOLDER CANCELLATION LOWELLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIE$BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELfVEREO IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTH/OORIIZl D REPRESENTATIVE p 1988-2009 ACORD CORPORATION. All rights reserved. 4CORD 25(2009109) The ACORD name and logo are registered marks of ACORD