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HomeMy WebLinkAboutBuilding Permit #849 - 90 CAMPBELL ROAD 6/28/2006Permit NO: J Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received l� + IMPORTANT: Applicant must LOCATION 90 caPA 64/ 611 all items on this Print iA PROPERTY OWNER r vww- I nt MAP NO.: 1D,C ff PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT TYPE OF IMPROVEMENT I PROPOSED USE ❑ New Building VOne family ❑ Addition ❑ Two or more family ❑ Aeration No. of units: epair, replacement ❑ Assessory Bldg ❑ Demolition ❑ Moving (relocation) ❑ Other ❑ Foundation only DESCRIIPPTION tOFA WORK � TO BE PREFORMED ' '� Tr111 n Ir f _ YLC-o/. re e /c c z yl e iN V<;4- Identification ';4 OWNER: N Address: CONTRACTOR Name: Identification Please Type or Print Clearly) CAI YES ❑ Non- Residential ❑ Industrial ❑ Commercial ❑ Others: /V`�t�ev O . F t M 1 ea •- (" 5, -3-- ��)a Address: 6 -Vye-- 'YMcu��e� R� Supervisor's Construction License: 0 -7 1 3 215' Exp. Date: Home Improvement License: �l �f Exp. Date: Ci ARCHITECT/ENGINEER Name: Phone: Address: Reg. No FEE SCHEDULE. BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ %c;CG C--,- x10.00=FEE:$ ;;� 000 Check No.: Page 1 of 4 ,qS Receipt No.: '57' % ,1 Location No. Date TOWN OF NORTH ANDOVER 117 1- Is Aismd& Check # �2-i;-/ 19476 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ TYPE OF SEWARGE DISPOSAL Art ❑ Swimming Pools 11 Public Sewer 11Tanning/Massage/Body Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. El Permanent Permanent Dumpster on Site ❑ Meter location to ATATT _ proj ect erwnN cuntruc4*w,tnun7g.qsterea,cq tractors do not have access to the guaranty fund Signature of Agent/Own Signature of contracto Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plan ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATIO'1q'4 COMMENTS HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: DATE REJECTED ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE APPROVED DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED 11 Comments Conservation Decision: Comments Water & Sewer connection/Signature & Date Drivewav Permit Temp Dumpster on site yes_noFire Department signature/date DATE APPROVED PauP 4 of 4 Building Setback( Front Yard uired 7 Provided Dimension Number of Stories: Total land area, sq. ft.: Side Yard wired Provides Rear Yard aired I Provided I Total square feet of floor area, based on Exterior dimensions. 4 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofin , 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 Pape, 4 of 4 ol P ui z o w° a cn a rM m c w° o cG C U � G w a a' o pG is q w a w W o a: c� is q ii. C7 °�° o rx q w w w o ca 2 �' b cn o cn ui z 0 V v O O 4.J 2 0 O cm i p� H .O 'E m m Z O � O O C OL C3 C. = d. cmQ c c c ev .5.0 m CD c Z � �..� y � C C C c y 0 uj 0 Y/ W W 19 W U) CIS o O N C O V C.i • :1kR A i.a O poi CD Q C= 0v O o. N E in m o p �+ CM E O O O o; CAm O V CO C m �EN O � a cm cm's a �_ O p LO � Z O CO CL. CD C w = m CL. N N O t •H O &= C 0 r @. Z 22 LLA C3 O 0 a cm C ya m O� ` H C) = W 0L 0 V v O O 4.J 2 0 O cm i p� H .O 'E m m Z O � O O C OL C3 C. = d. cmQ c c c ev .5.0 m CD c Z � �..� y � C C C c y 0 uj 0 Y/ W W 19 W U) a iU • I i.a V3, O O �O z Cf) w 0 U ci) 0 V v O O 4.J 2 0 O cm i p� H .O 'E m m Z O � O O C OL C3 C. = d. cmQ c c c ev .5.0 m CD c Z � �..� y � C C C c y 0 uj 0 Y/ W W 19 W U) /ie �°mznroozcue 7 ✓a�uceet�d BOARD OF BUILDIN6 REGULATIONS License: CONSTRUCTION SUPERVISOR { Number: CS 071325 t i ;i� • Birthdate: 05/11/1967 r_ Expires: 05/12i/007 Tr. no: 12908 1 --- > Restricted: 00 CHRISTOPHER TAYLOR t 6 WESTMINSTER RD MERRIMAC, MA 01860 G' •. Commissioner G T. P..\ ✓�G (�'O.7JUl)1071IInl7(l{1 IILJ..(� .. .,.•��_.•.y.; I%.3JIXf.J1 UJ�3l.CO --_= Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 129512 Expiration: 9/15/2007- ' Type: Individual Taylor Construction Christopher Taylor 6 WESTMINISTER RD- MERRIMAC, Ma 01860 Administrator ropoatPage # rf of _� pages 3 IV t E C'1, }a H i90 LI I ( 7 Proposal Submitted To:}}� _ Job Name Job If {{ Address Job Location ff //"j Date f Date of Plans i 1 17 t _rte 1 r q o0,1 l' Phone #F6'# r s Architect ffWebmit specifications and estimates for:t"r.G_a ..._._"� o . r_ n1 ror c_�c,s.... __ ��� �_....._�.��e .._ __+. _..� 3G ___... Ystl.r_.L_� �'r rt � S � ..._ _ .... n f f..2 �k` _U f i ..... G.7 .c -phi ........_� L}} .l.c %i _... ..�. Cl.... i r...........lcl- .. ......t'. �.r . .1/l'.itu..... .._... .... . tti....... as . ; .. 1.. P t fI jV . _rare_ _0 .... ........ c5_ u/ r�r�-s�_._ac�s _ ............. .......... We propose hereby to furnish material and labor — complete in accordance with the above specifications for the sum of: cc $ ile C. C) Dollars with payments to be made as follows: A `' .,4 # Anv alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents, or delays beyond our.control. 23, 3 _ 1 �f_ •� X333 33 A 333 33 Respectfully submitted ' Z - Note — this proposal may be withdrAn by^Gs if nbt accepted within 7< _ days. Acceptance of V t ``J The above prices, specifications and conditions are satisfactory and are Signature '�- hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature 71, 1 s1 I NC3819 MADE IN USA I ACORDr„ CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) F06/20/2006 PRODUCER (978) 462-0833 Byfield Insurance Agency, �' Inc.. 57 Main St. P.O. Box 400 Byfield MA 01922- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Christopher Taylor Taylor & Son Corp. 6 Westminster Rd. Merrimac MA 01860— INSURERA: Penn America INSURER B: INSURER C: INSURER D: INSURER E: r�TilTl3c7rd�� 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 LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) _ LIMITS A GENERAL LIABILITY PAC 6557262 02/21/2006 02/21/2007 EACH OCCURRENCE S 300,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FKOCCUR DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 ^ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 300,000 X POLICY I JECOT F I LOC / I I I NOWND AUTOMOBILE LIABILITY ANY AUTO - COMBINED SINGLE LIMIT (Ea accident) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) S HIREDAUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S AGGREGATE S OCCUR EICLAIMS MADE $ DEDUCTIBLE S S RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS OTR E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT S SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS UMM 1 IYIk A 1 C MULUMM GANUtLLA I IUN - ( SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT Mary Penny FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 10 Campbell Rd. INSURER:ITS AGENTS OR REPRESENTATIVES. , North Andover MA 01845- ACORD 25 (2001/08) © ACORD CORPORATION 19RR INS025 (oioe).o5 ELECTRONIC LASER FORMS, INC. - (800)327-0545 Page 1 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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 to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) q,TM INS025 l01oel.05 Page 2 of 2