The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #547-13 - 960 JOHNSON STREET 2/1/2013TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received 1 1 1 Date Issued: IMPORTANT: Applicant must complete all items on this page 'LOCATION 9wt! -fib 1-1NS10A/ PRQPERTrY OWNER MAP'NO,: PARCE i c tc Print _ 1000Year•OId Structure yes no:. ZONING DISTRICT: :Historic i 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 D-�,Septic ❑ Well = D Floodplain. El -Wetlands. ❑ Watershed District 11 Water/Sewer DESCRIPTION OF WORK TO RE PERFORMED: w' ^� Oyv j , S I r2) r✓ & , 1( 1 1 c 11 f r✓ , A6194,011 C xi ! i >r✓G O i;e4C 1711 3C M Er -f STlq/A /I £ Pt -1z * -r- , ~Z '' �1- o-J/L Identification Please Type or Print Clearly) OWNER: Name: + �i� G, 1"M'1t fA_ Phone: 92S -'5-0 yo `; Address: �, Sf�4f --fv/L j it'?,V(/C0 j Ul 9 Z r3 ,CONTRACTOR Name: /i ' L�-*tit- Phone: PZ y9 Address: Si-Y�U /Lig Supervisor-s:Construction License: C 5, 0 7 S— Exp: Date:--- (o Ll —7 _ �t. Home3lmprovement�License: f (v5r3 Exp. Date z 0 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: $ to06 000 °O' FEE: $ 2,g0 Check No.: J�61-TI Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the uara fund Sig_natureof Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ti V 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 PLANNING & DEVELOPMENT COMME CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ Reviewed on Siqnature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Commen Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW 'Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes. no ocate . at:124 Mair?'Street:. .. Fire Ddlia mi en't signatureldaie ' .COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Deter 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 fohowing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits v Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work o 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) o Engineering Affidavits for Engineered products (VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o 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: Doc.Building Permit Revised 2012 Location .&2 11" j I No. 7— Date Check # J X20 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $0 -- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 26131 Building Inspector 0" ,► Enter construction cost for fee cal - North Andover Fee CakulatiOn Construction Cost $ 609000.00 m $ - $ 720.00 Plumbing Fee $ 90.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 90.00 Total fees collected $ 1,000.00 960 Johnson Street 547-13 on 2/1/2013 Replacement Windows, Siding, Kitchen, Repair Existing Deck, Basement Stair Replacement 2nd Floor Laundry �I Z Eq * f ter\ H Q _ LL pZ O m C s Y \ Y_0 O 0 E Y In U Q ,cuLL N ccz W Ln Z Zco m C O 'O O Lj- t w d' T N c U LL O f"u W 0. V) z J C -C to 7 OC LL O W a `^ Z v W W t bn d' N U V) LL w Q �-- LLI N z Ln l7 -C 7 c co LL Z. W Q W p LU 25 LL i m 6 �+ U1 N Y O N Z m CD Z W w a.X LUH LU a. 1� ti ti \I w O O O O GC 0 Z CL OCM N D � I 0 .— CD G :2 " Qi �= a) m m CL �S O �+ v o O0 ca C CL a CL CD Q OM cc v_ J •0- 0 ; = O CL Z N U wCL = w 0 LLI LLI N W W OC .W co o_ CL =� c� o 0 N (LD �.EQIA Z m CD Z W w a.X LUH LU a. 1� ti ti \I w O O O O GC 0 Z CL OCM N D � I 0 .— CD G :2 " Qi �= a) m m CL �S O �+ v o O0 ca C CL a CL CD Q OM cc v_ J •0- 0 ; = O CL Z N U wCL = w 0 LLI LLI N W W OC .W co r 1 AC & CERTIFICATE RTI F I CAT tt DATE(MM/DDffM E OF LIABILITY IIVSURAI C+: 1/31/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTi U � N THE CERTIFICATE HOLDER- THIS CERTIFICATE DOES NOT AFEIRMATIVE�Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE COV GE JJFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TH : SSUIG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(lesj must be endorsed. If ; BRO¢ATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this rt?fica(R does not confer rights to the certlflcate holder in lieu of such endorsemont{sj_ PRODUCER Parente Insurance Agency Inc. �NRE: ~ r 94 Lynn Street NE 978531-8854 ;,FAx978-631 6587Peabod MA a/c Ne'Y. 01960 mi ..e.,e.,..,r.,...._ . ,� _ -- INSURED 9 Stafford Rd. Danvers, ma 01923 rINuRrRc: "•��^�� CERTIFICATE NUMBER: R ION (HUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ONE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DO ENT 1i TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED :I EIN ISiSUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. S IR TYPE OF INSURANCE DR POUCYNpMBER PO/LDIDEFF PSD EXP '! ; UMny W GENERAL LBIIJTY OCCUR ENCE $ COMM ERCIALGENERALLIABILITY P S R NT $ CLAIMS -MADE 0 OCCUR ME I P M prig Der6on $ .1 PE $ NAL&ADVINJURY $ N'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PR CTs - C1bMP/0P AGG $ ( 5 I AUTOMOBILE LIABILrII' ANY AUrO ALL OWNED SCHEDULED AUTOS NO drAINFD HIREDAUTOS AVrpS DO E : NED MI F LE LIMI BO 11 INJURI� (Per pelsavl) S B0 IL' INJUR o(Pereccidem) $ Pe ;SRT IMAGE $ � :? 5 �; CURR NCE E UNIaRELLA UAa OCCUR EXCESS L IAS n. _... .... WORKERS COMPENSATION „ $ AND EMPLOYERS- LIABILITY STAT - TK_ ANY PROPRIETOWPARTWAAEXECUTIVE Y I N LIMI 017RCER/MEMBER EXCWOED7 El N / A E.L., ' N ACCT®ENT $ 1 OO (Mandatory m NN) tlB-4/i%OP03rJ-2 DZ/04/201? OtiO4/Z013 n yes, dezcfte under EL 11 EASE • 4A EMPLOYE $ 600 DESCRIPTION OF OPERATIONS below E.L: �.#EASE-FrOLICY LIMIT 1100 n p:]"I I I tl:? I, DESCRIPTION OF OPERATIONS I LOCATIONS I VP�1oLFS (A -M ACORb 101, Addidonal Remarks Schedule, N more space Is required) , �I CERTIFICATE HOLDER Town of Andover Building Dept. 1600 Osgood St. North Andover,Ma 01945 SHOULD ANY OF THE ABOVE THE EXPIRATION DATE TI ACCORDANCE WITH THE POL ®1988-2010 AC( ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Produeed usury Fomm 6056 Web software, www.Forrnseoss.com: (D Impressive Publlshing 80( To'd oz:ST MT T� uer Z8SST2S8Z6:Xp3 y:. I ' 1 GG 1. D POLICIES BE CANCELLED BEFORE D NOTICE WILL BE DELIVERED IN SIONS,: U, c jl '\ b �43RPOOATION, All rlght5 reserved. 4} r 3DNddASNI 31N3dUd i 7 , Office o m� ec A a�r�ines`a o HOME IMPROVEMENT CONTRACTOR Registration: 0,„165325 Type: Expiration: ,2/1!2014 DBA G fiHIER CONSTRUCTION- 11 RICK GAUTHIER� = 9 STAFFORD RD. \E` DANVERS, `MA 01923; Undersecretary .f ,...1.. ✓ _ assachusetts - Department of Public Safetl Board of Buildings Regulations and Standard! Construction Supervisor License One- and Two- Family Dwellings License: CS 62075 -RICK A GAUTHIER 9 STAFFORD RD DANVERS, MA 01923 Expiration: 6/14/2013 Commissioner Tr#: 17532 G'. i I r