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Home My WebLink AboutBuilding Permit #741 - 98 MARBLEHEAD STREET 5/14/2007Permit NO: eoc— Date Issued: O BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received � t10RTF/� p �t�eo ,a• tiO * o q_ cecwc.e..K 1. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition Xwo or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other DESCRIPTION OF WORK TO BE PREFORMED: - � _ . n // / OWNER: Name: ,e or Print C TF L)-/ P / .oq�3 ARCHITECT/ENGINEER Phone: x 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: $ "7"D d 0ZW FEE: $ Qt7 Check No.: f d- Receipt NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund G Srgtlture df AgentJOwner, .. r ,/'`.r . Srgt�ture ofcontractbr . 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 o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses u Copy Of Contract Li Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) o 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) a Building Permit Application Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) L3 Copy of Contract u Mass check Energy Compliance Report Li 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 2.2007 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 DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS HEALTH COMMENTS ZoningiBoard of Appeals: Variance, Petition No: Planning Board Decision: Conservation Decision: DATE REJECTED ■❑ Comments Comments DATE APPROVED Zoning Decision/receipt submitted yes Water & Sewer Connection/Signature & Date Driveway Permit I nratari at 3Rd nennnri Ctroct Dimension Number of Stories: 3 Total square feet of floor area, based on Exterior dimensions. 3 76 O Total land area, sq. ft.: 13369 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 I ❑ Notified for pickup - Date I ....................... , ......................................................................................................................................................................................................... J Doc.Building Permit Revised 2007 Location t ' !/4� rr � No. Date NORTq s TOWN OF NORTH ANDOVER Certificate of Occupancy $ 'Ss,cusE` Building/Frame Permit Fee $ M Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check # 2024 Building Inspector N 9 FD X22-0 Y - Date .....................2 .. .. TOWN OF NORTH ANDOVER RECEIPT 7 'Z' This certifies that .... .......................................................... haspaid ...... 2 ...................................................... . ........ . ... ........ ...... for... ...... Received by ... ...... . ... ..... 7 Department.......... .................................................. WHITE: Applicant CANARY: Department PINK: Treasurer The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P. O. Bo -.K 1025 State Road, Stow, MA 01775 El PERMIT D a t e: North Andover Permit No City of Town If Applicable) Dig Safe Nurn er In accordance with the provisions of M. G.Ll. 4 8 Chapter_l_()_ as provided in section —922 --EM R 3 4 I--- Slar-t Date This Permit is granted to: Full name of person, Firm or Corporation Permissionto locate dumpster for construction/renovation/demolition of building. Comments: dumpster must be 25' from structure if unable to place with required Restrictions: clearance dumpster must be covered with plywood or tarp end of work day at Or Zee ( Give location by street and no., or describe in such manner as trqyted adequate identification of loication Fee Paid $ 50.00 Fire Chief This Permit will expire //L - G - �-o Signature of offical granting pen -nit) Offical granting permit (Title) --"* TWI.q M=PUIT M 1,qT Pt;= rnmqmri ini iqj V r3r1<,T;:n I IDr1KI TLjr-: C)Dg=mi11zc:c 4� !f7 C^�Y?<, t�..�T2!/tii�[./.6?. rj lJ-,?'ri:✓';, �7C15E BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 069242 Birthdate: 05/13/1964 Expires: 05/13/2008 Tr. no: 21117 Restricted: 00 FRANK R STEWART 115 BLUERIDGE RD c, N ANDOVER, MA 01845 Commissioner ; KTIFICATE OF LIABILITY INSURANCE DATE (MDDrYY.WVy) E 01 r20-1200- rKUL'lA;k:K MacDonaid& Pangione Insurance Agency: !no. 0. eox 4'8 1104 Main Street Andover,THIS CERTIFICATE IS ISSUE A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE SY THE POLICIES BELOW L, j ,oAndover,u. , o�u 1 INSURERS AFFORDING COVERAGE ; NAIC 9 :NSURED Frank Steyvart KU,,Fr 4 PREFERRED MUTIJ4L!NSLIRAN-11- 15 Sluendge Road ks PER F THE HARTFORD G ROUP t No Andover, NIA 01815 fE'- c ONE BEACON NSURANCE COVERAGES THE POLICIES OF INSURANCE LISTED EELOVV HAVE SEEN ISSUEC TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTV41THSTANDING ANY REQUIREMENT, TERM OR "ONDITION OF AN,' CONTRACT OP OTHER DOCUMENT WITH RESPECT TO IVIIHICH THIS CERTIFICATE PA(W BE ISSUED OR MAY PER rA.N. THE INSURANCE AFFORDED B'.'7HE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL r4E TERMS, EXCLUSIONS AND CONDIT:CAS OF SUCH PO' -(CIES. AGGREGATE LIMITS OHOWN MAY HAVE BEEN REDUCED BY PAID CI.4a& A�LaOIAL LIABILI'll.' CPP 01 10 53 4` 7 P V,&REC-ATE TlEPCl;;kL GENEPAL L,AFL--v 1 DO, 000 PER «.DV r—:jP,0C. .90C GENERAL Af;rFE(-. n i -E LL 3,000-0oc A X, r rr C A `y 55 4 z5 y AiJ% p !`LL CVJNE0 AL;Tlz SCHEC L' ---D At -'T -- HIRED Au -0S NO N -OWN 0 GARAGE UABILnY Ny 0 xcI= G --sspjysRrmLLA LABILITY LAIl.l.z WCE -EDJ,176LE PET FNI"') "I 1210122006 12/02;2007 I 1,00c,00C V,&REC-ATE 1 DO, 000 PER «.DV r—:jP,0C. .90C GENERAL Af;rFE(-. n i -E 3 3,000-0oc A rr 0411 'i ? -006 04. /1 1 12 0 07 'ta acjdni' E-- esoln) 1,000.000 $ 1.000, 000 I 200,000 b WCRKERS COMPENSATION AND 08 V!ECRP12:342 EMPLOYERS-LA91LITY 06jC9;2006 or,4ER -------- 0,4, J -b SiRanOvatiO!'* 58-100 Merbiehea,-J St, No Andover. IVA 01945' E.- EACH. ACCIDENT EL D'SEA SE - EA EMPLG'(E=- V,&REC-ATE 20 . QQ D 06/0912007 —MICR TINT fG or,4ER -------- 0,4, J -b SiRanOvatiO!'* 58-100 Merbiehea,-J St, No Andover. IVA 01945' E.- EACH. ACCIDENT EL D'SEA SE - EA EMPLG'(E=- 5 0 0' 0 0 20 . QQ D FICATE HOLDER- CANCELLA7*N SHOULD ANY OF THE AB--, = DESCRBEC POLICIES BE CANCELLED BEFORE THE -=Kp6RATICN Tcwr, Of North Andover j DATE THEREOF, -.-j= 'SSL';'40IN-SUR-rRWILL ENDEAVOR TOMAIL 1C DA',S VIRT—SN Riding Dopa;!meaNCTICE TO CERMFICA—1, �i,','Z�Rqu&=OTO i-HIELEF-1. SUTFt�LURIE 70 DO SO SHALL NOrtr: Andover, MA 0 1 845 IMPOSE No OBLIGATION ORUAB'L;� CF: ANY KP;V UPON -'HE INSUREfi. r7S r GENTS OR i AUTHOMzEo FtEpREsE?lrrATN c ACORD 25 (2001/08) CACORCCORPORATION 1988 Gerald A. Brown Inspector of Buildings Please pmt TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION DATE: .s -1Y -O P7 JOB LOCATION: y ov' ✓410 Number Street Address Telephone (978) 688-9545 Fax (978) 688-9542 q -zs HOMEOWNER �v�a-•�.1 ? 7,' 6 ?7 9'/ 9S 17011- d Y Name Home Phone Work Phone PRESENT MAILING ADDRESS //S City Town State Zip Code The current exemption for "homeowners" was extended to include owner-(ccupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which helshe 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 two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that helshe understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. i HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Fofm Homww=s Exemption 130ARD OF ,1.PPFAI. S 688-9541 CO.NS>•Rv:\TION 684-9530 HEU-111688-9540 PL:L`NING 648-9535 Em O z W tv /E, CO2 y O CL C 0 CD cc CA O Q .Q CO2 C O O C _O d COD ISO H = "r 3 .,o O o L CL 0. C Q 4-0 C O 00 CO Z s CDCL y C LLI N LLI cn W W ce W CA w° cf) o w C w° w°' U —cd w w '� a W cd—cow x c PQ cn O cn CO2 y O CL C 0 CD cc CA O Q .Q CO2 C O O C _O d COD ISO H = "r 3 .,o O o L CL 0. C Q 4-0 C O 00 CO Z s CDCL y C LLI N LLI cn W W ce W CA