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HomeMy WebLinkAboutBuilding Permit #347-2016 - Exception 5/1/2018 JC / A. C,> zP s" BUILDING PERMIT NORT{I q TOWN OF NORTH ANDOVER o� APPLICATION FOR PLAN EXAMINATION Permit No#: l /`��y Date Received �`� " ", �•4 reo SSACHUS� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �7����y C772 /'a,�►� t�g� y 2T71 ,nuL�2 / /�7���j/C C(//'T�x ll(� Print PROPERTY OWNERyUQ(�S S�C/�OUL Print 100 Year Structure yes 0 MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes o 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 s�'Others: ❑ Demolition El Other JC#OOL ❑ Septic ❑Well 0 Floodplain 0 Wetlands ❑ Watershed Districtf ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: ('T l:b5J,.L aw 'L�'7�Y"lba ram WALL 91oCK, 1�vDl)£D r �' �iNNL-� /1-s� !7[ACE. �i�INTiCEI/�?C� C'vNe2£7�7�Z�i� t✓iLL 13E /�0�2� 7UtC�' II it'vaM 14 L ce,t,G 0 7,--M' D /Va2r'1 �ZCT�� Identification- Please Type or Print Clearly _ OWNER: Name: ��avKs SCl�o�L Phone: c17�- 7,57JC� Address: ,Q 6e07 Pg>.� 121I>. NugD4 /4my)g e Contractor Name rq�4b kcizlw j Phone: -373 ---)22_3 Email: Address: 16Q 2tb ,rx QVC' VL-YZP,LL AA C aso Supervisor's Construction License: 1,S -102-z Exp. Date: 47(Az Home Improvement License: Exp. Date: • li 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: $ 72(,bC�• FEE: $ �� Check No.: /UZY Receipt No.: �93c �I NOTE: Persons contracting with renregistered contractors do not have acces e guaranty fun F -- ------ of Aq7eni/b\�&W__ _ �_ i i 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 OTE: 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ,rP Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 2014 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. I 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 it NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL. Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools El Well 11 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 P -ANfdi Reviewed On �=(&ignature_ Jf G n COMMENTS (/ I/11 eeN&E-RAhATiON Reviewed on Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes 'Planning Board Decision: Comments r 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 Located at .124lMain.S6eet Fire Department signature/date COMMENTS Location No. —� ,7�) Date / �7 i r . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ p TOTAL $ Check# � 7 '� � Building Inspector i NORTH Town of 1 EAndover 0 0% No. C� �..49. h ver, Mass, :" s' c NIc"t WICK ,Q coi'. A0RATEO APp��y r S V BOARD OF HEALTH Food/Ki tchen PERMIT T LD Septic System THIS CERTIFIES THATl!t7Q. .�......S�`io° / BUILDING INSPECTOR ........... .................................................................... �i Foundation �I has permission to erect .......................... buildings on m... - . . ^��1.. . ............................ 1 L Rough to be occupied as .... ............ ....��....................r�...... .................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 i Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S ARTS Rough Service .............. ...... . ........................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. Brooks School 4hledc Complae S �e ail T- "74 T (v" f Gor°� comps '(ber Gfass�'in r----------------------------I Nork Completed Bre Cut Remore&Repour Triad t4SSOClies �1C, 100 DOfancS 9 Ara �averhGl� /�(Cb Q1830 Con? ac� pal(a q(-Y-47q-3664 4---------------------------- l � tY � u � II a k I 1 y r 5 � v 1� A 1 I ' ' .I,. tr + �"��r-�C.,• �itlr �r�`Fp�r �XA,•sn. "lam,, ✓'��,. . tire rfyr?'it a.. '� ,�✓�, � . af'a ..• ij fi `',,{Ta7N +J`'� `� ''/,� rltJ'� 0 ! j y v rf � ,!��qy�f � w'i`�•;�.)IL'�!'€�� �€i� ��P e k�� .�Ju} tt?'t �J,�y`F� r ��° 'e r'� ��,I'" � 4""•*T'� /a nr �'''y!t�'°�y,;�*J'� A4,�J'., y � .J,. �r kn�$7t r�! �'�a. � �t� � t n i f trd �T r,•+ N ! , J u rA s�'f f �I t�3 �/ r wrl 4 �y�Ail t(r. C! s:�la 9JJ}'n+ ,,,./t? •Lnrzr ,r ` (y`' � nr � rx" fAr'l� I ��! 'i ,(�J�'� fs�f�I l� tF ¢.' at`e• ;. IX �i� t �. ,_ : ` �-. '�-LI :':y et j 7�l�N t .r Fe yy�yyrr ,/I! �•�.j.� ,9/r dS yds � ��i,��''.$# �dll�f Ol VT 41 r .� �.. rZ.,���y a`f as 1v ire°r' .r t ��'Y(, �rS��ir' �l�•! e�.a, r y IMF �f I ft Y OR qPM I � � �r F YI F''��t�BF'p I• �i'3 ft��, {,S�t"r�,�.g7 � � � y• r,�ll�� r r"W-,,� ,��y1,�1�� ,_, s! Hwy•, i I y .+.J i f e 'j � � �`',t•. r r: �, `� t`f:l t�?t.—r�' a 'Y�i.3�J`t�0"!)^ r`�j Ai`• ! ?t5t ,J .k. ",•LL t 3��'ry¢{ 1� kt f a jl i a,� i � i I C; ! �J r r �f�:G M r.r V4 I•(lttf• ��YY��, P i f 1 1 3 i �„t r 4 Y yY,fy �Y�,�, r:`.Fin ! ' 1 x �a ,�. i rt t o t t f i{ i ) K i t'��fi y•„ � ; i,, t A, j 1ra� �'t• F'�SJ i � r y 1, rh Snr1 Oil 4 , ' x , TRIAD-3 OP ID:SG ACORO• CERTIFICATE OF LIABILITY INSURANCE DATE0911 /2015 `--"� 09/17/2015 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 COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)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 to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Planright Insurance-Salem PHONE James A Santo FAX 224 Main Street Suite 3C A/c No Ext:603-890-6439 ac No;603-890-6521 Salem,NH 03079 E-MAIL James A Santo ADDRESS:jaM!e@santoinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance 31325 INSURED Triad Associates Inc INSURER B:Union Insurance Company 100 Downing Ave Haverhill,MA 01830-2661 INSURER C: INSURER D: INSURER E: INSURER 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/Y`!YYI (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE [?�]OCCUR CPA5076502 03/29/2015 03/29/2016 PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 2,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY a jECT F_X]LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 BIANY AUTO MAA5076507-12 03/29/2015 03/29/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE HIREDAUTOS X AUTOS NON-OWNED $ AUTOS Per accident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,00 A EXCESS LIAR CLAIMS-MADE CUA5093457 03/29/2015 03/29/2016 AGGREGATE $ 1,000,00 DED I X I RETENTION$ 0 $ WORKERS COMPENSATION X PER OT - AND EMPLOYERS'LIABILITY Y/N STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE 6076611-12 03/29/2015 03/29/2016 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? N N/A WCA (Mandatory in NH) 3A: MA NY E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 A Leased/rented equi CPA5076502 03/29/2015 03/29/2016 Leased eq 100,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached N more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards License: CS-102225 DAVID J HABIB ' ' 1 DEBBIE TERRACM o ' j HAVERHILLMA 011V Expiration Commissioner 04/09/2017