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Home My WebLink AboutBuilding Permit #790 - Millpond 6/4/2007TOWN OF NORTH ANDOVER NpRTIt APPLICATION FOR PLAN EXAMINATION 3r0` F y 'A �/ Date Received (�L u 60,6007- Permit NO: .044rm •��4� Date Issued: D cNustt P RTANT: A icant must complete all items on this page LOCATION, `%t- �V`� t - 'As( rl �, ATO(. U c PROPERTY OWNER Print MAP NO.: PARCEL: ZONING DISTRICT: TVVF ANn ITCF. n1Z RiTiT.n1N(_' HTCTORIC nTCTRirT VFS 11 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 0 Addition ❑ Altera ' n ❑ One family Rlwo or more•family No. of units: ❑ Industrial P-It6p-air, replacement ❑ Demolition ❑ Assessory Bldg 0 Commercial ❑ Moving relocation ❑ Other ❑ Others: ❑ Foundation only [631UyLs]N;4IC639.1 Ipdentification Please Type or Print Clearly) // OWNER: Name: `� �`` Phone: : q m Address: j 7` 1>` l � � i A) CONTRACTrrORN(\ame: s4 ,?, 019 &z C_ *6Q�,_1-1b�b Supervisor's Construction License: S Exp. Date: /_ I /_I come Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE. BOLDING PERMIT. • $12.00 PER $1000.00 OF THE TOTAL ESTIMATE COST BASED ON $125.00 PER S.F. Total Project Cost :$ fo, mo, 00 FEE:$C) Check No.: ��40 Receipt No.: Page I of 4 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 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:BPFORMOS Page 4 of 4 TYPE OF SEWERAGE DISPOSAL Art ❑ Swimming Pools ❑ g Public Sewer F1Tanning/Massage/Body Well ❑ Tobacco Sales ❑ Food Packaging/Sales, ❑ Permanent Dumpster on Site ❑ Private (septic tank, etc. Electric Meter location 4o project iNum: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner, Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED Stamped Plans ❑ DATE APPROVED 1-1 DATE REJECTED DATE APPROVED Q U Q DATE REJECTED DATE APPROVED U FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS 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 Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required]—Provides Require Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA — For department use Page 3 of 4 Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC. Jan.2006 m m X m m N m _ CO) a Z CD O CL d dS. CD a� o p Q c CD o CL _p 5.2 CD _ H 10 CD 0 210, H _ 0 CO) C 0 C COD d CD O _ .-o CD c'+D y� CD H O CDD 0 CD ' NCO 2 cr N 0�• CO) c 31m m Z C3 C4 o �-C y O w n O Nft T o?m y O � O • N p O m073 0 n 0 owe V �Y c �O •' 'tt J aGo moa"'"+. i/) omL COL d n .3 O cn a sw", ►a l C A H y ' V IL nN CD CD N `n O CCALN :N �m a c C2) CD. W p Cl w N t:9 L oGa v^ a n ro � C) ro C ro w Location No. �K Date TOWN OF NORTH ANDOVER i Certificate of Occupancy $ • i b ,SSACMUSEt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ l 4 Check # -S-b 20247 ✓`—Building Inspector w 05/29/2007 10:51 9782784008 GREAT NORTH Board of Building Regula ons and Standards One Ashburton Place - Room 1301 Boston. Masmebusetts 02108 Home Innprovemeri C&bxtractor Registration .• _._ r�.y!r, := $ RAFI�alr011pR: 155000 Type: iti Wuel MARK AUDETTE Expiration: 511.�i� m NARK AUDETTE 48 HIGH RD. NEWBURY, MA 01951 DPSCM 8 SdIFOEAG-PCsgaO Hoard "QUIRE Rq*%9t m and Stmftrds HOII� appovEmm CON RAC M 4 I.T. Tf* 25603 MARK AUDeTTE MARK AUDis ETTE • �� `�?'��/ N -MORY, MA 01951 AdnoeMPsE? t , j -- PAGE 02/02 Tr0 255"3 Vlore Addrem and rmrn card. Mark re.oa fat' eaaaae. C Addrm (] Renewal Q Employmot C] Led Caird LJMN or re8istmthM valid for IndAMW w onty bdat+e Um mptrativa datL Ufarad reWn to. Sacra of B�Atmna Aega1aom and madamb one =1111too P1aw Rm 1301 Doaioo, Ma. 62118 not VON wieboat sknatare xwA 13ra3SHI dH WHZIeTt 4002 92 ReN MAY -29-2007 10:41 MCSWEENEYR I CC I 17818373399 P.01/02 aCORQ_ CERTIFICATE OF LIABILITY INSURANCE OPID $ PROWR MASEL- 05129/07 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION McSweeney i cci Ins Ina AND CODERS NO RIGHTS UPON THE CERTIFICATE 2021 ocean Street HOLDER- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Msrehfield MA 02050 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PhOne:781-837-7788 Faz:781-837-3399 "' INSURERS AFFORDINGCOVERAGE RI311RED NAIC 0 1NsuaEAA: National G Mutual ISI 6 S El INSURERa 9afet Insuranco C n ygctric PO Scott ye� INSURER C; `- AbingtOn MA 02351 INSURER D1. THE POLICIES OF INSURANCE OSTEO BELOW HAVE BEEN ISSUED TO THE ANY REOuREINSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWIMTANDING MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WN RESPECT TQ WHICH 03 CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY "AVE BEEN REDUCED BY PAID CLAIMS. LTR' OF BLSVRANCE POLICY NUMBER ODAf1' POLICY OATS GENERAL I ABILITY umm AVAULTOMODUUARk" COMMERCIAL GENERAL LIABILITY FAC"OCCURRENCE s 1, 000, 000 MBS56471 10/27/06 10/27/07 PR ses oceluanee $ 500, OOO CLAIMS MADE a OCCUR MED EXP IMT ene Psraon) $ 10 , , 00 er/Cont Prot. PERSdYAL 00 a ADV INJURY $1,000,000 GENERALAOGREGATE s2,000,006 REOATE LIMN APPLIES PER: Y JPEM .LOC PRODUCTS-COMPIOP AGO s 2 , 000 000 ILE UARk"UTO 3934591 03/06/07 03/06/08 COMBINEDaNGLELAIIr�.�1�nn WNIED AUTOSULEDALTO$ BOL )URY AU7oS f100000 WNEDAUTOS SODILY INJURY 13000 O j _ PGARAQELI&RUM ANY AUTO EIICESSRIMBRELLA UABEITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION s WORKERSCOMPENSATIONAND A EIALorEllrLuOILITy oFF10EWMEMER ELc EO"T^'E WC856471 (Pp soermm) 0 rPROPERTY OAMAGE (p,rwc nt) 1100000 AUTO ONLY -EA ACCIDENT s OTHER THAN EA ACC S AUTO ONLY: AGG i EAC" OCCURRENCE AGGREGATE S s , s TORY LIM1T8 ER _ 01/17/07 01/17/08 E.L.EACHACgDENY 1100000 EL0141EASE-EA EMPLOYE $100000 E.L. DISEASE -POLICY LIMIT 1 $ 1%LTLCTRICAL i1 mzm WITHIN ___. _ ,-..-..�..o, IUMMIT/SPECIALPROVI51 BUILDINGS 2006 tW SAVANA VAN ICDH932VO61132983 SNDOLO ANY OF THE ABOVE OE,CRIBED POL 1CIn RE CANCELLED BEFORE TTM EX =ft TOWN OF NORTIq A DOVER DATE THERROF, THE NRLIRNO INSURER WILL ENDEAVOR To MAIL 10 DAY, WR"gM &LECTRICAL INSPECTOR NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, BUT FAILVRE TO DO SO SHALL $IDOSE IA NO OBLIGATION OR LIABILITY OF ANY PRD IPON THE MlSURER, ITS AGENTS OR NO . ANDOVER MA REPRESENTATAfM TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 1 60160D?— Date 060D?—Date Issued: A , r '(% IMPORTANT- AIipliiahtmust complete all items on this page _ LOCATION'.. lG�`� U AS l PROPERTY OWN MAP NO.: PARCEL: "rung A Nil iTCF AV RiTii.i 1N(_ ZONING DISTRICT: HiSTORir i IRTRiCT YF.S n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition ❑ Altera ' n ❑ One family R/rwo or more'family No. of units: ❑ Industrial P4te'p-air, replacement ❑ Demolition ❑ Assessory Bldg ❑ Commercial ❑ Moving relocation ❑ Other ❑ Others: ❑ Foundation only I I I a L, '[I] -,A -,m Lei .I Identification Please Type or Print Clearly) 1 q OWNER: Name: � � Z, & �� c� Phone: K k b Address: 1 3' 1� l i 1� P i A) CONTRACTOR Name: �i 5 �-E7 �' �� b Phone: Address: Supervisor's Construction License:- L Exp. Date: Nome Improvement License: 61,5 Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE. BOLDING PER IT $12.00 PER $1000.00 OF THE TOTAL ESTIMAT COST BASED ON ai2S.00 PER F. Total Project Cost :$z(.0-00. coo FEE:$ Check No.: Receipt No.: Page I of 4 I Board of,Buildfng jjegujatjons and Standards Comtruction SupeMspi LIC"".0 Llcente".�.CS 85725 J&P1611956 E�C8 ien=�- .4 00 MARK L AUDET I 18 HIGH ROAD NEwSURY. MA & Commissioner RightFax Norcross 11412007 10:13 FACE 003/003 Fax Serve :a::i•Y a ... , .:. .. ... y �.......... _ _ S 9:R is i:; 2.CC:2: -cr • i%:•;£J ::' �isai�� (i�RRilft t• T.};. - ?i:' i {([{moi •jt,.�.�;�ve i pSCERTIFICATE IS ISSUED AS A MATTER OF'.BNF PRODUCER ONLY AND CONFERS NO RIQHTS UnN THE CERTIF14 LYI�fA1t INS AGC' INC BOLDER. THIS CERTIFICATE DOES NOT AMEND EXTENE ALTER THE COVERAGE AFFORDED SYTHE POLICIES BELOW. 299 BALLARD'JALE ST COMPANIES AFFORI}IBNG COVERAGE n1ILN.INGTON -MA 31887 COM'ANY 72 - INSURED A INDYMNITY COM'ANY 9 JGCA, INC. CjO GREAT NORTH PROP MGMT I1IC COMIANY 100 DANIEL WEBSTER HWY, C RASHUA NH 03060 COM -ANY 9 ` P6�SiF I� :iii% ;:�.:; %f:fi:•' -•HE•POLICY PERIOD NAMED ABOVE T -•,••IFY•THATTHE,POLICIES•OF INSURANCE LISTEDBELOVV HAVE�6EEN•ISSUED.TOTHElNS 7HIS >S TO CERT lNDfCATEd, NOTiMITHSTANDING ANY REOUIRER1ENi, TERM OR CONDITION CERT)FICATE PAAY BE ISSUED OR MAY PERTAIN, :THE INSURANCE AFFORDED EXCLUSIONS Affil) CX3A)DITTONS OF SUCH POt1CIES. l Vv)!TS SHOWN A4AY HAVE INSURED OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERNIS, BEEN REDUCED BY PAID CLAIMS. POLICY LT PEO INSURANCE POLICY NUA6BER DAT£ EFFECTIVE POLICY EXPIRATION LIMITS (MWGDMYY) DATE(WMDtYY) GENERAL LIABILITY GENERAL AGGREGATE $ COdMERG AL GEVER41. UABf_ITY CLAIM-- MADE Q OCCLR. OWNER'S & CONTRACTORS PROT. • PRODUCTS-COMP/OP AGO. S PERSONAL S ADV. INJURY $ EACHCCCURREW E $ RAE DAMAGE (Any one The) g MED. EXPENSE ;Any one person) g A iOMOMLELIAGIUTY COyE1NaISIF� LE $ LIMIT ANY AUTC BODILYINJJRY $ (Per Perscn) ALLOWNEDAUTOS SCHEDULEDAUTOS HIRED AUTOS NON -OWNED AJTOB BODILY INJJRY (Per Ac:idenq PROPERTY DAMAGE S GARAGEUABILTTY AUTO ONLY - EA ACCIDENT 8 OTHER THAN AUTO OHLY. `}" _'s xw„z;rj z; ., •_i ANY AUTG EACH ACCIDENT g AGGR_WE $ 1 EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ _ (pAffia-IFORAt A OTHER —u -AN JUBRELLA FORM 1VDRkER'S COMPENSATION AND ERiPLOWJABlLRY (UB -0354360-4-07) 01-01-07 01-01-08 STAMCPY LMr'S EACHACCfOENT DISEASE—POU” Y LIMITS L ern TFE PROPRIETOR! INCL PARTNERSIEX 0ZI'VE OFFICERS ARE. EXCL DISEASE—EACH EMPLO EE S ER THISIp� •PLAC•ES AVY MILLPOND HOD?EOWER3 ASSOCIATiOT 123 MILLPOND Id ANDOVER DNSN LESPRESTRICM S! PE ITEMS IOR CERT--FICATE ISSUED TO TFE CERTIFICATE HOLDER AFF:-;CTING t+)ORKERS. COME' COVERAGE. .6 'U , •�'sri i ......:.:......•.......v -:.....:.-.v v;: -..::•�. r.,... i::.�..-.:- ......vq-. :' .v :... r •' ...:.n ..r...nv.v: .. . r.•.v r . . 2 : ...... .. ivV .<. ...:.. n... — "_.:: /}.tv. ....`J-,Vv':1 "xl•r r .... '✓.-y"v,. ,. .:.:. e. ...... .,.w ... ....... ... ..:...:. .V vr.i i.., m.... .i :'v-: ii" v':w-. :::r �'r:ii... .. '•i. :.+ �. v - SHOULDANYOF THEABOVEDESCRIBED" POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY %MILL ENDEAVOR TO MAIL .0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BLIT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AIA 01845 AUTHORIZED REPRESENTATIVE 4".0-. rw%�Lti +wv/. T..JA1•-.. v --.. u:E^n-Ki:i :S"s' ',y'i:::ww X:. MAO C'0RA y,y�... ..x.#wS -�i�.:_. r ::•;,`:n:: vGCc>cA' '�??2:•'rxeC