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Home My WebLink AboutMiscellaneous - 1100 SALEM STREET 4/30/2018 1100 SALEM STREET 21O/1O6.A-0056-0000.0 N-o 1783 Date..../:.a.d 1.T..... HCRTF� " TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSAc11us� This certifies thatv.. .........1rc�!j ............................................ has permission to perform � .��...,�. ............................................... wiring in the building of. f^�r- .r r.V..p.,. �.................................... at....F �. /�..�,: '� - { 1 ..................North Andover,Mass. Fee... .. .... L,ic. ....... �._, ��.. �1 .. .I ... �.. r.. ELECTRICAL INSPECTOR 07/22/99 13:26 75.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer f Location n o 0 ��/�al 6 � S-Ir' U� � No. -5 Date i ,.ORT1y TOWN OF NORTH ANDOVER ` Certificate of Occupancy $ • i f r0� 4 • _ r �� jµj5<� Building/Frame Permit Fee $ :30 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3 r Check # I 10 9 6317 Building Inspector 1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING <:.. . BUILDING PERMIT NUMBER. f DATE ISSUED. i SIGNATURE: ic Building Commissioner/I t of Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: l `S Map Number Parcel Number I" 1.3 Zoning Information: 1.4 Property Dimensions: C p ZoningDistrict Proposed Use Lot Areas Frontage(ft) J`J 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ _Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Ar Name(Punt) Address for Service: Sig lure Telephone 2.2 Owner of Record: Name Print Address for Service: O Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number t Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name rn Registration Number r Address r z Expiration Date ^ Signature Telephone !1I SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be (?FFICIAL USE'fIhILY Completed by 2ennit applicant K z � 1. Building �� (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC 3 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. -Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS D1IMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE . NORT{l q �r O'tt�eD *6 t6�O Q - Town of North Andover - Building Department c* - •>'' 27 Charles Street � CHUSES�y North Andover MA 01845 Tel: 978-688=9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE V� -r t)3 JOB LOCATION k kc3CN ppb A t5 b Number Street Address Section of Town "HOMEOWNER 1017 g_ �0 u,— `l C\ 'Z$- 3\9 2 Number Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six 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 109.1.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one to six family dwelling,attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes,by-laws, rules and regulations, The undersigned"homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger,will be required to comply with State Building Code Section 127.0 Construction Control. r-NORTH Town of Andover No. ....... .... �� `:� �:� 0) C" �FCOC dover, Mas 001 0 so) - RATE D 10C) H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR vp� NIV W-A THIS CERTIFIES THAT....x P4...... ............................Aa.. ca ........................................................................ . ........... Foundation OD has permission to e ..................... buildings on (.'.e ...... . . . Rough to be occupied as.................!!kg .....ACCP yW. Chimney ................................................. provided that the person accept ng this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws elating to the Insp on, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR is—(, VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough .............. ..................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. Location gd SP�e of No. �� Date NORT1y TOWN OF NORTH ANDOVER ►O?'• • LS Certificate of Occupancy $ �'�s'"'• E<�' Building/Frame Permit Fee $ t9 C14 f Foundation Permit Fee $ Other Permit Fee $ or 0— TOTAL $ U Check # 193 15910 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. / Z DATE ISSUED: 0 / • r SIGNATURE: Building Commissioner/I for of Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 1\�o Spm s� f46.A ooS� �l ^ M Map Number Parcel Number Uvv ' �� `��\S`l� 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distrid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: — / Public 94--' Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System f I / 4 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record ame(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Signature Telephone SECTION 3-CONSTRUCTION SERVICES 1 9 3.1 Licensed Construction Supervisor: Not Applicable ❑ Q�In (Y)e-cz.1� or`�M�CC-�t ort Litems d'Construction Supervisor: O L{j (Y��sG�VP�(1 License Number Address Expiration Date a_ Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name m Registration Number i Address r Expiration Date ^ Signature Telephone G) SECTION 4 WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work chec applicable New Construction ❑ Existing Building Repair(s) Alterations(sl A Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ S,peci Brief Description of Proposed Work: Q-�C�b'� �QQ1-a.CSyC��I"T b SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OF+FIC);AI; SE"01ihy Completed by permit applicant la--Building �� (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUII.DING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. -Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, � as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Prinme 4T 02, Si at ire of weer/A ent Date Aa_ NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIN(MERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE I SEP-27-200'2'(FRI) 11 :38 A&K FOWLER INS. (FAX)973, 664 2209 P. 001/001 . ................................ DATE!MMIDPIYY) A CC )RD M '51- ..."r ........... N WIN— .9 27 02 P A QOU C.F.RTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fowler Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 203 Park Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Rmadirg, mh 01,964 COMPANIES AFFORDING COVERAGE COMPANY A Preferred Mutual insurance Co. COMPANY Jean Morin Construction a Savers Property G Casualty 45 Simone St. COMPANY Methuen, MA 01,844 � C COMPArN D T�i!S IS TC CEF2TIFY ThiAT TWE POLICtF5 pf IN5URAhiCE _IST[t7 BELOW FiA�iE OEEN ISSUED TO THE PNSUREfl NAMED ABOVE FOR THE POLICY RICO THIS CEFr. IFICATE h1AY SE(SSUcD OR FRAY PERTAIN,THE INSURHNCE AFFORDED BY THE PCJLICiES DESCRIEirD HERE{N IS SUBJECT TO ALL THE TERMS, A PoUr EFFECTIVE POLICY EXPIRATION OAT MM4)Prf- LIMIT3 I DATE(MMIDDIYYI .r-NERAL LIAWLIT'Y j_GENERAL AOGAWATE s 2 000 0..0.0 A X COVMEACIAL.F�FIALUABILTY 2/04/02 2704/03O2,000,000. 1ROLCTS-COMPfOPAGr .. I_t :14IM";MADE 'LJOCCUR PERSON A;&ADV INJURY T 000_,000 OWNER'$&CONTRACTOR'S PRar SACH OC;CURRENCE-- I I.00o,Coo FIRE.DAMAGE(Any MED ExP(Any 0110 F AUT*MO61LV LiAosury ANY ALTO COMBINED SINGLE:LIMIT ALL OWNED AUTO3 UCF.EDULCD Autos I (Par p-9n HIRCID AUTO BODILY INJURY NON-OLWIED Avros (Per dCCi(ionll PROPERTY DAMAGE $ AUTO ONI Y-FA �,OENT s GARAGE LIABILITY ANY A.70 OTHER THAN AUTO ONLY, i;C;ACCMCNT $ AGGREGATE CACI-I OCCURRENCE LIMEREUA FORM AGGREGATE. 11 oqicR714AN UNQRF"A FORM WORK911S COMPjjIkJjIA-jIQN AND IEYLkLOYERS!LIABILITY 10�RY LIMITS ...... L "T $ %001000 T"r PROPRICTORI I PAR1NrR&0T-CUTIvE JNcL 12/i4/01 12/14/02 I LIMIT $EXCL Soo 000 OFFICDRSARG'. -.ISS! I... 000 I OTHER EL D!SFASF,:-FA EMPLOYEE s 1001 OPEPA"ICN-'ILOCA7i6m3rvXH'C',EWltl'ECiAL JT9M-; Insurance veri Z,-;.cation fox permit application at 1100 Salem St. North Andover .............. . ..... ...... Trisha legit MOULD ANY OF TME ABOVE DrMCNINED POLICIES OF.CANCELLED Sgroftt THE 1100 Salem St. : POLICIESXPIRATION DATE THEREOF. THE IsaWALL COMPANY LL ENDFAVOR TO MAIL North Arldover, Ma 01845 10 DAYS WfkIr79?J NOTICE TO THE CERTIFICATE Kouxut NAMED to THE LEFT, TILT FAILURk TO MAIL OUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIAaJLrrY Of ANY FIND UPON THE COMPANY, ITS AGENTS OR RIEPRESENrATNIFS. AUTWO1412CO JIVrjI;59NTA1 M IAlan: X Fowler NORTII Town ofE Andover e9� - C'0� +o� ;� dover, Mass., / o ♦ v� ADRATED S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ��fC,: �� BUILDING INSPECTOR THISCERTIFIES THAT...... ......................................... ....................../DO.......................................................................... Foundation has permission to erect...��.:R f... ........ buildings on ....I..................... ......�..f..�.................. Rough to be occupied as 4 oq m0 R a% 00 C'a. Chimney . . . . . .. . . . . .. . . .. . ....................................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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. ♦0 ` p. � �`Q � PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STA S ELECTRICAL INSPECTOR Rough Service BUILDING INSPECTOR Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove R Rounal No Lathing or Dry. Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det.