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Home My WebLink AboutFOUNDATION ONLY BUILDING G AT COMPASS POINT I BUILDING PERMIT Of poRT b�ti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * t _ Permit No#: Date Received A-ATIED�PPy�S �SSgcHusEt Date IA= s��d: f IMPORTANT: Applicant must complete all items on this page LOCATION ► PROPERTY OWNER r r Pnnt 10D Year Structure yes MAP �r PARCEL ZONING DISTRICT Historic District yes ,,, . ,.,..: Machine Shop"Village yes 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 �Aeptic,. 1Nell; Q Floodplain a Wetlands,. d Watershed Distr ct UVater/Sewer; DESCRIPTION OF WORK TO BE PERFORMED: '61J C)o-W Identificati - PleasV Type or Print Clearly OWNER: Name: �� V�C� � i'�1�,� ,� Phone: 1 >s Address: .� Gontractor,Name ` fC ,;t`Ytt Phone:' 5 133 Su eruisor's Construction License �° Ex Date ` r� p, p .. Home Impro�eme,nt,License . �� Exp Date ARCHITECT/ENGINEER GLI c) ( c. c- Phone: k7 � Address: tiled �C` C'kO MCA Reg. No. '� �t (� FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ FEE: $ '.0,/?411) Check No.: �1) Receipt No.: NOTE: Persons contracting with unre istered contractors do not have access t tit ranty fund Signature of Agent/Own Signature of contractor Plans Submitted ❑ Plans Waived [I Certified Plot Plan 11 Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art F] Swimming Pools We 1 11 ❑ Tobacco Sales ❑ Food Packaging/Sales 11 Private(septic tank, etc. ❑ Pennanent Dwnpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS CONSERVATION Reviewed on s. Signature LQ IJJ�7,1"" LCCOMMENTS ),- C (4 HEALTH Reviewed on Siqnature 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE,,DEPARTMENT Temp,Pum' psfe'ron site yes p no. Lbcated,atA24 Main,Street" ire'DeDa merit sic na Urb/_ate" ?! COMMENT8, FORTH Town of T E% . ...'.1,. O ver ® h T �O LAKE h ver, Mass, , X41 COCKICNEWICK ��• A°Rg7Eo PP4��,t5 ` S U BOARD OF HEALTH Food/Kitchen ERMIT T LD p / Septic System THIS CERTIFIES THAT ...........,1' . ::::'��..4.. , .... ..'l ........................................ ...................... BUILDING INSPECTOR ... ... ....... ...... has permission to erect .......................... buildings on ... f ' ation .. .... : t... Rough tobe occupied as ..............�.................................................................... ...*................................... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final IT EXPIRESIN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CTI STARTS Rough Service ........ :...... �,nc.s�,rr.-r�cr�... .. :«�r,....I......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired t® Occupy Buildinz Rough Islay in a Conspicuous Place on the Premises — ®o Not Remove Final No Lathing or Dry Wall T® Be ®one FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. a VAU -•„ C l p`, fco c h CIM 12i12 �A xpto U x� ' pop R C �'"� CeyC00,� MP x, 'r d, *5 Board of MAkfing RegWations and Standards License: CS-059359 TIMOTHY M BA> P.O.BOX#12 �e 4 South Grafton MA 01 Commarssk,mer 01/24/2016 y Office of COIISIA(nCl Affairs&Busiess Regaiation eve f OME ��r tarrce�,r��"is gistrIMPROVEMEN CONTRACTOR m� �a xPIration: , 7/29/208 Type: DBA BARLOW BUILDING TIM BARLOW 13 DEPOT ST S.GRAFTON,MA 01580 Undersecretary f PubHc Safety Massachusetts DepartmentBoard of:Bkj0d4ig jaiar�,��and Skanau°ris l ken : CS-089359 TIMOTHY M BA"P.O.BOX#12 ? 'm South Grafton MA 01 t ��♦ ki��_ ,o rae '° Expiration a°a�vaua°ws C�Ca�ro�'.v" 01/24/2016 l I l A ®® CERTIFICATE OF LIABILITY INSURANCE 2/10/15 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(ies) 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 NAME: Coonan Insurance Agency, Inc. PHONE FAX 267 Main Street MAIL 508 987-7122 No): (508) 987-7152 ADDRESS: cindy@coonaninsurance.com Oxford, MA 01540 INSURE S AFFORDINGCOVERAGE NAIC# INSURERA:Travelers INSURED INSURER B TJK, Inc. INSURER C: PO BOX 12 INSURER D: South Grafton, MA 01560 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 Do SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER M/OD/Y MIWDD/YYYY LIMITS A GENERAL ABILITY 680-335M1703-14 11/3/14 11/3/15 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERALLIABIUTY DAMAGE TO RENTED $ 300,000 CLAIMS-MADE Fx-]OOCUR MED EXP(Arty one person) $ cj 000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-OOMP/OPAGG $ 2,000,000 X POLICY SCOT- LOC $ AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT $ ANYAUTO BODILY INJURY(Per person) $ ALLOWN=D SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS eraccident $ UMBRELLA LIAR F OOCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION IE-UB-99141101-3-15 1/26/15 1/26/16 X I WCSTATU- I 0TH- AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETORIPARTNERIEXECUTIVE N/A E.L.EACHACCICEW $ 100,000 OFFI(ERMIEMBER EXCLUDED? N , (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100,000 If YYes describe under DES�RIPTIONOFOPERATIONS Wow E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,ifmore space Isrequred) 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. 120 Main Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Cindy Davis ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: tdbuildinq@aol.com