HomeMy WebLinkAboutBuilding Permit # 12/9/2015Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL Public Sower ❑
Tanning/Message/Body Art
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Swvnmisg Pools
❑
Well
❑
Tobacco Sales
❑
Food Packaging/Sales
❑
Privato (septic took, etc-
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PormaneutDempster on Site
❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On Il /iP /IS Signature
COMMENTS le r (t'rci, leNct,r 4Y1T•ttud,
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
P
I` RAI C LIP
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/signature & Date
DPW Town Engineer: Signature:
Driveway Permit
Located 384 Osgood Street
FIRE DEPARTMENT Temp Dumpster en site: .yes
LocpI at l24 d , Main Street
Fire Department signature/date
COMMENTS
fiEhmension
Number of Stories: I 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 off
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G erin.$106-$1066 fine
NOTES and DATA — (For department use
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PERMIT
THIS CERTIFIES THAT ,/47"/ 43 a4r f.< 6,p7
has permission to erect buildings gn ......<./<
to be occupied as
provided that the person accepting this pernVt shall in every respect conform to the terms of the application
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.
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCT TO,,N STARTS
BUILDING INSPECTOR
Occupancy Permit Required to Occupy Building
Display in a Conspicuous Place on the Premises — Do Not Remove
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector.
BOARD OF HEALTH
Food/Kitchen
Septic System
BUILDING INSPECTOR
Foundation
Rough
Chimney
Final
PLUMBING INSPECTOR
Rough
Final
ELECTRICAL INSPECTOR
Rough
Service
Final
GAS INSPECTOR
Rough
Final
FIRE DEPARTMENT
Burner
Street No.
Smoke Det.
No.
PERMITTHIS CERTIFIES THAT
Ti
has permission to erect buildings on V
"evie'04""
to be occupied as 4,
provided that the person accepting this per t shall in every respect conform to the terms of the application
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.
VIOLATION of the Zoning or Building Regulations Voids this Permit
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCT STAR -
BUILDING INSPECTOR
Occupancy Permit Required to Occupy Building
Display in a Conspicuous Place on the Premises — Do Not Remove
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector.
BOARD OF HEALTH
Food/Kitchen
Septic System
BUILDING INSPECTOR
Foundation
Rough
Chimney
Final
PLUMBING INSPECTOR
Rough
Final
ELECTRICAL INSPECTOR
Rough
Service
Final
GAS INSPECTOR
Rough
Final
FIRE DEPARTMENT
Burner
Street No.
Smoke get.
Brown, Gerald
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Important Notice to Poii
CONSTRUCTION MATERIALS AND
.The Declarations, Supplemental Declarations Common -er:c,rnz 1 ,..nc-Comm,
:Policy Conditions, Commercial Inland Marne Conditions. A Stock Company
'.Coverage Form(s) And Endorserrent(s), if any. issued to ,Administrative Office: 1400 American Lane
.and forming a part thereof, complete the Commercial Schaumburg, IL 65196
Insurance Policy numbered as follows: '..
THIS IS A COiNSURA'CE CONTRACT
O New Policy SR68586716
❑ Renewal of Please read your policy.
❑ Rewrite of
In return for the payment of the premium, and subject to all terms of this ooticy, we agree with you to provide the
insurance as stated in this policy.
1. Named Insured and Mailing Address: 2. Producer Information:
Andover Federal Credit Union A Nama- DOHERTY INSURANCE AGENCY. INC
190 Lupine Rd PO BOX 1985
Andover, MA 01810 ANDOVER, VA 01810-0034
6 Telephone k= 9]844502613
C Fax # 1 978 435 c3c3
D zunc:'1 Predueer ir£ 11335288
3. Policy Period— From: 1e/16/2C15 To: can 612016 E Field Office Name
12:01 a.m. at your mailing address above_ F Field Office Code
4. Form of B E, Individual ❑ Partnership 5 Corporation ❑ Joint Venture ❑ Other
5. Limits of Insurance (either One -Shot or Reporting Form as indicated below)
E SL.P PLEMENTAL DECLARATIONS I
(If this box is checked, Supplemental Declarations is attached to and forms a part of this policy)
❑ Reporting Form (continuous policy) '. I o One -Shot (non -reporting formisingIe structure policy)
E Annual Rate ❑ Monthly Rate (H81$-4) I❑ 1-4 Family Dwelling J Commercial Structure
Property Location
A) Any one building or structure $ ' 91 .5 Main weal
B) Ali covered property at all locations S Norm Ardover, 8,81845
C) Rate Per Report
D) Premium Per Report New Construction
E) Total Taxes and Surcharges Per Report A Any one building or structure S
(per attached endorsement) ' B) All covered property at all locations $
F) Total Fully Earned Policy Premium Per Report (same as A unless otherwise noted)
Remodeling
D) Renovations and improvements $ 150,000
E) Existing buildings or structures S 75,000
E) Rate $ 0.36
IG`- Premium S 828.00
1 IH) T ta:: Taxes and surcharges S 0.00
(per attached endorsement)
',. I) Total Fully Earned Policy Premium S 828.00
(minimum premium applicable)
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7. Forms Applicable To This Coverage Part:'..
SEE SCHEDULE OF FORMS AND ENDORSEMENTS
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