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Home My WebLink AboutBuilding Permit #722 - Stacy Drive 5/6/2007BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 722-. Date Received /Q`4S�ED 16E•N� °� h� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building X One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ® Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic;. ❑ Well ❑ Flodplair"Uetlads C rshecf District at El Water/Sew �_ , DESCRIPTION OF WORK TO BE PKEFUKMtu: Remove c3id ssh;nales and realace L—,Jh +hree fab 05pbcAU shingles Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools • Q Well ❑ Tobacco Sales ❑ Food Packaging/Sales" ` C Private (septic tank, etc. ❑ permanent Dumpster on Site ❑ A '� THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS ❑■ ■❑ ■ DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED 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 Located at 384 Osgood - Sheet - FIRE DEPARTAIIEN"T` --.Tem Dum sten on site m Street p p Yes- � nog ,- Located at 124 Maim Str'�et •, Fire Department signatureldate 41� COMMENTS'` an e � n Fa Dimension Number -of Stories: Total square feet of floor area, based on Exterior dimensions. 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 Doc.Building Permit Revised 2007 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 NOTE: 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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: 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 ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: 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: INSPECTIONAL SERVICES DEPARTMENTMITORM07 Revised 2.2007 Location No. ' . Date 14ORTol TOWN OF NORTH ANDOVER � • LA ` Certificate of Occupancy $ Building/Frame Permit Fee $ 8 s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r '� 20 to Building Inspector • • 1 NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: e v l a e is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: 3 FT Waste Sv5-isms .- PrabodV, MA bli(n (Location of Facility) Fire Department Sign off: Dumpster Permit f Sioiature ofly rmit Applicant Date r - --- M:0i1,H►. PRODUCER The Douglas Insurance Agency Lynnfield Woods Office Park 220 Broadway Suite #301 Lynnfield, MA 01940 - - --- j INSURED --------------._--- Johnston Construction Co., Inc. 2 Reo Road Peabody, MA 01940 DATE (YWOD/Yl') y. 3/19/07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY 1 A Commerce Insurance Co COMPANY------- - --- _ B Zurich -American Insurance Co. COMPANY C �v, rvl I n0 1 ANUINU ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT R THE TOLWHICH ICY PERIOD CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERTHIS MS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - CO------- - - LTR TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POUCY EXPIRATION r DATE (MM/DD/YY) DATE (MM/DD/YY) UMITS GENERAL LIABILITY _ X COMMERCIAL GENERAL LIABILITY CLAIMS MADE !� OCCUR A OWNER'S 8 CONT PROT J N9125 8/20/06 , 8/20/07 AUTOMOBILE UABILTTY ANY AUTO I X ALL OWNED AUTOS A SCHEDULED AUTOS OOMMT16128 j 1/11/06 HIRED AUTOS NON -OWNED AUTOS I I GARAGE UABILITY ANY AUTO EXCESS UABIUTY UMBRELLA'FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATX)N AND EM 1/1/07 GENERAL AGGREGATE --_—_30-0,0-0-0- f _300, 0UQ PRODUCTS-COMP/OP AGG- f -300,000 d ADV INJURY -f X00, 000 EACPERSONAL H OCCURRENCE -----.-$-'300,000 FIRE DAMAGE (Any one fire) f--'--------_.__- f --50,000 j MED EXP (My one Peen) f 5,000 COMBINED SINGLE LIMIT f BODILYINJURY(Per f 100,000 BODILY INJURY (Per accident '300, 000 PROPERTY DAMAGE f 100, 000 AUTO ONLY EA ACCIDENT f OTHER THAN AUTO ONLY EACH ACCIDENT f AGGREGATE f EACH OCCURRENCE f AGGREGATE f PLOYERS UABIUTY STATUTORY LIMITS 6ZZUB-673X905-1-01 9/20/06 ! 9/20/07 EACH ACCIDENT y B THE PROPRIETOR/ - . -1 00, 000 OFFICE RS/EXECUTIVE DISEASE - POLICY LIMIT _ _ _ 500,000 L OFFICERS ARE EXCL - OTHER r ---- _T ,DISEASE - EACH EMPLOYEE yLO� n09 i I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL REMS Construction work at various locations - - - CERTIFICATE HOLD -ER---- Town of North Andover Town Hall North Andover, MA Attn: Building Inspector CANCELLATION - ------ -- - - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BI FAIL E TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABILFfY i OF Y KIND UPON THE .'COAIPA ITS AGENTS OR REPRESENTATIVES. LUTHO IZED F7RFR€ sFNrirnc-.:--------------_� _._....-. -- ACORD 25-S (3/93)1 B7y • M c el -- v q� r a s �. LIQ ur rs�znrnmu�ecz�� .. llrsarzc�uaelks BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 021906 Birthdate: 0913011940 Expires: 09130/2007. Tr. no: 5551.0 Restricted: 00 DAVID E JOHNSTON 2 REO RD PEABODY, MA 01960 Commissioner ✓/e �oa��noauavaltf o�✓P�rx�:saclttaP,tt� - Board of Building Regulations and Standards f = HOME IMPROVEMENT CONTRACTOR ,y Registration: 123124 Expiration: 12/1212008 TO 125437 Type: Private Corporation JOHNSTON CONST CO; INC. DAVID JOHNSTON 2 REO RD PEABODY, MA 01960 Administrator License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ma. 02108 _— Not valid witho signature t LLI z :co o a U w a Co w a W a jaJ m d —cc.. w a W � W w 0U� a w O Z� w W rA 2 cn Ca o cn t LLI z :co ., M-1 4 U O O v .,m O ai • v � Z p. O CO) o c Cm I C C O■� Ca h O O 'E m m = O� •� 3 .o O O Lm Ca Cc o a o- cma Ca r� C3 •v a) Ca ZZ V h O C C•�1_+ •� C c CLCa w ,Cl YI LLI C4 oe w w 19 W H o O ` C N O G v V C G LO O O G O � t Ea ` O O on zE E- =0 G r i0i y0.. CM CD CL.c E o mFA � g c • V G Ca 0 Ww V � rr Co �� mm = o �" •L7 Cm G ops ,gym o m w a C' O -Z O CL C a O y O C m 3 b C O _ m c c- +� o CLC N _ mum, H cc v� d= o '� W go Z O Lu ID CML2 �� =1=3s 5 "go = S L1rm ., M-1 4 U O O v .,m O ai • v � Z p. O CO) o c Cm I C C O■� Ca h O O 'E m m = O� •� 3 .o O O Lm Ca Cc o a o- cma Ca r� C3 •v a) Ca ZZ V h O C C•�1_+ •� C c CLCa w ,Cl YI LLI C4 oe w w 19 W H