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HomeMy WebLinkAboutBuilding Permit # 1/23/2017 TOWN OF NORTH AND0VE APPLICATION FOR PLAN EXAMINATION Permit NO: _ � Date Received )z-3/�el'7 Date issued:_ IMPORTANT:T: Applicant must complete 01 items on this page L0tATIbNrc Prot PROPEkTY JWNER i�Pnnt �E'Br�C�tdxF'ilCttlfe /eS Wr r ii i t MAP Na_ _ PARCEs p Mac�ri'g rhofilla ' y a . TYPE OF IMPROVEMENT PROPOSED USE RPOne ntial _ Non_ Residential ❑ New Building family ❑Addition ❑ Two or more family ❑ Industrial D Alteration No. of units: ...❑ Commercial Rl�epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other ❑ Septic - ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BEPERFORMED: Identification Please Type or Print Clearly) � OWNER: Name: 'L4 .. c, m. L , OU l< Phone: c ,. 04 Address: f CONTRACTOR Name: NAGv C'. , / Phone. _ L`` Address: tv5, 1 "VI Supervisor's Construction License: o Epp. Date: t I h e)r __ .. Horne Improvement License. E4 xp. _._...".. _._ DateLl�__ ARCHITECT/ENGINEER e) Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ... ' a FEE: Check No.: Receipt No.: NOTE: persons contracting with unregistered contractors do not have access to the guaranty fund . .. 9 g... Sgr�aturp of countractor: S� nafure of A ent/Ovuner. . . „� . �en Plans Submitted F1 PIa s Waived �...� Certified Plat Plan F-1 Stamped Plans ............ ............................ ---------- ............. tAORTH T own N - 1 —4,of - Andover 0 : %6 §- ..- No. ri h ver, Mass, COC 12 *a /9 0/ 0 L0kK12 C 0 Hic"awic" 1W A-rEo PV BOARD OF HEALTH Food/Kitchen IL 19 PERMIT T L U Septic System THIS CERTIFIES THAT BUILDING INSPECTOR .... . ..... .. ............ . .. ........ . ........;................. buildings on ...... Y...... .... Foundation has permission to erect .......................... b ....... Rough to be occupied as ......Rtm.0�.�4......... .................. ...... ................. 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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building.Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUSCSURTS11-A. Rough Service ....... ...... . . ........t:............... Final BUILDING INSPECTOR GAS INSPECTOR Occupang Permit Reguired t® 0ccu, uildi 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. 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Tob Site.A.ddress: aedaxatlm]?ag(vvhtig P A,t4;aclx a copy of�hewaxl?exs' cO.xnpensationpoliey In atiniu tO$i>5g0.gq , ure to sccnaxxo coverap; des, the form of a STCYR WORK 61")M.and a�rto Ofuli iO $250.00 a l ail ©as To unclex aJ 7 52,§25Ais a eximina[violation nrrai�hablc the I��A for ans�taranac ar7d/or'ane yearixnpxison men asyell as civil P be lazararrlcd to the O€doe of In o of his s'tatclnea:t may -� day against the violator.A-cagy aavexage`verification. � �-- � det tCepains ar�f�penaTties ofPerrzrYy1zat floe znforrrratior2 �ovxde�ci above is due ar2J arree. X�t�eby c,Plzf,3' Date: zcrz zssG o>xry. .T)o not-write in tCiis area,to he carnpLeted by city or Lowry of fic Of • :Ckex:Oaxtfp�xeenxse CRY or TaWAZ — s ecton lsst g Axr4lzoxity(circle one): ` actOx 5. lrtrr�b otg 1. Oard:a tealf,'h 2.T3ntildirngX)epantorent 3.C"itYr Own C lexl ;JectxicalXnsp 01/24/2017 15: 54 9786886398 MARC RINALD PAGE 01 )QM 0,jT#4 66m Acis m 17r AT Y,6,e16 h'77j-lo ori ACC?RDTM CERTIFICATE OF LIABILITY INSURANCE ot►23r rRnoILCNL 8784MO.0826 TKIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOANNE K MILLS INSURANCE AGENCY ONLY AND CONFERS NO FUGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOE'S NOT AMEND. EXTEND OR 159 HAVERHILL ST ALTER THE COVERAGE AFFORDED DY THE POLICIES BELpW. METHUEN,MA 01844 INSURERS AFFORDING COVERAGE MAIC i •IOIIIMD .-..............-.. _...,.-..-,...._....�_...::...,._..._... .......IIJbURIrR u....-._........ ._....... .. ..._._._.._.-,...... ., ',. A: QUINCY MUTUAL:GROUP , RINO CONSTRUCTION INrUF19R B: MARC RINALDO/ IN&URER C: 12 KENSINGTON AVENUE 00SUR6ft D: METHUEN,MA Dib" :"WORERE COVERAGES THS POLX:SES OF INSURANCE LISTED BELOW MW BF_FN ISSUED To THE INSURED NAMED ABOVE FOR THC POLICY PERIOD INDICATED N0TvNTHSTAN0iNG ANY REQUIRCMENT,TEAM OR CONENT10N OF ANY CONTRACT ON OTHER DOCuUtNT VOTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY Pf-RTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL1.THE TERAS,EXCLUSIONS AND CONDirrC"OF SUCH POLICIES_A(NEGATE L)WrS SHOVW MAY HAVE BEEN RF-DWED BY PAID CLAUS MINK ra{,"mulM{fM AMM No�kYr Id ICY Lm wv A �4MAgI To iFIc11TE©" X COMMERCW.0ENERALLAABIUTV B02050Q1 Ob07-1B DS47-1?' uREwIsEGlEawxasreleA} s �,OW CLAMS MARL: DrXAM MED raXP IAM oris vwrrttl s :1000 PERSOWLAWIIMJURY i GENERALAGOREGATF, s 1MILLION 6EM'L,MgWEGATE1I101T APPLIES KRPREyOUCT9-OOMP/OPA[3[? .F 1MIt.LIONI Poesy p LOC 3 Mliara�ltLIMMT/Y COMBUIFOWOLELILIITtea mmpdm" { Ann AVTO All,DY**D AUTOS wmy Bk"w { &CWOL&WAUTDS (perplllten} . 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DEDUCTIBLE { _ RETEMION s x Ljoss lascooMIN"TTOM AMD STATU, H mmpL/TTRt'LMrJTY EL EACHACCIDENT { ANY PROPRKTOTIIPARFNEROEXEC nNE,, orw►eE�w leEa ,elvo��, FL MWACE-ExEMR.OVEE, F NSEAGE_mi"UMIT i OTME araCqwTtoaaFgrMATI(MILbaAmOMaIvlltl=MiRxeUMMOMA=XDVY0"MRt3MUTISPW-i^L IWMMgk CERTIFICATE HOLDER CANCELLATION alauLLt ANY OP TILE AMM eEaol»PaUMn IM CANCIM"A►a{ILI THE ma"m41or BATA(TUFTING►,TM 1llfMlllo rMWEIN VILA"MAYTTM TO MUM- DAYS IMIMTTlw JIM LYONS pajT To THe cppMV%U'M HOLD=RAO®TO"M UWr.AUT 0RAM To DLT SO MHALL 4 BRIGHTWOOD AVE rrroae iso OsnTaAnaa an LIArILITY or AMY IM upGn TIIQ INQIIIN:T4 itR Aman oR NO ANDOVER MASS 01945 �rT+aswrTATrII�s �/J �/ AwT n Im+erRLl®rrwTM " i/CJ[1l AGc)RD 2612064lOal11 0 ACORD CORPORATION IM Massachusetts Department of Public Safety �. lc�s.,t�clrr,t�lta Board of Building Regulations and Standards -yna�rcuerc�lusnessReguladon License: CS-043801 ^Office of Cousumer Affairs C B CONConstruction Supervisor s tiONf1=iMPROVEiyIENT TRACTOR Type: i c � ,N istration .,.1D1177 MARC W RINALDO '; - Reg individual -f' Expiration 612512D18 12 KENSINGTON-AU�N 7 METHUEN MA U1844 Marc Rinaldo 12 Kensington Ave —" Expiration: iJnderseeretary Comrpissioner 11/19/2017 MA 41844 Methuen,