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Home My WebLink AboutBuilding Permit #93 - 130 LISA LANE 8/8/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION 0 1"D 06 gtio a m o � Permit NO: 3 Date Received *�D Date Issued: r� SACHU`��y IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER N QPrint Prial MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ne family ❑Addition [I Two or more family ❑ Industrial ❑Vklteration No. of units: \l Repair, replacement ❑'Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) _ ❑ Other ❑ Others: ❑ Foundation only DESC TION OF W K TO BE PREFORMED U 1�r CGr � otf s ra in r pace w Jfh ones }� t Tn r 6f� rid- c So ci-r Identification Please Type or Print Clearly) p OWNER: Name: og Phone:Sd Address: J /� -=- CONTRACTOR Name:W ) `I 1 Norge Phone: Eo� ✓�g � ��'�� ` Address: a 0 0 V U, f( d 5� I On( ,, ni G 0 17) Supervisor's Construction License: Exp. Date: G / Home Improvement License: 1 / S Exp. Date: D l ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING P R T:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED CO T BASED ON$125.00 PER S.F. Total Project Cost :$ ��f'2 �f FEE:$ G• — Check No.: -Receipt No.: Page I of 4 i Building Department I 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 L3 Building Application ldin Permit A lication ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract j ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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 DEPARTMENT:BPFORM05 Pani 4 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ � Tanning/Massage/Body Art E] g Public Sewer ❑ Well F1Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guar my fund Signature of Agent/Owner S'6c co ro C F Signature of contractor � Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ to ped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/S' nature& Date Driveway Permit Temp Dumpster on site ye no_ Fire Department signature/date i t Building Setback( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension J Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA—(For department use) I j f I a �I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 r Location 3 G. i SGS 4/\,/ No. �� Date r r E r' lEl, Ft NORTH TOWN OF NORTH ANDOVER tp O R + ; ; Certificate of Occupancy $ CNusEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ E TOTAL $ Check # i �334 B611ding Inspector ,NORTH TO" Of _ Andover 110. 50 A dover, Mass., CW ja IV OE LIE go COCHICHEWICK �d ADRATED Af �� `S BOARD OF HEALTH PERMIT. T D Food/Kitchen Septic System • BUILDING INSPEC'T'OR THISCERTIFIES THAT............ ....... ......... .... ..... ..... ................................................................................................ Foundation IrAhaspermission toXere ....................................... buildin s on ... , ...... . ...Amis......................... Rough to be occupied as ��.... �. t ...... .... D... Chimney ,� .......... provided that the ' epti g is permit shallin every r pest conform t he arms f the application on file in Final this office, and to the provisions of the Codes and By-Laws lating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERmrr EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI TARTS ELECTRICAL INSPECTOR Rough Service BUILDING INSP 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. o��/G2a�ar��u,�aeC� Board of Building Regul tions and Standards One Ashburton Place-Room 1301 Boston,Massachusetts 02108 Home Improvement Contractor Registration Registration: 147685 Type: Supplement Card Expiration: 8/1/2007 UNITED HOME EXPERTS INC. JONATHAN STEWART -_- 200 BUTTERFIELD DR.STE. I ASHLAND, MA 01721 Update Address and return card.Mark reason for ch Address [] Renewal F] Employment Lo: DPS-CAI n 5OM-04lO6-PC6696 �/e�ommwvuoeald o�./�aaw�/uaella Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 147685 Board of Building Regulations and Standards Expiration: BH/2007 One Ashburton Place Rm 1301 Boston Ma.02108 Type: Supplement Card ' UNITED HOME EXPERTS INC. JONATHAN STEWART 200 BUTTERFIELD DR.STE.I (Lft kAm--- ASHLAND,MA 01721 Administrator Not valid wilhout signature I i i I i I I i 819482 PAGE 2/3 11:56 RPR 14, 2006 Client#:27859 UNITE 041141 CERTIFICATE OF LIABILITY INSURANCE MBDITYY/) ACORD,N oa11aro6 PRODUCER THIS CERTIFICATE IS ISSUED AA S MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Herlihy Insurance Agency,Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 65 Elm Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester,MA 01609 508 756-5159 INSURERS AFFORDING COVERAGE NkIC e VISURED INSURERA Acadia Insurance Company United Painting Company,Inc.and INSURER B:American International Grou United Painting Company,LLC. INSURER C: 200 Butterfield Drive,Unit I INSURER D: Ashland,MA 01721 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICYRATE MEFFECTIV POLICY EXPIRATION WITS LTR A GENERALLIAenm CPA01133BT12 04115106 04115107 EACH OCCURRENCE (1000000 X COMMERCIAL GENERAL LIABILITY PRFMI OALIAGETORENTED $250000 CLAIMS MADE O OCCUR MED EXP IAM Irne Pew) $5.000 PERSONAL L ADV INJURY $1 M 000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-OOMPIOPAGG $2000000 POLICY PRO- LOC A AUTOMOBILE LIABILITY MAA011338812 04115106 04115107 COMBINED SINGLE LIMIT $1,000,000 (Ea xodenl) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Par prem) X HIRED AUTOS BOOLY INJURY $ (Per ecddae) NON-OWNED AUTOS X Drive Other Car PROPERTY DAMAGE $ (Per wciderd) GARAGE UUBILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGO f A EXCESSAIMBRELLALIABLIrY CUA011339112 04115106 04115107 EACH OCCURRENCE $1000000 X OCCUR F�CLAIMS MADE AGGREGATE S1 OOO 000 $ DEDUCT0.. f X RETENTIONO $ I,r,., nRllsms 08115106 X WCSTATIA oTH- .Vu U- SA T krveiLmoen ut:LJU�u'r "' .. UEC deaulee utler SPECULPROVIStONS OeION E.LDISFASE-POLICYLIMR $500"ODI) OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECY4.PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY Of THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION United Painting Company,Inc and DATE THEREOF,THE ISSUING INSURER WIILENOEAVORTOMAIL 10_ DAYS WRITTEN United Painting Company,LLC. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 80 SWILL 200 Butterfield Drive,Unit 1 IMPOSE NO OBLIGATION OR LIABILITY OF ANY RIND UPON THE INSURER RS AGENTS OR Ashaidn,MA 01721 REPRESENTATIVES. AUTN��OO{Rjj-�UREPREBE—IVrp ACORD 25(2001108)1 of 2 026801 t/1�`ERRV ®ACORD CORPORATION 1986