The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #467-11 - 180 LANCASTER ROAD 5/1/2018 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION C Permit NO: Date Received 7,4 °Rwreo,�Pay(`� SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page ILOCAION I - IPR®CE RTY0pWNER� o`e _� f.SQ►'1 t_" �� U� t i MNAPtrN�O PARCEL; �Z®NING ®ISTtRICTr __ ,iWricl®Istnct dyes; ,no t �_, _aefiine�Sfop Uillage_. . ; TYPE OF IMPROVEMENT PROPOSED USE Res' ntial Non- Residential ❑ New Building e family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other €0 Sep ICt °®Well i+ .I� oodplain } IWetlands i ❑ Watershed District, I t_ J DESCRIPTION OF WORK TO'E PREFORMED: t to Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: t�CONTRACT�OR 1Rhone: Supervisor�sC:onstructionLlcense q 530& r Expo iDate m kHL' omelinprovement1License ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$110000.00 THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ MAI FEE: $ Check No.: Receipt No.. &��— NOTE: Persons contracting with unre tered contractors do not have access to the guar ty fund 1 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swunmmg Pools " ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ 4 ti4E FOLLbWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Sionature COMMENTS R Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes i Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: 'y- =��••4�'�oc��ed °�S•$'4yOs ood Street i = Y DummppFIREDERARTMNsteron x_ ro _ y_ = .Located{at�24pMain Street' r fFiretDepartmentsignatureldate 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 E New Construction (Single and Two Family) 1 ❑ 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 DEPARTMENTMFORM07 Revised 2.2008 � ORTIy T0VM of _. Andover No. 1 _� 4LAKE O dover, Mass., COCKICMEWICK S'A T E D `sS BOARD OF HEALTH Food/Kitchen Septic System PERMIT T U BUILDING INSPECTOR THIS CERTIFIES THAT.........Z.... ... .r!'�1. . .... .. ...... � .................................................................. ... Foundation has permission to erect..... :....................... . buildings on ...�.co.......Lao%&*.w. .. .................. . Rough to be occupied as ��. .. .., ..... � ��. Chimney ........... ................ , provided that the person accepting this per it shall i�Tevery respect con orm�tothe terms of the application on file in Final 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final +36� PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTR TARTS ELECTRICAL INSPECTOR Rough ........... .......... ........................... ........... .................. Service BUILDING R 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. instal to 7815375464 >> ` "'Wal, P 212 of Im4wrkiAc d��a Offte of in W4,4010,I't o Baton, Djj_yz ` AM-ILCag in X11A01davjL, Name �� a !e. B 'Addma° - pi® r� w ama SPO (fUR �e Q�e g �' f 4� af a � CjRaw omkdwm WAd eA ®e� 9, [N� n 694613 •. 0 �e yyPl area s` aa ® bye � OfCampown W MOL I I'E3 2lbjmWq up6Rm®B • RODg�� w� ays®Roampan �M . Mg Mi 9 i'd.E3 Int an ® Pm Z7 I b xab aag A ► &o 10 48 If 6`WO6i5A a mpyP �S Ulm m �� Ee a�dCS ft =tuber*nd-pman gg. G'ap 202 325 . ® . . wan f fides as da P N4 D a�'�e Y . a�vv a eef 8 y be ceded Asa 040e®ef We a eat -7 Jk m_ Don MY 6.other— tons IIl # ZOOIA YVd 90:9I OIOZ/60/80 i Y t OP ID;JT CERTIFICATE OF LIABILITY INSURANCE 11123110 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATPIELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 13Y 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, BMPORTANT. If the cerllticate holder is an ADDITIONAL INSURED,the policy(in)must be endorsed. If SU13ROGATION IS WAIVED,subject to the tuns and conditions of the policy,certain policies may require an endll'rsemenL A statement on this wMilcale does riot Gong rights to She ceirurcaLe holder in Meta of such endomme"04- PRODuceR 759=245-4300 p,, �p +�d�6,®.8,p� 7 NatoEACT Chas-IF.Ht SS.home 769-246-W10 @BONE FAX A1C,Nol: Waftfleod,NA 09 080 ADINM 116-,14AEL A LAURANO ER m O.GERAD-1 - aesuRfm(Sl AFFORDING COVVtWF f�LAIC MURED gado Carta WURERA:NGM Irhsalranrce+Cori9pae91! 94738 S Siroh Larne - INSUREat 8: Topsfield,MA 01963 INSURERC INSIIRple D. IN WR E: ENSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER- THIS IS TO CERTIFY THAM THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT,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 CONDrMNS OF SUCH POLICIES.LIMITS$"OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. l TYPE OFINSURANCE POLICY UMBER b� p�EXPLla M GENERAL LfABR61TY EACH OCCURRENCE $ 1,000,0001 A X commERctAL CaFNBtAL LIABRITY iif PK5183X 19198/10 10!98!17 REN7'E �� PREIAISES S 500,90 CLAIMr- ADE I�"J OCCUR MED EXP pVM $ 99,00 PERSONAL&ADV INJURY S 1,00D, GENERAL AGGREGATE $ 2,090,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRQDL#GTS-CON•YOP AGG 3 2,000.00 POLICY PRO- LOC $ AUTONOOME L901HI'QTY COMBINED SINGLE LIMIT S 300,00 A ANY AUTO 90 1 S 04/24110 04124/19 (EA aY iN tf - BOD1LYfNJURY(Perperaorl) $ ALL OWNED AUTOS BODILYNAM(per ao*kfd) .S X SCHEDULED AUTOS HIRED AUTOS PROPERT r DAMAGE $ (Per ERTY f) NON-OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE_ $ EXCESS LIAO CLAWSMASE AGGREGATE S DEDUCTIBLE $ RETENTION_j_ WORXERS COMPOISARON UVC STATU OT- AND EMPL*YEW LIl1891.nY Y r N ANY PSKIM[TORIPARI NEIVE)MCVIIVE E L.EACH ACCIDENT i CFFICER/MkMBER E)CLUDED> MIA Iwarabtwy an rIII) E.L.DISEASE-EA EMPLOYEE $ R YW OesaiBe un0er - DESCRIPTION OF OPERATIONS below EL DMEASE-POLICY LIMIT i DESCRFFMN OPOPERATIONS I LOCATIONS I VA$iCLES(afa9dl AP.ORD 1D7,ANNPial RettfBfke SC1tIeGttlq U more bpflCg IS . Lowe's Companies,Inc-and arty and aall subsidialres are naaated as additional rer inseds am res eels to GenMI LIabilily fflmd and Non-owned auto endorsed on the general liability policy. Job site: W Winchester NA CERTIFICATE BOLDER CANCELLATION LOWESCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL EE DELJVERED IN LmlNE'S Companies,IrBC= Lg ACCORDANCE NIUTH THE POLICY pROVOH& Richard AUTNora�D ITEI+RESF3fTaTN1E 136 Turnpike Ind Beanie 160 Southborough,MA 01772 MICHAEL A LAURANO 01908-2009 ACORD CORPORATION. All rights resemd. ACORD 26(2009109) The ACORD name and logo are m&tarsd narks of ACORD K:ET ®T-CZ-ZT ane s4wt xP A M a: RIO c o K ?/Okefif?ons --��r 10 Park Plaza a Suite 5170 Boston, Massachusetts 02115 Home Improvement Contractor Registration Re+4i"= 161645 Type= Individual Te# 206441 E=jrafjon: 11 j9?j2012 CERARDO CASERT� �GE.RARDO CASER 5 BIRCH LANE --._ . .. -- ___— ----_----- - TOPSFlELD, OR983 _ ._. .._.. _ r _------- 'iJgnda4e Address and vcReara canr'afl.Mortcreason$01•clsaotle. Address1.1 Re-newa) I....l Eeeaploylnemt 9.os4fiord DPS-CA1 0 50W04D4-G10121s License or regj5ismiiG o a craw sn9•lndevideal use o>aiyr J/ �. �ii9ah� '� 6l �etore the e%pirstion dsto. if foal<eed return to: ®fes F R came a4�assssallesgr A$�-airs and sassiness Regul"'ou HOME IMPR0!lEMEPiT Registravon: 161643 9sldividlsmt fl�p aro fl°I»-SseaBe Sfl7® Boston,MA 02116 Expiratioaa: 11/1212012 iG ARCC}CASERTA GERARDO CASIERTA G��' ��___ 5 BIRCH LANE Piasteo n +�i Deet sugsasEesve TOPSFlEM AOA 01963 Ylnderserre4srY 0 9 a.� Ala; 2. 1006-43a gerardo Caserta (978)$8740993 PA �I %hom-chwselu-lk-Icat-ment ref Public"%arete Eaa.trd of BuNind Re-ulation.and Staodards Construction Supervisor License License: CS 963 Restricted to: 00 GERARDO CASERTA 5 BIRCH LANS TOPSFIELD, RAA 01983 Expiration: 31412012 i ('•.mmarci..n�•a Tr:-': 19%4 o� b^�