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HomeMy WebLinkAboutBuilding Permit #030 - 1801 TURNPIKE STREET 7/24/2006 I TOWN OF NORTH ANDOVER NORTIi APPLICATION FOR PLAN EXAMINATION of t%.%o ,6, • t Permit NO: Date Received —� 4 � OpAo x.«c ewK Pyq. Date Issued: sgc►+us���� IMPORTANT: Applicant must complete all items on this page LOCATION 1 TU(LK) P `LE_ S�ACeT Print PROPERTY OWNER CAPS LTA Print MAP NO.: PARCEL: ZONING DISTRICT: I TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑ One family ❑Addition ❑Two or more family ❑Industrial ❑Alteration No. of units: ❑Repair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED 6 ,4011 1 F . 1"f laLf 0,J ex41;4 w�adow OoosZS i'�C[ ©(�°P W r N� R d- P tip tin e s df W9 l N,IL l P.�r e�✓ S, l 9A/� �a �� x w x �!f ti< Identification Please Type or Print Clearly) OWNER: Name: S u]__�0 W 141 L L iv v(X S/w G k1a M C Phone: Address:_ /'%-b ( V�-►y P(IK- S f N /9 vrj 0yell- CONTRACTOR Name: Cg,102 C(6vy d' CRA�,QwO 1)74S_0t&44l !1-✓C_ Phone:'?? Address: Sj,lesl,A Cl LawfkP w( k I( ?s SS Supervisor's Construction License: S n-] a Exp. Date: Zd` 0 Home Improvement License: lL4 7 OF Exp. Date: -7- I ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. I FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BA-SED ON$125.00 PER S.F. Total Project Cost : (, (�, p © x12.00=FEE:$ Check No.: - Receipt No.: q p l Page I of 4 r i F TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art E]Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well Permanent Dumpster on Site ❑ tank,etc. ❑ - Private(septic a Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner ignature of contractorA ' 1 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ i ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS t DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS I 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/Signature&Date Driveway Permit Temp Dumpster on site yes_nc% Fire Department signature/date i Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension 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 I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. I r 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 Addition Or Decks a ❑ 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 ConstructionSin le and Two Family) � g Y) ❑ 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 Paw.,4 of 4 i Location 40 I No. 0 Date i NURTh TOWN OF NORTH ANDOVER �4�4t`60 .0., f Certificate of Occupancy $ • r '' ' /3 = - s+ E<� Building/Frame Permit Fee $ AC MUS Foundation Permit Fee $ T Other Permit Fee $ — NOTAL $ Check # 3� '� 1 `Building Inspector 'r TApRTH -g Town of ® No. 0,30 L A' 1 o o dover, Mass., . Q lep GOCHICHEWICK y . %ADRATED S E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT....... .���. .......... ....... .. .............! /� .................: Foundation has permission to erect........................................ buildings on ... . ....Q�.........T. R.. ................. Rough to be occupied as.. ito."40&.......�fN � .. .......... .�. ................... Chimney e provided that the person accepting this permit shall in every respect conform to the 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU AR _ Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to ccupy 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. • ��1ze '��iyzzzrr�rzue a�,�laa:scu;�ecrvelta _ 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: Board of Building Regulations and Standards Registration: 147681 One Ashburton Place Rm 1301 Expiration: 7/2g/2007 Boston,Ma.02108 Type: Private Corporation CAPUANO&CAPUANO MASONRY&GENERAL CO INC GAETANO CAPUANO 1 SILESIA CT. _` LAWRENCE, MA 01841 Administrator Not valid without signature ✓fie �anzrizaizr���z/�� n � l�a.�,xretcrae� I BOARD OF BUILDING REGULATIONS d. ,. License: CONSTRUCTION SUPERVISOR Number: CS 074892 ,r Birthdate: 10/30/1960 Expires: 10/30/2006 Tr.no: 15883 Restricted: 00 GAETANO P CAPUANO ONE SILESIA COURT LAWRENCE, MA 01841 C �� Commissioner ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID JYJ DATE(MM/DDIYYYY) CAPUA-2 07/24/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Michaud, Rowe And Ruscak Ins. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 198 Massachusetts Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover MA 01845 Phone: 978 688 8829 Fax:978 557 2130 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Safety Insurance Company 33618 INSURER B: Preferred Mutual Insurance Co. 15024 Capuano & Ca nano Masonry and — General Construction, Inc. INSURER C: 23809 1 Silesia Court INSURER D: Lawrence MA 01841 INSURER E: j COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE 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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDIYY) DATE(MMIDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 B COMMERCIAL GENERAL LIABILITY CPP0120569674 PREMI ;ES(Ea occuence) $ 50000 CLAIMS MADE �� OCCUR MED EXP(Any one person) $ X Business Owners 09/09/05 09/09/06 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2000000 POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ A ANY AUTO 1630672 06/14/06 06/14/07 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ 100000 X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ 300000 X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ 100000 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR El CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIAIU- MITS ER C EMPLOYERS'LIABILITY ***SEE BELOW E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ If yes,describe under — SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Project: Sutton Hill Nursing Home; 1801 Turnpike Street, North Andover MA ***Granite State Workers' Compensation Certificate to be issued directly by Granite State. CERTIFICATE HOLDER CANCELLATION NORTHI3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Town of North Andover NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building Inspector IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 384 Osgood Street North Andover MA 01845 REPRESENTATIVES. AUT E RESENTA E ACORD 25(2001/08) ©ACORD CORPORATION 1 Capuano &Capuano Masonry Corporation Esti:rpate 1 Silesia Court Date Estimate# Lawrence, MA 01841 MA 978-685-2988 4/11/2006 414 NH 603-425-0348 Name/Address Sutton Hill Center 1801 Turnpike Street N.Andover,01845 Attn:Carlos Coreia Fax:978-794-8265 Description Qty Rate Total Put up protective barrier and remove existing window.Remove all 11,600.00 11,600.00 debris and prepare for opening to be cut.Cut out concrete foundation appx 6'long x 1'high x 8"thick.Cut even with floor for new door.Frame door size opening with elliptical window above door to be installed by allied glass.Put trim around door inside and out and repair any drywall if necessary.Prepare sidewalk appx 32'L x 6'W.Take up bushes.Prepare area appx 32'x 6'w.Dig up grass and loam to gravel.Compact.Form sidewalk appx 32'L x 6'W.Lay down dura wire.Pour 4"thick sidewalk appx 32'L x 6 W with 3500psi concrete mix.Surface will broom finish.Strip forms Cut expansion joints with saw. Total $11,600.00 w Signature i �1ie !�omvnumrc�eczl�..o�✓�ysa��uaella Board of Building Reguiations and Standards License or registration valid for.individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:. Board of Building Regulations acid Standards Registration: 147681 One Ashburton Place Rm 1301 Expiration: 7/28f2007 Boston,Ma.02108 . Type: Private Corporation CAPUANO&CAPUANO.MASONRY&GENERAL CO INC GAETANO CAPUANO 1 SILESIA CT. LAWRENCE,MA 01841 Administrator Not valid without.signature v2 iva?4 TIONS " BOARD OF BUILDI G REGULA1SOR TRUCTION`SUPER License CONS i Number GS 074:892 X1013011960 Birthdate Tr.no: 15883 1AI3012046 } tr Restricted _ OA,E'AN %U P "UA-; z *f G ONE'V COUORas41 Cortmt$slone------------------------ r t 1 s i i