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Home My WebLink AboutBuilding Permit #667 - 200 SUTTON STREET 5/10/2006Of NORTH 7ti �9SSAC HUSE� Permit NO: 'G ' Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received: 5 Ito Lo IMPORTANT: Awlicant must complete all items on this page LOCATION CC) <Lj, A4A^ ,, / � „ PROPERTY OWNER �:.,�/i6�.l liPrint x AiAt/.�/ i Print MAP NO.: PARCEL: TYPE AND USE OF BUILDING ZONING DISTRICT: HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition ❑ Alteration ❑ One family 0 Two or more family No. of units: ❑ Industrial ❑ Repair, replacement ❑ Demolition ❑ Assessory Bldg ❑ Commercial ❑ Moving (relocation) 0 Other ❑ Others: ❑ Foundation only (2!) 6 be DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) IL OWNER: Name: A0J" Phone -Jiff'1111121 Ka P "11 CONTRACTOR `� O, 40�wz' Ii� Supervisor's Construction License: Exp. Date: �k O % Home Improvement License: / 301 l 2�! Exp. Date: /r— o5601 -r-- 4- ARCHITECT/ENGINEER ARCHITECT/ENGINEER Name: Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT. $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ rOC� x10.00=FEE:$ Check No.: b O O Receipt No.: Page I of 4 TYPE OF SEWARGE DISPOSAL Art ❑ Swimming Pools ❑ Public Sewer 11 ❑ Tobacco Sales ❑ Tobacco Food Packaging/Sales ❑ Well ❑ 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 guarar y fund Signature of Agent/Owner Signature of Contracto ( 'e ` J Plans Submitted ❑ Plans Waived, ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS q - k HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer connection signature & date DATE REJECTED ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE REJECTED DATE REJECTED ❑ ❑ Comments Comments Temp Dumpster on site yesno_ Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 DATE APPROVED DATE APPROVED DATE APPROVED Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions., NOTES and DATA — (For department use) Page 3 of 4 Doc INSPFCTIONAI. SF.RVICFS DEPARTMENT RPFORM05 Created JMC. Jan1006 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 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 Page 4 of 4 Location goo S.7 -- No. Date S51�04, RTN TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ 4., Building/Frame Permit Fee $ S CHUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # C) 19,185 Building Inspector } Board of Building Regulations and Stand urib HOME IMPROVEMENT CONST Registration ; 132126 Expiration 11/22/2006 Type DBA EDDIE VIEL'S CARPENTRY SERV t MARD VIEL JR . jA i 55A PORTLAND ST.• LAWRENCE, MA 01843`` i - - Administrator e j d - ./IP. l!'07)Yil2�lU/Q.I�LUt- �(7.(J:7:id.I�iLIC(1(.GC4 y ; BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 000505 Birthdate: 09/27/1935 Expires: 09/27/2007 Tr. no: 4055.0 Restricted, 00 ; EDWARD E VIEL 55 PORTLAND ST C LAWRENCE, MA 01843 Commissioner a N m m 4 m m N v m v y � d 'C O CD az CO) C.O C ? O CL= co) aCO -0 CD o p CDCL cr o s Er cc CD C O CO) CD�. 060 CO) CO CD v C05 O CD z O CD C CD O�a O c�oc �+ _ dorm y Oa:nn y � CL Z � W �� CA O d?d O y O m y rr N 1101 �•' m 2 = m O O E n W •O fA m o W O m y r� m Joao co C41 d cr CL ;V c W CL r V) �1 m to .rt m y ? y N .d—► y O O m c: o C.): 0 • O ..w . CD O M O w• JA�o .:� CCA CD 0 oo: W. CL 0 0 o c o CD.: PTI d w w SR w rto tb w c P) d o O � 7d 7d NATIONAL GRANGE MUTUAL INS. CO. EDWARD E VIEL DBA VILLAGE KITCHEN & APPLIANCE Agent: CHAS F HARTSHORNE & SON INC Policy Number: MP I66885 Account Number: CAC I66885 Effective Date: 0 9/ 2 0/ 0 5 Producer Code: 20 0 16 7 CONTRACTORS POLICY DECLARATIONS - LIABILITY SCHEDULE LIABILITY COVERAGES PROVIDED kT Code Premium Advance Premium Classification No. Basis Rate Prems/Op & Product. STATE - MASSACHUSETTS CARPENTRY -INTERIOR 74231 41725 32.227 1345 * PD DEDUCTIBLE = NONE PAYROLL ADDITIONAL INSURED BP0402 MANAGERS OR LESSORS OF 2 # INSD Total Estimated Liability Premium 1345 * LIABILITY PROPERTY DAMAGE DEDUCTIBLE PER CLAIM 64-N188-2 9/00 09/08/05 RENEWAL MC INCL 1 INSURED a aNATIONAL GI'ANGE MUTUAL INSURANCI', COMPANY 55 West Street, Keine, JH 03431 Telephone: 1-888-64 . /36 CONTRACTORS POLICY DECLARATIO Named Insured and Mailing Address EDWARD E VIEL DBA VILLAGE KITCHEN & APPLIANCE 200 SUTTON ST REAR BLDG NORTH ANDOVER, MA 01845 Agent: CHAS F HARTSHORNE & SON INC 781 245 4300 POLICYHOLDER INFORMATION Policy Number: MPI66885 Account Number: CAC I66885 Producer Code: 2 0 016 7 Named Insureds Business: CARPENTRY INTERIOR Entity: INDIVIDUAL a Policy Term: 12 Effective: 09/20/05 (12:01 A.M. Standard Time at the address Expiration: 09/20/06 of the Named Insured stated above) In return for the payment of the premium and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. See the attached schedules for Description of Premises, Property Coverage, Optional Coverages, Forms and Endorsements applying to this policy and Mortgagee Schedule if applicable. BUSINESSOWNERS LIABILITY COVERAGE LIMITS OF INSURANCE Liability & Medical Expenses - each occurrence $ 11000,000 Personal and Advertising Injury Limit $ 11000,000 Products -Completed Operations Aggregate Limit $ 2,000,000 General Aggregate Limit $ 2,000,000 Fire Legal Liability - any one fire or explosion $ 500,000 Medical Expense Limit - per person $ 10,000 Business Liability and Medical Expense: Except for Fire Legal Liability, each paid claim for the above cover- ages reduces the amount of insurance we provide during the applicable annual period. Please refer to section DA. of the Businessowners Liability Coverage Form. For policies subject to premium audit: Annual Audit Applies. Countersigned: 64-5470 (9100) Estimated Annual Premium: $ 1,368 TOTAL PREMIUM AND CHARGES $ 1,368 09/08/05 RENEWAL MC By: