The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #113 - 232 CANDLESTICK ROAD 8/14/2006 i TOWN OF NORTH ANDOVER X10 R T►•r APPLICATION FOR PLAN EXAMINATION o` ("LSD qy 32 0.. • � oL o p Permit NO: 1 Date Received - ID �a e Date Issued: �' y& �9SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION_ pa /V /I,') d , Print PROPERTY OWNER ��Q$ �9�5 C1j i ,n< Print -J MAP NO.: N&A PARCEL: �J ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building [-,`bne 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 TOB E PR-�FORMED Identification Please Type or Print Clearly) OWNER: Name: ��S Chk�i h� Phone: Address: �G��'Jc�l � Sit c k e? , A 4,1 d- i �1 CONTRACTOR Name: / OcJI^y�3 Ff ►' Phone: Address: 169 MCI � S M e/A Supervisor's Construction License: Exp. Date: Home Improvement License: I cJ Exp. Date: '` -�)06 ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER 51000.00 OF THE TOTAL ESTIMATE COST BASED ON$125.00 PER S.F. Total Project Cost :$ FEE:$ `� Check No.: Receipt No.: Page I of 4 i I i I Location k.12, S L fC- No. t 2 Date 'O NOR71y TOWN OF NORTH ANDOVER O:� r•o •1.�.p O� L A a y Certificate of Occupancy $ CHU <� Building/Frame Permit Fee $ �U i Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r aT 19352 Building Inspector- TYPE OF SEWERAGE DISPOSAL Public Sewer r] Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco 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 guaranty fund Signature of Agent/Owner Signature of contractor W Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped 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 ❑ � COMMENTS Other CONSERVATION DATE REJECTED DATE APPROVED ❑ � 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/ mature& Date I Driveway Permit i Temp Dumpster on site yes o. Fire Department signature/date T40RTH own of 4Andover No. .7. r _ = A E dover, Mass.,-& ' COCHICME WICK y1. A014'ATED P`P�\ '`� `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System a, • BUILDING INSPECTOR THIS CERTIFIES THATM01...... - .................... ..................... ................................................................................................. Foundation has permission to erect........................................ buildings on .a3.1t....cze.^ 4 -fir .G.to .......a .............. Rough to be occupied as...... .Q.................ST ►1. ... / I' ...................... Chimney .............................. provided that the per on accepting this permit hall in every respect c o to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to 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 CONSTRUCTION S Rough ........ ................ ............................ ................... Service BUILDING INSPECTOR 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. 05-26-06 04:39pm From-AIG +973 331 8599 T-6 F- OTO P 002/002 F 070 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NEEME ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Degnan Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 85 Salem St ANTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Lawrence, MA 01843 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED James Oebrecini - 2 Tanager Way Lcn�cnddt�y, k'H 0305a-0000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA'T'ED,NOT WITHSTANDING 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REpUICED BY PAID CLAIMS, Co LTR TYPE OF INSURANCE POLICY NUAI3RR POLICY EFFECTIVE PATE POLICY EXPIRATION DATE q ORKERS COMPENSATION AM EMPLOYERS'UAINLrrY LIMITS E PROPRIETORI ARTNERSIEXECUTNE OFFICERS ARE INCL O EXCL 0 8744233 5/1112006 5111/2007 TATUTORY uMITs OTHER veraga Applies to MA Operallons Only, ACCIDENT $ 100,0 00 (SEAM POLICY LIMIT $ $00,00 EACH EMPLOYEE $ 100,00 DESCRIPTION OF OPERATIONSNEHICLESISPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION JENSEN DEVELOPMENT SHOULD ANY OFTHEABOVE DESCRIBED POLICIES EE CANCELLED BEFORE THE EXPIRATION PATETHEREOF,THB ISSUING COMPANY WILL ENDEAVOR TO MAILJQ 5 PINECREST RD DAYS WRITTEN NOTICE TO THE CERTIFICATE HOUDER NAMED TO THE LEFT,BUT ANDOVER, MA 01810 FAILURE TO MAUL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABILnY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE From:=yeodeo Stephen ..K-iley FadD 201-=31-90°? TC: JE�N;,N I„ IdCE nGCY.INC. Date 1 1/219/C5 Pdl pzGe of= AC0170. CERTIFICATE OF LIABILITY INSURANCE OP ID D DATE(MWDD/YYYY) J&DWEP.4 11/29/05 PROCUCER THIS CERTIFICATE 15 ISSUED ASA MATTER OF INFORMATION F A KELLEY CO INS AGCY OF DIIi. , ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE INC. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 145 rRINGATE ST. , STE 402 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HAVERHILL IMA 01832 Phone; 810-797-6713 Fax:800-370-2924 i INSURERS AFFORDING COVERAGE NAIC# INSUREDFamily s� i r&URE X NAUTILUS INS. Co. ers NSLIRER B: i 168 MAPLE ST. .NSURERC: METHUEN, MA 01844 NSURERD NV JRER E: COVERAGES — THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN!SSUED 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 EF°-GYNE POL.:'i EXP!PATlON ----- LTR INSRO TYPE CF INSURANCE POLICY NUMBER DATE MMlGD I DAT= MMIDD LIMBS GENERAL LIABILITY _AC:-'JCCUF4ENCE $500, 000 ;{ _G'✓'dERC=LGE.'_=t- uT'; NC503333 I 11/26/05 ! 11/26/06x81Ez`ccxa'Ice) $50,000 CLAIMS MACE I 1 :_,CCJP VED EXP(4 one pe,-.on) s 1,000 PERS-\\lk 3,=3V INj-9Y $500,000 GENERALAGGREGA,-- $1,000,000 "L A(, A. PRC-17-J=P�I P=R. I ?ROC.'CTS-:^,MP/CP AGG S 50 0,O 0 O -OLGY I j EC- I LOC I AU')MOBILE LIABILITY I ' •-CME NED S NGLE I-AlIT ANY AUTO I 'Ee accident) s ALS-OWNE-Wi CS — =DULE=AUTOS Der-a—son) I -.IF.E)W'5 - —� 1 - ?ODI_'dart:v ?I,iC.= ♦ ?erzcc:dent: CA'dAGE 'Per_c:inert'. GARAGE'_IABIIJ'Y — l 1UiC:NLY-EA ACC CENT S >N kJTO 071'E=THAN --- XCESS/UMBRELLA LIABILITY = = VCc E DEDUCTMLE .5 i '�� 3 `NOWERSCOMPENSAMON AND j EMPLOYERS'LIABILITY aNYP.ROPRIETCR/PAF'NER/E;'-=GUI`✓= I I E.L.EACH ACCIDENT ; — OFFICERi1dEMBER EXCLUDED' El DISEASE-EA EPAFLOYEE''$ f yes,cescnbe Lnder SPECIAL PROVISIONS below E.L.C;SEASE-POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED SY ENDORSEMENT/ST_CIAI ';,OVISIONS CERTIFICATE HOLDER CAM-ELLATION 4 BOLTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL BOLTON, CL IVE & LAURIE IMPOSE NO OBLIGATION OR LIABILITY OF ANY I IND UPON THE INSURER ITS AGENTS OR 5 SPRUCE CIRCLE REPRESENTATIVES. ANDOVER MA 01810 AUTHORIZIM REPRE hwATIVE I�PiRYANN CQb�U ACORD 25(2001108) ®ACORD CORPORATION 1888 AL FOURNIER Family Roofers & Painters JAMES DEBRECENI 168 MAPLE ST EXTERIOR PAINTING - CARPENTRY - ROOFING METHUEN, MA 01844 FREE ESTIMATES TEL. 683-5127 ,t T4 Yet ki 1 � TOTAL ON ACCEPTANCE i WHEN STARTED Ced i HALF COMPLETE BALANCE jU WHEN COMPLETE j ALL CHECKS TO ALBERT FOURNIER - I! i Board of Building Regulations and Standards or License registration valid for individul use-only , HOME If'RROVEMENT CONTRACTOR before the expiration,date. If found return to: �: Standards � Re istrattonc Board of Building Regulations and S r 9 1 _ _. _. .. 109 98 . m 1301 __... n Place R Ashburton Rxpirafion ��/2006 One AsltUu i _ ,- ;./;, Boston,]Via.02108 :r Type ,-aridividual _ ALBERT FOURMER�z-� Albert Fournier i 168 Maple Street -- Methuen,MA 0.1844 Administrator ` Not valid without signature i I i I i / I I 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 f ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract Proposed Interior Work ❑ Floor Plan Or p � 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 Contractrinkler Plan And ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sp 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 Building Plans (One To Be Returned) to Include Sprinkler Plan An ❑ Two Sets of g Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report the decision from the f et this recorded at the Registry of Deeds. In all cases if a variance or special permit was required thlec nt musown h then rks office ce must stamp Board of Appeals that the appeal period is over. The app application i One copy and proof of recording must be submitted with the building app Doc:INSPECTIONAL SERVICES DEPARTMENT-MFORM05 I - I