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Home My WebLink AboutBuilding Permit #236 - 38 SAUNDERS STREET 9/26/2006 TOWN OF NORTH ANDOVER N0RTF1 APPLICATION FOR PLAN EXAMINATION 0 tui° 6g+ Q. �6 0 4' Permit NO: Date Received Date Issued: ' ® SACMIIS��9 IMPORTANT: Applicant must complete all items on this page LOCATION S,4,4 v,v 01-e Print PROPERTY OWNER�i� � G 2- Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building 4KOne family ❑ Addition ❑Two or more family 11 Industrial ❑ Alteration No. of units: O'Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PVFORMED �o� c� c �i�,•cam Identification Please Type or Print Clearly) OWNER: Name: °°y / �° /�' Phone: Address: -� x C'Qu^�� _ � • / �� e Z- �� -P_l! Phone: 9l i c— CONTRACTOR Name: ✓� Address: � ./I i� �h i/��Q /A r`j e,4� Supervisor's Construction License: Exp. Date: Home Improvement License: 12/15--3 Exp. Date: 9 �� ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ G _ ✓ FEE:$ 1 Check No.: Receipt No.: 1�1G� Page I of 4 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art E] Swimming Pools 11❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractor do not have access to the guaranty fun Signature of Agent/Own Signature of contract 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 ❑ ❑ COMMENTS �� T `� S�.it/t �/ �' �o;A DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ i COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS ZoningBoard of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature& Date Drivewav Permit 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 Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan2006 N_ 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 � �' 'r r, No. 9-3('e, Date NORTF� TOWN OF NORTH ANDOVER O a s • , . Certificate of Occupancy $ ~ E<� Building/Frame Permit Fee $ 4CMU5 Foundation Permit Fee $ >r Other Permit Fee $ TOTAL $ Check # 19523 Building Inspector V40RTH � Town of RAndover .v , .......... C% Irdover, Mass., LA /fesCOCMIC HE WICK ADRATED pP�\ "♦y S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT..........f .#.L............T ... ...too r..................................................................................... BUILDING INSPECTOR Foundation has permission to erect.... ................................... buildi s on ...�. ......... .�a��►CI..4 .r'........�.. Rough to be occupied as......... r1. '� Chimney provided that the perso accept n this permit shall in eve spect 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 3014000 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTR1\54041MBUILDIN-G- TS Rough ...�CIZT .......... .. Service � TOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal j 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. VDAC InTF°RD WORKERS COMPENSATION O S O MPEN ATI S O AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6S6OUB-5102C15-7-06) NEW-06 INSURER: HARTFORD UNDERWRITERS INSURANCE COMPANY NCCI CO CODE: 80411 1. INSURED: PRODUCER: 3ML CONSTRUCTION CO INC CHARLES J COUGHLIN INS 2 NIGHTINGALE CT 14 DINLEY ST LAWRENCE MA 01841 PO BOX 10 DRACUT MA 01826 Insured is A CORPORATION Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 05-06-06 to 05-06-07 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in Rem 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A r D. This policy includes these endorsements and schedules: r� SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE o� 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating a Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 05-30-06 DB ST ASSIGN: MA OFFICE: ORLANDO DA HTFD 05G PRODUCER: CHARLES J COUGHLIN INS 73KCY ---- `$ � {i�FIIliiGiJ Big➢!A INA Q r rg%Err neva v+,.w.-...- c�t Y C e M aE�rnFic� 199 N"Oulau"tts Nam ,nes Ma 01845-4190 Phone.-979. 688.9929 Iran:97 9-97S-9989 I 1i19WRERB AFFORDING COVERAGE NAIC� MUM A: O affin d l MML nova ft Ur, 15024 as sr ti on Co fts ova vasm a CA7118M8�►�t°S THE FOLK=QF NOMM IOMBNAMHMMMGWWTOW OMMi AWA FWtTMPCiltr'YPFFRJ06iVCACATW. AMYF=MtMMWrTMQRCCNWMQFAWCOWPtACTOR YaMAEP'TQVACHIMMMWATLIU%YBEWJWQR MW PF.fC rAIK 7M�AFFOM SY THE R�REi W Si�BJM TOALL'PG T EW. t 11W1 i�QF87CnM QF VLW PQiX�8. ATB ut,E'!'4MRY HA1fl8� B4'Piga. Emit WAVY tBpif�t umm a ntt u+ s O $1000800 $ « pAl 0Tal 10I20/Os 14t0t0$ _ $50000 ._ aAMr 11000000 480MLMORSUM $2000000 MftA=fWATEUWTAPFMPM, ! PMDJM. AW $2000000 awe ,r .�....., spar AWAM ( 4 ALl.C1EfYNWAUMS s HW AIRM ; cam+�.wavrae s EFOAVAWs trMb '4 j AMOKY-SkACCUW ! AWAufp ; FA A= S ON SqM � f Q=vLVp= s � � a famam s Mmmww"""m AM mcaym UAItmrAWFFMPW ec EMN Air s -- CFFAXRWANM eiaau� - EL CWRA0E-12ASWPLOVki AGopabof JtsWNW el.o{Brnag-Pomumf : 0�1 aa�QIP�tA7fWIB1:�Cx JYd�i iS Atx�o BY B�fiBf 15REpRt.F�Vti101fB ""` cs�,�txx~ c t �L�.ATtt3P� ZMD=3 AMYa�THeA a"t�at °"eat 'tHSemuTtoi DAYS""SN"SN �uoATs�,c� cossaH I i =� Board of Building Regulations and Standards C :S HOME IMPROVEMENT CONTRACTOR (•' , f ! Registration: 134830 r., Expiration: 1/29/2008 i Type: Individual MICHAEL J.LAROCHELLE �e MICHAEL Lp,ROCHELL 9 2 NIGHTINGALE CT. G G--• ' LAWRENCE,MA 01841 Administrator Page of s Q O COMS 'RUCTIGM, Imc. Mike Fax 978-975-9874 978-258-1131 PROPOSAL SUBMITTED TO PHONOATE�J STREET JOB NAME . -�,� �.�L��/�l✓;Z-� S/ �� C S�✓,�� `-� =�� 1, �� CITY,STATE and ZIP CODE v JoC 47,vC�l,,.—e �' e��ATIorGt:� /' ARCHITECT DATE OF PLANS t rQ JOB PHONE We hereby submit estimates for: /f rc 4�s Iv L.r� 1iA W@ P"PI ! hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: dollars($em—) Payment to be made as follows: All material Is guaranteed to be as spectfled.All work to be completed in a workmanlike manner according to standard practices. Any atteratlon or Authorized deviation from above spoclHcations Involving extra costs will be executed Signature only upon written orders,and will become an extra charge over and above the astimate.All agreements contingent'upon strikes,accidents or delays beyond our control. Owner to carry fire, tornado and other necessary Insurance. NOTE:This proposal maybe Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us If not accepted within days. Arca of — The above prices, specifics Iona and conditions are satisfactory and are hereby ] � ` accepted. You are authorized to do this work as specified. Payment Signature Q will be made as outlined above. l.' SI nature Date of Acceptance: g