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Home My WebLink AboutBuilding Permit #002 - 47 CRANBERRY LANE 7/5/2006 y TOWN OF NORTH ANDOVER > APPLICATION FOR PLAN EXAMfNI ATION �Js�cMus� ' Permit SIO: �'b �� Date Received: Date Issued: IMPORTANT: Applicant. must complete all items on this page fo C.XTION �5i?V0 0 Print ' PROPERTY 0V1 SER (A" Print ti1AP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES 0 TYPE OF IMPROVEMENT PROPOSED USE Resi ntial Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Repair, replacement Assessory Bldg Commercial lic Demolition Moving(relocation) - Other Others: = Foundation onlyfn S f i I� DESCRIPTION OF WORK TO BE PREFORMED � N i S 11 l�A� r i'VI —r' Identification Please Type or Print Clearly)P&OV%'NER: Name: P Phone: Address: CONTRACTOR Name: t 0 Phone:. ;address: Ih D 'y l4 SuperN isor's Construction License._ ` _ C Exp. Date: z'�OO — ment License: 6 o_ Exp. Date: u °n Home Improv •c kRC'HI1'ECT. ENGCvEER \.1me: Phcne: a ddress: Reg. No. — FEE SCHEDL LE:BULDL\G PERMIT.510.30 FER 51100.00 OF THE TOT.IL£STI.6j,-ITE'D COST BASED 0A SI?f•'I)0 PER.S.H. Total Project Cost :$_____ 10�' v - 12,400 FEE: 0 Check NO.: Receipt No.: 1)a:w 104 1 Location cam► No. dQ?'' Date MGRTol TOWN OF NORTH ANDOVER • O A Certificate of Occupancy $ CNUs Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �1033 1 J `sT b 7 Building Inspector TYPE OF SEW'ARGE DISPOS\L Tanning'%lassage Body Art SN imming Pools Public Sever Tobacco Sales Food Packaging Sales ' Well � -- - Permanent Dumpster on Site _ PriNate(septic tank,etc. _ Electric deter location to project NOTE: Persons contracting with unregistered contractors do not htive access to the gua anty fund Signature of AgentO%ne -�Signature of Contracto. Plans Submitted Plans Waived Certified Plot Plan S amped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- l; FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ - j 1 ❑Water Shed Special Permit CJ Site Plan Special Permit Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ 110 COMMENTS DATE REJEC'T'ED DATE APPROVED HEALTH CO1viMENTS Toning Board of Appeals: ariance. Petition No: Zoning Dccisii�n,receipt submitted ,-cs P!arining Board Decision: 4-oascrviticn Duci iun: --- ----Conunei�ts 'V:itCr' SJ1i(,r connection datc tirnp Dempster rn site yes_ no lire Department signature date Building Permit Appro%cd and 15suud by: Building Setback (tI.) Front Yard Side Yard Rear Yard ! Required Pro%ided Required Provides Required Provided DIMENSION Number ofSkviem: Total square feet n[floor area, based onExterior dimensions.- Total imnny Tota| land area, sq. ft.: NOTES and DATA-(For department use) __ 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 V11'ork 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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydrau 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 cop) and proof of recording must be submitted with the building application til'.R%'WPi UF.P'R'l MEN NOV PARTITION WALL, FURNACE NEW CAPt�ET I i SCALA:; 1/8" l" BASEMENT LAYOUT I NORTH It Town Of Andover No. DOZ C% , over, Mass, • 0 LA 2 COCHICHEWIC W 0C RATED PPG BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D THIS CERTIFIES THAT..W 01 10' N-41 BUILDING INSPECTOR ................... ................................................ Foundation has permission to erect........................................"uildi.ns on .......... .4,1101on........U-&swL Rough tobe occupied as...... jr4k.*C00 ... ......... .. ..... ................................................................................. Chimney 0 ep oil 1�:Oj�this IS �i S provided that the person accepting 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 a b PERMIT EXPIRES N 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR ...& " 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. Page 1 of 1 Harleysville Worcesterinsurance Company Contractors Business Owners Producer ffBEDFORD MARKETING ASSOCIATES INS AGCY TION INC 150 WELLS AVE AD NEWTON MA 02459 730Quote No:IO 183045 e Date:03/01/06 Expiration Date:03/01/07 Term: Today's date:02/28/06 This is a quotation only,and does not constitute a binding contract.Quotation is valid for 30 days.This quote is subject to normal broker of record letter procedures in the event that there is a duplicate submission received. Thank you for giving us the opportunity to prepare this commercial insurance premium quotation. The quoted premiums were developed under our current rating plans using the information you provided. This quotation may be subject to change,or be withdrawn,if later underwriter analysis develops information which differs significantly from that provided. if we quoted more than one line of insurance,credits,if any,are applied under the assumption that we will write the entire account. IMPORTANT In order to comply with the Terrorism Risk Insurance Act of 2002,it is necessary that one of the forms below,state specific,be attached to all quotes from Harleysville Insurance.You can obtain this form on our Agent Link. IL7157(09/04)-Georgia IL7158(09/04)-New York IL7156(09104)-All Other States Bulldin Covera es Description Ded LocBld Loc/Bid Loc/Bid Loc/Bldg Loc/Bid Loc/Bld Loc/Bldg Loc/Bid Loc/Bld Loc/Bldg 500 001/001 tate MA errito 018 lass 17512 Protection 04 onstruction Frame Limit BPP Storage Prem 137 Property in ILimit 10000 e Open PremIncluded .�H221 *Included is premium for coverages which are included in the All Other Coverage Premium Liability Limits Business Liabilit Each Occurrence 1,000,000 re ate Limit 2,000,000 Llablilt Covera as Description Ded Loc/Bid Loc/Bid Loc/Bldg Loc/Bldg Loc/Bid Loc/Bid Loc/Bid Loc/Bldg Loc/Bid Loc/Bldg 001/001 State MA erritory 018 lass 17512 Limit 44500 Prem 1509 optional Coverages State■MA Description Deductible Limit Premium Additional Interest Premium LocBld Loc/Bldg Loc/Bid Loc/Bid Loc/BldgLoc/Bld Loc/Bid Loc/Bid Loc/Bid Loc/Bldg Policywide Additional Endorsement Premium Loc/Bldg Loc/Bldg I Loc/Bid Loc/Bldg Loc/Bid Loc/aldg 1 Loc/Bld LOC/blag I LOc/Bld Loc/Bid Policywide Subtotal: 1646.00 All Other Coverage Premium: 0.00 Surcharges: 0.00 Total Premium: 1646.00 i 14 https://hnet.harleysvillegroup.com/cgi-bin/WEBPRINT?PRFX—IQ&PNUM-183045&CICS—HMPCICSB&... 2/28/2006 NOTICE z NOTICE � W TO a TO EMPLOYEES EMPLOYEES ODM -4'b The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21,22 &30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: CNA INSURANCE COMPANIES NAME OF INSURANCE COMPANY ONE TOWER SQUARE HARTFORD, CT 06183 ADDRESS OF INSURANCE COMPANY (GS59UB-723OA43-6-06) 03-02-06 TO 03-02-07 POLICY NUMBER EFFECTIVE DATES WALTER KWAN INS AGENCY 72 KNEELAND STREET SUITE 301 BOSTON MA 02111 NAME OF INSURANCE AGENT ADDRESS PHONE # 0 YAN CONSTRUCTION 15 JONATHAN LANE BEDFORD MA 01 730 EMPLOYER ADDRESS N m EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably `— connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 006063 W20PIG02 TO BE POSTED BY EMPLOYER I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR r�lr Number: CS 080235 Birthdate: 09/20/1954 Expires: 09/20/2007 Tr. no: 4028.0 Restricted: 00 MANCHIU HO 15 ORCHARD ROAD BEDFORD, MA 01730 Commissioner YnnriardS Qoard of QuiWing Rcgutations and S TCONTRACTOR' t HOME IMPicOVEfJIEN� r € Reg.istration, 136308 - 3 Expiration: 711012006 orntion Type. Private COMO" z YAN CONSTRUCTION INC' i HO rlal� �.. 15 ORCHARD RD. rtcDF3 1p,MA 01730 Adnn+u�U-a.�r