The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #395 - 5 VILLAGE WAY 11/20/2007 BUILDING PERMIT 0* "°RTM q TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ° � Permit NO: Date ReceivedOogA*Eo'Pa`��y &A �� Q 7 Sg�9CHU5fc Date Issued: �� IMPORTANT:Applicant must complete all items on this page Y Y LI CATION � �ft07��ERTIr 0 VN1=R xi1 Y .�''e a! .ns 11rl f'NO i fPA EL' � �OI�1NG D1�TR�CT Hrsto��c *a H NJacline Shop pillage , Vires *ino a ` TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building kOne family Addition Two or more family industrial Iteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Seatic fi 1eil '3loodpla�r; }V�fletlands 3 V1latershed,1D a p.,. h r r/Seviiier -i .rte:. _ i';.;�tF .. r'3- .A� ",. .�. .... rv,. n, t...,..... DESCRIPTION OF WORK TO BE PREFORMED: PP vn ( 3 nada z K, f-c h-a x- C" h Q c l (o VICE W I?X r tw Q(mCJ a-bQe'1Q p ajtj 4zr- �L� . h�serc/n C h2►ado.-h e i h �rtur'�f`{ ►'h dS �12+�-��,�+ �—Identification Please Type or Print Clearly) OWNER: Name: e &o h o fiovo Phone: ct7� LkS 7S 9' 7 Address: of v l c., C., r n C01 #�ACTI7R Names , L-�uluc�CczTon "r +t Th f n ao Sperv�sa�-'s Cons#ruction nse �Ep Dates .§ oe'Irr;provementiLlcerise. w �.., xp Date ARCHITECT/ENGINEER Qu v cd M icl2r.4 ( -Jej rS n Phone:_ 7 c Address: 3G f1G-cC��. l�f�hr," l r;t:7cz Reg. No. . Ss fTl L� FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ctl 0 Cl/ FEE: $ Check No.: � ,� Receipt No.: o el6 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of''Agent/Owner _ Signature of contractor - Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION 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/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENIT Temp DumpsteT on site yes 'no Located at 124 Mam`Streef: ;Fre Departrnen signatu.refdate ... - _ .:C. .. ;COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use E. ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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:BPFORM07 Revised 2.2007 Location No. 3y Date �oRTM TOWN OF NORTH ANDOVER O:O•,,`ao ,a,hO R Certificate of Occupancy $ ,SSACMUSEt Building/Frame Permit Fee $ 4pe)d Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #3-5—ef o 208 '16 Building Inspector NORTH ® of over 0 over, Mass.0 LAK COCMICHEWICK ORATED o`Qa�,�S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THATD0v. � � F 'l1? ( F l QI/p BUILDING INSPECTOR t.. ......................... ........1........................................................... . "' Foundation has permission to erect..................... f /'��a buildings on LN..`.... ................... Rough to be occupied as. .... � l...-. .. ..�..... I.I.C., C `.. ............ . ` � deY�� Chimney b e, Ch'mne . . ........................... . provided that the person accepting this permit shall in every respect conform to the terms of th application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ........................... ................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy BuildingGAs INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Fna;h No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner ir Street No. SEE REVERSE SIDE Smoke Det. ��- / 202 ♦ zoo '' J QQ / 202— / I ; LAYGROUND \ 204— / I \ 210 I I DECK 212 EXISITNG BUILDING I I I o/212 LINCOLN / GARAGE 1210 REALTY TRUST I iI °1 ,'. .214 '2,2_ \ .. . _ 4' _ — 4 PARKING SPACES / (9'x18) \ i �LO .':':'r:::'_v:err :r:':-::':'rr:':'-r.�::..::. ...............:: :': ::':.:'Jf.'J '... :::::......':.:':.: :. .'.'J....:'.Y. .... ............ SMH ....... ti RIM 202.87 VILLAGE WAY PARKING PLAN 5 VILLAGE WAY + NORTH ANDOVER,MA ASSESSORS MAP 104.C,BLOCK 0111,LOT 000.0 1 »` - PREPARED FOR 'G •�rS".F DAML.LE DELLOVO 5 VILLAGE WAY NORTH ANDOVER,MA SCALE:1"=50NOVEMBER 2000 2 7 rf NEW ENGLAND ENGINEERING SERVICES,INC. (' 1600 OSGOOD STREET BUILDING 20,SUITE 2-64 NORTH ANDOVER,MA 01845 ;r i .i'yi':✓ I ` (978)686-1768 DRAWN BY: SHEET#: CHECKED BY: r y C.P.H. 1 of 1 B.C.O.Jr. FB.E#: DESIGN BY: 1343-WC-PP B.C.O.Jr. The Commonwealth of Massachusetts Department of Fire Services T Office of the State Fire Marshal. .. p . _.., .0,Bmc.102i,Sr<ite Road;Stow,MA oITfS . - PERMIT North Aad o v erDate: Permit No (Citgaf Town) (If Applicable)' Dig Safe Num er In accordance with the-provisicas of Nt G:L.14 8.Ghapter�_as.pmvided in section-5-22--f-MR 3 4 Start Date / ,;.This Pannit is granted'to: �L(/f S •?'��/�i , Full name ofperson,'Fum oe Corporation Permission to locate dumps.ter for construction/renovation/demolition o.f building. Corrunents:. dumps.ter must be • 25 ' from structure if unable to lace with require d Restrictions'clearance dumps.ter must :be covered with Plywood or tarn end of 'work -day ('Give location by stre and rno.,.cr desc c iauch manner o 'ed ane uale identificatio of location) Fee Paid S 50.00 . s 'Fire Chief This Permit will spire• (S ignature of ofcal granting permit) Glucal granting.p'cmm t (Title} Ij CERTIFICATE OF LIAEiLITY INSURANCE OP ID s DATE(MMIDDIYYYY) �' LEVIS-1 10/25/07 PIRODUCER THIS CERTIFICATE 13 ISSUE 1)AS A MATTER OF INFORMATION ONLY AND CONFERS NO RI:';HTS UPON THE CERTIFICATE Michaud, Rowe And Ruseak Zns. HOLDER.THIS CERTIFICATI: DOES NOT AMEND,EXTEND OR 198 Massachusatts Ave ALTER THE COVERAGE AFI ORDED BY THE POLICIES BELOW, North Andover MA 01845 Phone: 978 688 8829 Fax:978 557 2130 INSURERS AFFORDING COVE RAGE NAIL# lNSURID _ INSURER A: Preferred)>dutual Ie ilrsane Co. 15024 _ INSURER 9: Guard InSuran.:.e Gro 'To Co>:m incl S Inc. 1NsLIRE9C Safety Insura :.ce Company 33618 Joseph Levis 160 Pleasant Street INSURER D: North Andover MA 01845 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISPED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE-:IOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS :ERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCI USIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, POLICY NUMBER DAT "4`TI�E'P liTION— LTR INSR TYPE OF INSURANCE GATE E(MMIDMMIDDIYY I DATE MIWDdYY LIMITS GENERAL LIABILITY EF :H OCCURRENCE $ 10 0000 TJF .T7rC`�TORE7TE A X .COMM�C;ALGENERALLI,Ad!LITY CPP0100599059 10/26/071 10/26/08 PF :MISES(Enalcurera) 1 ,50111111 CLAIMS MADE Ix I OCCUR MI 1)EXP Any one person) 15 55000 PE ;SONALBAOVINJURY `S 1000000 GI 1ERALAGGREGAT= I S 2000000 GENL AGGRE;ATELIMITAPPLI"ESP�P: FI )DUCTS-CDMP!OPAGG 151000000 R POLICY I PJECT `PLLOC - �--� L��i SINGLE LIMITAUTOMOBILEUASILITY .ANYALrrG821254 ` 01/01/0? 01/01/08 A'.LcwNEDAUTO$ a:OILY INJURY '3 500000 SChEDLLEO AUTOS I (F pe son) "PED AUTO I l 8:DILI INJURY X NON-CW-M- AUTOS � I I (f .r acaOHr^I I s 500000 - - - cPHxrrDAMAce �S 250000 C)nr acadenq GARAGE LIABILITY I ATO ONLY-EA ACCIDENT 1 S _ ANY.AUTO I C HER THAN EA ACC 5 -{I t17C ONLY; ASG S EXCESSIUMBRELLA LIABILITY ` vCCJR E ICH RENCE OCCUR CLAIMS MADE I ,GREGATE 5 l j DEDUGT3LE I 5 R_TEMON S I y I WORKERS COMPENSATION AND T79G STA ITORY 1,iM,TS�FR EMPLOYERS'LIABILITY • 8 ANY PROPREIORIPARTNERlEYECUTIVE LEWC90362502/27/07 02/27/08 LCHACC;DENT $ 100000 OFFICEWMFAIB°R EcCLUCEP7 L.DISEASE.EA=-MvLOYEE�S 100000 If yes,desorlbe under SPECIAL PROVISIONS below L.DISEASE-POLICY LIMIT 13 500000 OTHER I . I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMCNT!4reCIAU PRrnnaot4 Residential Construction and Remodeling, Offica Bldg Reiwdeling- CERTIFICATE HOLDER CANCELLATION NORTHI3 SHOULD ANY OF THE ABOVE DESCRII i:D POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,YHE 1S3UING INSURE i WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HDLDEF NAMED TO THE LEFT,BUT FAILURE TO DO 90 SHALL Town of North Andover IMPOSE NO OBLIGATION OR LIABIUTI 7F ANY KIND UPON THE INSURER,ITS AGENTS OR 384 Osgood street North Andover MA 01845 REPRESENTATIVES. AUTHOR E5ENTATI C ACORD 25(2001108) 0 ACORD CORPORATION t JOSEPH G. LEVIS; JOSEPH LEVIS STREET _-_-- --- 160 PLEASANT NORTH ANDOVER, MA 01845 UP date Address and return card.Mark reason for change. --- - - - ,S`---" P to y m e nt r] Lost Card Address Renewal Em PS-C At 0 5oM-051or-PC8490 License or registration valid for individul use only Board of Building Regulations and Standards before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration::103772 One Ashburton Place Rm 1301 Explrat�i�cn 7!9!2008 Boston,Ma.02108 diyidual e Yp. JOSE VIS ._ ,�:_-_ •:•--- . JOSEPH LEVIS t�: `�_ _=-� c,' _- _----- — -- ------ '_ nature Not valid w io g 160 PLEASANT STREET.:`_-�=;-% Administrator NORTH ANDOVER,MA 01845 Deputy _., ,,,'',��,/`/ 6 ✓ 4 4'l11i11t4'7u�"L � ` ✓� � . � • 11 G DI N REGULATIONS BOARD OF BUIL � !rONSTRUCTION SUPERVISOR , i•. License: C i ' - Number..C S 030651 Birthdate:`_01107/1954 14186 is ')Expires:01.!0712008 Tr.no: k Re�stucted 00 ' JOSEPH G LEVIS / �J I: O 160 PLEASANT A01845-'- ,,G,'. N ANDOVER, Commissioner