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HomeMy WebLinkAboutBuilding Permit #698 - 65 COURT STREET 5/23/2006TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXANIIN:XTIUN �4s�c Husa Date Received: Permit NO: Date Issued: ���_al IMPORTANT:.Applicant must complete all items on this LOCATION coo Print PROPERTY OWNER �'"�� e L y Print 1.9AP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT TYPE OF IMPROVEMENT PROPOSED USE Residential = New Building One family Addition Ii,_Wo or more family Iteration No. of units: -q Repair, replacement = Assessory Bldg Demolition Moving (relocation) = Other Foundation only DESCRIPTION OF WORK TO BE PREFORNIED. L't j I K c/ e OWNER: Name:, ,kddress: i 6 01 P i Identification Please Type or Print Clearly) e CLSO Vdu CONTRACTOR Marne: YES ❑ Non- Residential Industrial Commercial Others: 'A �a le 2 f3 C.- cwr 0 in 1---ry 11.4 ©LJ'✓' ,,kddress: S.. _ Supervisor's Construction License: � 3��.5 / Exp. Date: --L--- �Exp. Home; Improvement License: (� 7 Date: ,ARCHITECT.' ,N, C- NEER N.amc: Phcne: \,Idress: Reg. No. FEE SC HEDL LE: BL LDIAG PERMIT: 510.30 PER 3/')00.00 OF THE TOT. IL ESTIJI-I TED COST BASED ON S/2-5.0 PER SJ. Total Project Cost :$._-__- xI0.W FEE:$ Check No.: &_ Receipt No.: z � P;wc M4 La U t5 Pho ti �i yt U Cl 0- V ,,kddress: S.. _ Supervisor's Construction License: � 3��.5 / Exp. Date: --L--- �Exp. Home; Improvement License: (� 7 Date: ,ARCHITECT.' ,N, C- NEER N.amc: Phcne: \,Idress: Reg. No. FEE SC HEDL LE: BL LDIAG PERMIT: 510.30 PER 3/')00.00 OF THE TOT. IL ESTIJI-I TED COST BASED ON S/2-5.0 PER SJ. Total Project Cost :$._-__- xI0.W FEE:$ Check No.: &_ Receipt No.: z � P;wc M4 Location-� 4f No. 4" .9Y Date jORT" TOWN OF NORTH ANDOVER of..•o ,•,h.0 S Certificate of Occupancy $ 's''^°. EcA Building/Frame Permit Fee $ X75 s�CHUS Foundation Permit Fee $ Other Permit Fee $ a� TOTAL $ Check # I?ew 1 92U4i" Building I&s'lector TYPE OF SEWARGE DISPOSAL - Tann ingAlassage; Body Art S\imming Pools Public Sewer _ - Tobacco Sales Well Food Packaging Sales � -- Permanent Dumpster on Site _ Private (septic tank, etc. _ Electric deter location to project NOTE: Persons contracting with unregistered contr eters do not have access to the guttranty fund Signature of Agent Owner. Signature of Contractor Plans Submitted 7 ' Plans Waived Certified Plot Plan Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS DATE REJECTED DATE APPROVED ❑ it ❑Water Shed Special Permit ❑ Site Plan Special Permit El Other DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED DATE .APPROVED HEALTH J J CUMMENTS Zoning Board of Appeals: % ariance. Petition No: Zoning Decision: receipt submitted yes P!auning Board Decision: – – -----(•nmmcnh; C,.;,iscruticn Decision: __--- ----'Comments 'V:ctcr & Seder connection JL,naturc & date i cmp Dumpster cn site yes_ no_— Fire Department si`_nature Jatc Building Permit Appros.ed and ISSUcd by: Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided r�r• rr+vc■��. A-FEVIC.r 311"A Number of Stories: __ Total square feet of floor area, based on Exterior dimensions. Total land area, sq. fi.: 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 a 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 o 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 Hydraul. 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 o 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 ?nr: AO\.1L. SEANAVi DFA' `.R'A'NF.\'1APFOW1115 1"we411 1 O z W W r7 s. q as G .0 o w ,v v cn F-4 U w z Gq G" o -o o w .c o u: U aa x 94 �1-4 a a x o c� a w F W a u a w x o w c w c� x o w c w W w A W x w v cA o z cn v o cn N CD 0 \O 4 V) W O O O ztsCD CL O y Q C CM I � C CA Q -0 CD O 'M m m CD CD CD L- H� Z -a :I% 3.0 a� CD Q o O a �Q c CO2 E ev 0 'fl C Z CD 0 CL V y O C C C CO) Q N Ul U) W W W N CIS m C O O LZ O y c O Ct V CLc m cc m c :moo m Ea +O+ c w V 0 IL y : om :Q RM CD m O �3y cm c � c m �c.o 'm C Q* O to m aU y O ; Z O C=m za C t MMM W c O c• C. c O H m C i om�3 H n O H r0.. NJ r. .y c« AD R 21.2 C Ow .y u p�,`� h O C. c O O 'O _ 0 �a4� CD 0 \O 4 V) W O O O ztsCD CL O y Q C CM I � C CA Q -0 CD O 'M m m CD CD CD L- H� Z -a :I% 3.0 a� CD Q o O a �Q c CO2 E ev 0 'fl C Z CD 0 CL V y O C C C CO) Q N Ul U) W W W N Bo:M.W ofmaug ciVguT:iti�fns Jl:ii :� d HOME IMPROVEMENT CONTRACTOR Registration: 103772 Expiration:, 7/9/2006 W; ; ; Type: Individual JOSEPH G. LEVISi Joseph Levis 65 Salem Sty Lawrence, MA 01842 Adminisfrawr License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rim 1301 Boston, Ma. 02108 valid out signati re - �iie Po7,rmaauueaCd o�✓jiaaacrclu�aelta kt I ' I BOARD OF BUILDING REGULATIONS li License: CONSTRUCTION SUPERVISOR �f Number: --,CS 030651 y Birthdate 01/07f1954 ExpYes 01/07/2008 Tr. no: 14186 Restricted.) 1 JOSEPH G LEVIS 160 PLEASANT ST� N ANDOVER, MA Commissioner ACORv_ CERTIFICATE OF LIABILITY INSURANCE PRODUCER Michaud, Rowe And Ruseak Ins. 198 Massachusetts Ave North Andover IdA 01845 Phone 978 688 .8829 ' Fax:978 557 2130 Levis Companies Inc_ Joseph Levis 160 Pleasant Street North Andover MA 01845 DATE(MpI� ONLY AND CONFERS NO EIGHTS UPON THE CERTIFICATE HOLDER. ER THE COTHIS VERAGE AF'FOROES DED BY THOT E POLICIES EXTEND i INSURERS AFFORDING COVI=RAGE NAIC # INSURER & _ Safety Insurance ace Company 33618 _ ' INsuRFR B: _Guard Insurar. =e Group INSURER Q Essex Insurar.:e Coz3pani39020 _ wsuWER*-,2urich Small :3usiness INSURER E _ — — OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PQUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS .:QRT1FICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS; EXCI JSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCEO BY PAID CLAIMS. IN LTR NSR " TYPE OF INSURANCE POLICY NUMBER POLTt�EFF I DATE MMJD0IYY LILY EXWiSA710N DATE MMIDDIYY �— — OMITS GENERAL LIABILITY EA, HOCOURRENgZ S1000000 C X COMtAERCTALGENERAL LIABILITY 13CP$20$ 10/26,05 I 10/26/06 RERTE>r— PRI MISE'a(EGOCurenco) S50000 I CLAIMS MADE U OCCUR I ME , EXP (Any one ppreon) so I PEI,SONAL&AOVINJURY $1000000 I GEI ERALAGGREGATE —3-2060000 1 OENLAGGREGATELIMITAPPLIESPER: PRf DUCTS-COMP/OPAGG S 1000000 POLICY IJECT LOC AUTOMOBILEUABILRY - - COt •BMEp SINGLE LIMIT S A I ANY AUTO 821254 I 01/01/06 01/01/07 �' °Cdo" S SOOOOO ALL OWNED AUTOS BCC LY INJURY X SCHEDULED AUTCS $ Wd3ED AUTO;; BOC LY INJURY 3500000 ][ NONWNAUTOS d)EU I (Pe, ,cmdent PRCi-ERTY DAMAGE . S 250000 (Por ,oCldenn GARAGE LIABILITY AUT - ONLY_EA ACCIDENT S ANY AUTO I 0TH' A THAN EA ACC S I AUT • ONLY` AGG S EXCE3S1JM8REUA LIABILITYI I EAC 10 CCURRENCE $ OCCUR CLAp.IS MRD"- I 4C+ C ?EGATE S 3 DEDQGTIBLE S RETENTION S I / I WORKERS COMPENSATION AND I ORY LIM(TS ER g EMPLOYERS' LIABILITY I LE4PC701295 02,27,06 02,27,07 EL.. AcuAcaDENT 2100000 ANY PROPRIE70R/PARTNERIEXECI.RiVE S10000() 1 OFFICERIMEMBER EXCLUOED7 Il E.L.: ISSEASE • EA EMPLOYEE Hy� desolbe under SPEC: IAL PROVISIONS below E. L.I ISEASE• POLICY LIMIT $500000 OTHER n Property Section IDE61934704 07/14/05 07/14/06 CGSCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS cANt;tL.LA I IUN NORTH -13 SHOULD ANY OF THE ABOVE DESCRIBED PT:LICIES BE CANCELLED BEFORE THE EXPIRATK DATE THEREOF, THE ISSUING INSURER WILI ENDEAVOR TO MAIL DAYS WRITTEN Town of North Andover NOTICE TO THE CERTIFICATE HOLDER NAMI'0 TO THE LEFT. BUT FAILURE TO DO SO SHALL Department Of Public Works IMPOSS NO OBLIGATION OR LIASILI'tY OF At ly KNO UPON THE IN34JREK 11TS A0ENT3 OR 386 Osgood Street North Andover NA 01845 REPRESEwraTnres__ :9