HomeMy WebLinkAboutBuilding Permit #762 - 733 TURNPIKE STREET 6/6/2006TONVN OF NORTH ANDOVER
,APPLICATION FOR PLAN EX.�:�tINATIUN
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Permit NO: Date Received: Z 6
Date Issued:
[IMPORTANT: Applicant must complete all items on this
LOCATION
Print
PROPERTY OWNER
Print
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MAP NO.: _ l � D PARCEL: -0— ZONING DISTRICT:
TYPE AND USE OF BtiILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
v, (Iteration No. of units:
= Repair, replacement Assessory Bldg VCommercial
r Demolition
Movin (relocation) J Other ,j Others:
Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
,,
Identificajon L Please Type or Print Clearl )Afvx
� n A4
. rt-.. / i, �� u� C � `���. (417)111-7071
OI NER: Name:
Address:
CONTRACTOR Name:
Address: 140 i II i ►�:,q S
WAMMW
Supervisor's Construction License: CS aExp. Date:
Home Improvement License: /22993 Exp. Date:
ARCHITECT.'I NGINEER Name: Phcne:
Address: Reg. No.
FEE SCHEDULE: BULDLNG PERMIT. ,510.00 PER 5100200 OF THE TOT. !L ESTIJI.-1 TED COST B ISED OA .S1Z5.00 PER S.F.
Total Project Cost :$_—RVQ -O � x10.00 TEE:$
Check No.: 0 q9 Receipt No.:
Fare 10'4
TYPE OF SEw'ARGE DISPOSALTan
'
_
ning"�tassage'Body .art �_
S� imming Pools
Public Sewer _
Well
Tobacco Sales
oXA_ckaging'Sales
'
J
Private (septic tank, etc. _
Permanent Dumpster on Site
a
e tri Meter location to
�_
project
NOTE: Persons contracting with unregistered eo rlo not have access to the guaranty fund
Signature of Agent�"Owner Signature of Contractor 4/ C
Plans Submitted Plan0'aived Certified Plot Plan IJ 4rped Pans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
j� PLANNING & DEVELOPMENT
v
I
COMMENTS
DATE REJECTED
❑ ❑
[]Water Shed Special Permit
Site Plan Special Permit
❑ Other
DATE APPROVED
DATE REJECTED DATE APPROVED
CONSERVATION ❑ (]
COMMENTS
/ DATE REJECTED DATE AXPPROVED
HEALTH ❑ 6 DG
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Zoning Dec isioni receipt submitted yes
Planning Board Decision: _ _ Comments
Conscr�atien Decision: ___ _^Comments
Water & Scwcr connection si- nature &elate
l-cmp Dumpster on site yes --no/ Fire Department signature. date
Building Permit Appro%cd and ISSucd by:
Puge 2 cl'4
Building Setback (f.)
Front Yard
Side Yard
Rear Yard
Required
Provided
Required
Provides
Required
Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
vu i t,5 ana UA 1,N — tror
F':uc3rA'l
Total square feet of floor area, based on Exterior dimensions.
r7c ' 7757 TTNAL SLR ICI I; olPA6 I,aL `4 ' 1411.OWN40 7
.�.nri. I,IC 11,'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
s( Building Permit Application
�t Workers Comp Affidavit
u/ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
Copy of Contract
a/ Floor Plan Or Proposed Interior Work �( 2
Addition Or Decks
/Building Permit Application
Surveyed Plot Plan
o Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraul
Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
o 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)
o 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: RSHA"1'IONAL. SERVICES DEP %R] ME`'r:UPPORc105
P:wc 4 r.l'.1
Location -233
No Date Y ,-
MORT#1 TOWN OF NORTH ANDOVER
9
Certificate of Occupancy $
E�� Building/Frame Permit Fee $ C-
JACNUs
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
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OFFICE OF BUILDING INSPECTOR
°+ TOWN OF NORTH ANDOVER
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-�. s • CONSTRUCTION CONTROL
PROJECT NUMBER:
PROJECT
PROJECT
NAME OF BUI
NATURE OF PROJECT: S'V'� `gc�L^— ��"J�att
MA'btm'
IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE,
I, _Io, �T�y m Cx REGISTRATION NO.k (( I A
BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I
HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,
COMPUTATIONS AND SPECIFICATIONS CONCERNING:
ENTIRE PROJECT
FIRE PROTECTION 0
ARCHITECTURAL 0 STRUCTURAL 0 MECHANICAL 0
ELECTRICAL 0 OTHER (SPECIFY)
FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS,
COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS
STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRATICES.
AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B
EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT
THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING
PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0
1. Review, for conformance to the design concept, shop drawings, samples and other submittals
which are submitted by the contractor in accordance with the requirements of the construction
documents.
2. Review and approval of the quality control procedures for all code -required controlled materials.
3. Be present at intervals appropriate to the stage of construction to become, generally familiar
with6the progress and quality of the work and to determine, in general, if the work is being
performed in a manner consistent with the construction documents.
PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT
TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR.
UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE
SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCC ANCY
SG �R
�SU43SCRIBED AND SW_ N T BEFORE ME THIS DAY OF //�—
JOHN P. SZETO
+ Notary Public
—NOTAR UBLIC Commonweh Wce@kMd$WN EXPIRES
My Commission Expires
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NEW SUSHI BAR �, P►�a►�► v►Ew
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www.►nass.gov/dia
Workers' Compensation Insurance affidavit: Builders/Contractors/Electricians/Plumbers
applicant Information Please Print Legibly+
Name tl3usiness organiAid 011llnLli�idual):
,lddress:
City; State; Zip:
Phone :#• � f2 g- 03 3
,ire ou an employer? Check the appropriates bgw '
:I and
The Commonwealth of Alassaehusetts
am a general contractor
Department of Industrial. accidents
have hired the sub -contractors
Office of Investigations
listed on the attached sheet.
600 Washington Street
These sub -contractors have
Boston, ,VU 02111
www.►nass.gov/dia
Workers' Compensation Insurance affidavit: Builders/Contractors/Electricians/Plumbers
applicant Information Please Print Legibly+
Name tl3usiness organiAid 011llnLli�idual):
,lddress:
City; State; Zip:
Phone :#• � f2 g- 03 3
,ire ou an employer? Check the appropriates bgw '
:I and
I .M I am a employer with
am a general contractor
employees (full and/or part-time).*
have hired the sub -contractors
2. ❑ I am a sole proprietor or partner-
listed on the attached sheet.
ship and have no employees
These sub -contractors have
working for me in any capacity.
workers' comp. insurance.
[No workers' comp. insurance
5. ❑ We are a corporation and its
required.]
officers have exercised their
3. ❑ I am a homeowner doing all work
right of exemption per MGL
myself. [No workers' comp.
c. 152, § 1(4), and we have no
insurance required.] t
employees. [No workers'
comp. insurance required.]
Type of project (required):
6. ❑ New construction
7. einodeling
4. ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
I I.[] Plumbing repairs or additions
12.❑ Roof repairs
13.0 Other _
'.\ny applicant that checks box 91 must ASO till out the section below showing their workers' compensation policy information.
+ Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating :such.
Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
I om an employer thitt is providing workers' compensation insurancefir my emplgveec. Below is the policy and job site
information.---
/,
Insurance Company Name:---'��-–=�� A Y"i`� ��� "� r
Z �f 6�5 Expiration Date: 8//
Policy or Self -ins. Lic. 4: 6Ku f 31_ _ _ p — 7 --
.//
lob Site Address:. 7,33 "a Ste/ 4 d. City%State;Zip:___9q —
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of %IGL c. 152 can lead to the imposition of criminal penalties of a
tine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a tine
Of up to $250.00 a day against the violator. Be adv iced that a copy of this statement may be forwarded to the Office of
Invc.Stigations of the DIA for insurance coverage verification.
l do hereby certify ander the poins and penalties . 'perjury that the informution provided above is true anti correct.
tiin:rture: i I fate:
Phone
-05
li�Jic•ial apse only. L?u nut n�,•ite in tltis area, to he :runplrtrd by r.1tt� „r raw» ��lJie•iul.
City or Tow n:
?A,:rmitlLicense 4
Issuing ,Authority (circle one):
1. Hoard of Health 2. (Building Department 3. City/TovNn Clerk t. Electrical Inspector 5. f`lumbing Inspector
6. Other
C'raraf:tdt 1'c�r�,nn:
Phone #:
FRCP'.' : " I I FAX NO. : 7812895289 May. 17 2006 06:04PM Pi
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CERTIFICATE OF LIABILITY INSURANCE im-motam"
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557 Broadway
Revuhre, NA 02151
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140 BdLlliags Street
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THIS CefMPICATrz 13 ISSUED AS A MAT -TER OF IWO-RMATIOr
ONLY AND CONFERS No RIGHTS UPON THE CMIFICATI
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ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW
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Board of Building Regula ons and Standards
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
1.1.1 ome Improvemer -16) -8kactor Registration
Registration: 1.29034
Type: Private Corporation
H< Exnlration: 6/25/2007
New Canton Corp.
1P Lee
140 Billings St.
Quincy, MA 02171
>S-CA1 is 50WW044101216
e 1 7 6go 0 ��
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Update Address and return card. Mark reason for change.
Address [] Renewal ❑ Employment (Lost Card
TO
AT
I/
TOWN OF NORTH ANDOVER
Name of City or Town
Hereby grants an
ENTERTAINMENT LICENSE 2006
(,SEVEN DAYS)
IRON CHEF RESTAURANT
733 TURNPIKE STREET
BETWEEN THE HOURS OF 11:30 A.M. AND 10:00 P.M.
SUNDAY 4:00 P.X AND 9:00 P.M.
FOR RADIO JUKE BOX TELEVISION AMPLIFIERS
CABLE TV
OCCUPANCY: 76
EXPIRES DECEMBER 31, 2006
Witness our hand, this 1 ST day of JANUARY, 2006
E� BOARD
Extracts from Section 183A of Chapter 140 of the General Laws
No innholder, conunon victualler, keeper of a tavern, or person owing, managing, or controlling
any club, restaurant or other establishmr.nt required to be lic,ased under section twe've of chapter one:
hundred and thirty-eight or under section two. twenty-one A or twenty-one h of chapter one hundred forty,
and no persons owning, managing, or controlling any concert, dance, exhibition, cabaret, or public show or
any description to be conducted un ut,y pre'rnises required to be licensed hider the scetions described
above, shall, as a part of its usual business, offer to view, set up, set un fuut, maintain or carry on a concert,
dance, exhibition, cabaret or public show of any description• unless antl until a hccnsc dicrrture has been
issued by the licensuig authorities.
THIS LICENSE MUST BE DISPLAYED LN A CONSPICUOUS PLACE
...:.x:.r..5.�••U'+id"wu��.S�LuLMa't''vix u.Y Wry^< CrA��� Ik. �.�!
LICUML
ALCOHOLIC BEVERAGES
THE LICENSING BOARD OF
The Town of North Andover
MASSACHUSETTS
HEREBY GRANTS A
COMMON VICTUALER
License to Expose, Keep for Sale, and to Sell
All Kinds of Alcoholic Beverages
To Be Drunk On the Premises
To Lucky Zou, Inc. d.b.a. Iron Chef Restaurant, Z,ong Song Zou, Manager
733 Turnpike Street, North Andover, MA 01845
on the following described premises
One floor: One main entrance and exit. One rear exit, small bar, dining room,
Kitchen, storage. Lounge not to be increased. OCCUPANCY 76
This license is granted and accepted upon the express condition that the licensee shall. in all resp
conform to all the provisions of the liquor Control Act, Chapter 138 of the General Laws, as amended, and
rules or regulationsmadelhereunder by the licensing authorities: Pis license expires December 31st: 2+
unless earlier suspended, cancelled or revoked.
N TESTIMONY WHEREOF. the undersigned have hereunto affixed their official signatures this 1
day of January 2006.
The Hours during which Alcoholic
Beverages may be sold are:
From: 3:00 A.M. - 1:00 A.M.
Monday through Saturday �f`'"`° `�C,
11:00 A.M. - 1:00 A.M.
Sunday 1,K14 fa
ticeinBoard
THIS LICENSE SHALL BF DISPLAYED ON THE PRFNIISFS IN A CONSPICtsOig POSITION A"HF.RF. IT CAN EARL
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