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Home My WebLink AboutBuilding Permit #180 - 9 CLEVELAND STREET 9/8/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONcF NORTH a OL Permit NO: J V Date Received Date Issued: - • INIPORTAN..T: Applicant must complete all items on this page rROPERTY �� C/l�e ,,,, l NER �e Pint 1/�, , Print PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential L New Building One family E, ,Addition 9Two or more family Li Industrial Alteration No. of units: VRepair, replacement 1:kf Assessory Bldg 'c��v?,c c� Demolition Commercial Moving(relocation) ❑ Other Foundation only L Others: DESCRIPTION OF WORK TO BE PFO ME S j � Identification Please Type or Print Clearly) - OWNER: Name: �- c*,*, Phone: Address:��oS .eC j �S'J' �� or CONTRACTOR Name: —3/�Z /�v<S ,G R:7 ` /6hone: Address: 9d /t.J61.9 le Supervisor's Construction License: Exp. Date: 1-lome Improvement License: Yg� Epp. Date: ARCHITECT,ENGINEER Lame: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PER,NIT.•S12.00 PER$1000.00 OF THE TOTAL ESTLYI,t TED COST BASED ON 72 00 PER S.F. Total Project Cost :$ �'S' j o FEES Z� 00 Check No.: ",-10 / Receipt No.: Location ' �� ' ` UF�GiI•-C� No. 0 Date � l �oRTM TOWN OF NORTH ANDOVER Of �ao ra,�0 1A 1 9 ` Certificate of Occupancy $ VSs ne•Et� Building/Frame Permit Fee $ AGMUS Foundation Permit Fee $ Other Permit Fee $ r TOTAL $ Check q/_0 955° Building Inspector E TYPE OF SEWERAGE DISPOSAL Tanning'lVlassageiBody Art F-1 Swimming Pools — Public Sewer Tobacco Sales Li Food Packagingi Sales Well Permanent Dumpster on Site — Electric Meter location to Private(septic tank,etc. = project 4',*%0'T5" C. MOTE: Persons contracting with unregistered contractors do not have access to the guaranty f olid A Signature f contracto Signature of Agent Owner G 11� Stl,n�ture o Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans U THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS Zoning Board of,-appeals: Variance, Petition No: Zoning Decision,receipt submitted ycs_ planning g Board Decision: Comments Conservation Decision: -- Comments Drivewa Permit Water&Sewer connection Si nature Sc Date 6 Temp Dumpster on site ycsno_ Fire Department signature;datg_& ---- Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Numbcr of Stories: O� Total square feet of floor area,based on Exterior dimensions�1 Total land area, sq. ft.: `� �✓ f NOTES and DATA—(For department use) -Se x,, 24eloo 1 I'ase?ol'1 hoc:INSPI C'I IONrV-SI-.RN,IC'LS D[P,kK i,AEN 1':13PFo)RMILi Craned.I AiC.Jan=UOh _ 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) j Copy of Contract z 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 n :�N.tiPE("I IONAI,SERVK EN UH:P.�R'I'�14:V7:BPI OR,\1115 NORT#q Town of over 0 TO No. C, E - dover, Mass., COCHICHEWICK 7�A04ATED FPS\ �5 `s BOARD OF HEALTH Food/Kitchen PER D Septic System MBUILDING INSPECTOR THIS CERTIFIES THAT.......... ......a ...... ... ....... ...��.. ................. Foundation has permission to erect....... ...... buildings on ...... ....-.... .. ....... .��. .. Rou h P 9 N. g to be occupied as........... 1... ....... �. . ..................................... Chimney ' e provided that the person accepting this p mit shall in eve W. orm o 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRUC N STARTS ..... Service BUILPECTOR !�,�W 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. The Commonwealth of Massachusetts OM Department of Fire Services Office of the State Fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover Permit No Dig Safe Num er (City of Town) (If Applicable) In accordance with the provisions of M_G.L.14 8 Chapter 10 as provided in section S 2 7 CMR 34 Start Date This Permit is granted to: Full name of person,Firm or Corporation Pennissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be 25 ' from structure if unable to place with required Restrictions:clearance dumpster must be covered with plywood or tarp end of work day at �F1�Z (Give location by street and no.,or describe in such manner as to provied adequate identification of location) Fee Paid$ 50.00 �I,,-- Fire Chief This Permit will expire , ,3y-C� (Signature of ofcal granting permit) Offical granting pemut (Title) �� -ruic m---n tA1T wni it---r oc r-r-,mcnir-i ir1i it--i v i irnr%oi -vt it nnr-ww,c�r-cam `� '-� Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 134830 Expiration: 1/29/2008 . Type: Individual MICHAEL J.LAROCHELLE " MICHAEL LAROCHELLE 2 NIGHTINGALE.CT. ... i rte✓ ` LAWRENCE,MA 01841 Administrator f. i e yr A Pape of a3 ad ) - g066, 3 M L C®NSTRUCTION9 INC. Mike ��, /C[' / RIZI Fax 978-975-9874 02K6 meq, 78-258-1131 PROPOSAL SUBMITTED T PHONE TE Q STREET JOB NAME CITY.STATE and ZIP CODE JOB LOCATIO bV ARCHITECT DATE OF PLANS JOB PHONE i We hereby submit estimates for: J ' O X. C�vr �o� SerA eeS '!�C' e WO PHIPM hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: dollars Payment to be made 49 follows: Y All material Is guaranteed to be as specified.All work to be completed In a workmanlike manner according to standard practices. Any alteration or Authorized deviation from above specifications Involving extra costs will be executed Signature only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent'upon strikes,accidents or delays beyond our control. Owner to carry tire, tornado and other necessary Insurance. NOTE:This proposal may be Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us If not accepted within days. "ll pwoe Of PfOVOW — The above prices, specifics Iona and conditions are satisfactory and are hereby accep1M.j,Yo�M authorized to do the work as specified.Payment Signature.- will 66'r'riaW.a3�outlined above. 7 Date of Acceptance. , Signet VDAC It WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY « TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6S60UB-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 i. B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed In item 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 D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Gassifications, Rates and Rating 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 9 ow molm THE CERTIFICATE aawCCBB®— L 026453"42�a�0g� �ytyp Age} �/q�/gg�p ��p�/�► e A 78-689—S ig Mm:9712-9 S-3RV J �MA �/6i'WT�YLUE NAIL 0 BMW= RUMMA: ftftSW==dJll2=&UWWMem W. 15024 G manv �afl 11: - E Ti+4S ��U�7 9 dWi1A t Ry i1�i 1i P� FDtcIL•VF�ii61MCAM Pelf .ZEi�I�l1'tC9�At@rfF�t�['l�tG�1i'�FI�i�TYifIT#1 '7�►iMit�t��S��IY� tJR wing! 1ifi�1Y�. '��Q.'�'��# BY3� C �i�JB�'►T'i4A�Tl�3 :414$I�Y�C3QF BQFSCYN1itA tlong um 31A +t1raw mrdwa $3000000 ,tem s140Q FammmaAm"m 61000000 GOOKAGammms2000000 wa.AGMEMIES sem:' 1 aGO $2000000 Soar is AURMBULAURM um VVVJMAUR56 a-• -� !l�Ritr0.9 i i 1 1OVDAMMs J LVAMM j spur-Eicr S F aan Ass€ i E4AW s _ A64 F QdJlLUiLt17 , tml0=6mom S F-LEMNAtCOM s Awl I show ,ego - r r S MM Tif�1Ca��t4CrtxiC�CCJMFSe&Ct�Bee�rer».�wa�ts , fty- IT= � sataax.3��t�'t1� � t7ax�E7ltEa8�;DlffpAB.t1DfDQ�aNp� . �aoom.�ax��i:�.krrmrp�sax�•�, � .n��esae