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Home My WebLink AboutBuilding Permit # 2/3/2016 %40RT11 BUILDING PERMIT TOWN OF NORTH ANDOVER ° � APPLICATION FOR PLAN EXAMINATION - Permit NO: Date Received 0� < „ „ �"4, Date Issued: sgereus"�� IMPORTANT: Applicant must complete all items on this page LOCATION 79 Milk- � Print PROPERTY OWNER k) " .1 Print MAP N . PARCEL ZONING DISTRICT: istoric Dis riot yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building LOne family ❑Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial [(Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer Identification Please Type or PrintClearly) OWNER: Name: KLt-b _ �J('f Phone: a S- Address: i CONTRACTOR Name: Phone; Address Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: FEE: $ _ Check No.: Receipt No.: �theguaranty NOTE: Persons co t ac °ng with unregistered contractors do not have a esfund Signature of Agent/Owner, - t �° Signature of contractor %AORTJITujown ofiiaover ? ¢ O �• s ' h ver, ass, COC HIC HI o CHE- 1 WICM � U BOARD OF HEALTH ERM LU Food/Kitchen Septic System THIS CERTIFIES THAT ,,,,cas,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,•,,,,,,,,,,, BUILDING INSPECTOR has permission to erect .......... buildings onM. Foundation . ...........:: ....Sr. .......... ............................. ....................... Rough to be occupied as ....... ... ...............AV-011PO4...................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 MONTFI?j INSPECTOR ® UNLESS TI TRough Service ................. . AR... ..................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 C§W Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: j - 7..Rf Number Street Address Map/Lot HOMEOWNER L! ( (,'i I j Name Home Phone Work Phone PRESENT MAILING ADDRESS ,.AJ findo ,\,,e,r 0 1 R,45- City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which lie/she resides or intends to reside,on which there is,or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE" t t APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption RC)ARD OF APITIAt S 088-954 CONSIAWAIJON 688-9530 HFAI,'m 689-9.�40 PLANNNO 699-9 35 The Commonwealth of Massachusetts Department of Industrial Accidents b I Congress Street,Suite 100 Boston,MA 02114-2017 y �`t wlvw.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE TILED WITH THE PERMITTING AUTHOR11TY, Applicant Information Please Print Legibly Name (Business/Organization/Individual): K(If hc yg dye C o Address: " tr 7f - City/State/Zip: 12; Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.Q I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in 8, R1 Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.1@ I am a homeowner doing all work myself.[No workers'camp.insurance required.]t 10E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13, Roof repairs These sub-contractors have employees and have workers'comp.insurance.# p 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.[No workers'comp,insurance required.] *Arty applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I ant art employer ilrat is providingtvorlreis'compensation irtsur'ance for my employees. Below is the policy anti job site information. Insurance Company Name: Policy#or Self-ins.Lic,#: Expiration Date: _ Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c, 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORD.ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. Ido hereby certify under thepains andpenalties of peiYwy that the information provided above is true and correct wn Siana "yt°" ' - L, + aa ) A Date: r a �- Phone#• Official use only. Do not sprite in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2,Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 1974°' KATHERINE CORA 8 4 42 2 rr 978.886.4355 mobile 19 4°' �2rr 85 4 rr 978.886.8432 Jose mobile 53 4„ 24" 51,'s` 29 8 r, 39;s' SITE:55 Milk St Andover,MA 01845 _ - Ceiling Height:99" mom _ W1536L W3018BUTT W1536R WA2436R Top Alignment:90" r 7 2-Layer Crown leaves GAP BPP12 BTP12 EZR36RHome Depot Site Analysis � - = _4— _ KRAFTMAID Cabinetry BEP11 2L SBHW P3L Door Style:Sonora Maple _ �: w = Door Const:Full-overlay Recessed Veneer Panel - o Box Const:Standard 1/2"MDF N d ' with some 3/4"Furniture Plywood Finish:Pebble Grey y m I Door Hardware:WDMK PULL 3129SN COCrown Molding:ACM8&AWE8 = Under-Cabinet Molding:AWE8 Cn **I approve the layout of the kitchen. N a **I have been advised of the est 4 week lead time afor cabinetry and that KraftMaid will contact = me directly to schedule the delivery date and time. VEZR301834L =—� —�°' -3 ** �I BF3 rte- m I have also been advised that cabinetry is CUSTOM fabricated for MY Project-it is therefore NOT RETURNABLE VC1$1834L N o P co once produced.I do have 90 days from receipt of cabinetry WA2436L m to report ANY missing/damaged items for a direct replacement FLS24 BF3_ X ***INSTALL NOTES*** -50" ;" 27 s„ a„ ,. 43 a„ —2-Piece Crown Molding Specified s a`` s 143 �C)4 z" **SEE Molding Detail[will leave gap at ceiling] 52„ 1„ -1-Piece under cabinet molding provided **Would like under-cabinet lighting -SEE Structure Plan for changes to room -SEE Elevations for Specific Install Notes All dimensions size designations -_ Phis is an original design and must Designed: 1/30/2016 given are subject to verification on not be released or copied unless Printed: 1/30/2016 job site and adjustment to fit job a applicable fee has been paid or job conditions. - order placed. 1300417b.kit FLOOR Plan Drawing#: 1 'No Scale.