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HomeMy WebLinkAboutBuilding Permit # 3/2/2016 IAORTH BUILDING PERMIT o��YL�a ,6 TOWN OF ORTH ANDOVER APPLICATION FOR PLAN EXAMINATION C, Permit No#: �,.� _ Date Received ArED Date Issued: �� ,w�-a�. AC us IMPORTANT: Applicant must complete all items on this.page LOCATION Print PROPERTY OWNER t,P .t .. i. CXV L MAP PARGEL' w Print 100 Year Structure yes no _ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED JSE _ Residential Non- Residential []'New Building R-dne family ❑ Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ,. ,,.,,.r /ir ,. // ,.,, // r:/r✓r .,// / ❑ r/ii/J ;, ,,.f,/i,F%,.r �i,rai r/�....f// �, <,✓.//r, r, r r.. ,,, i/i, „.✓r // „r/ ,/... /; e�, �, ;r,ir rr r„ ,aad , r, ,❑ Wetlan s,, rr ❑/�W to s,e �,D st c , I rr r r , it/� 1 r! i,// � r, J �, J/ /�,/„ G /� ��' rl 1 /. ✓ r r„r i,,,,r,n,, :.-,.,,. .,r,. .,,;:,,.,,�,/�,/e,,,vc,/r�/�r/Y/��� /,/,p��L✓„///i�/r1,o%,..r�/�ir/,,.,/„r////��/G /„r „rr��, 1/, ,.rl,.. ��r/!�//../.i,N ,�/„r�r//„�.,,,,/„/,r/,,,L„ r„ DESCRIPTION OF WORK TO BE PERFORMED: , . Icientifit�on-�Please'Type or Print Clearly OWNER: Name Phone: ..��"�t .” �� �.�(w�b . 1- �-'� u.. u.. gymW � � Address: a � �.� � � �� i (f ' �i w ..;v ! A; Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. GPERMIT: 00 PER$1000.00 OF THE TOTAL ESTIMATED COST BAS D ON$925.00 PER S.F. j Total Project Cosi $ : .4GO 0 12. I” t FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have bti�s to t ie gnaranty fund — � rafure of A �/J. nture_ofr cr�nfir'arfor ;; NORTH Town of ver © y` 0 *Vi h ver, Mass, COC NIC.EW.CM ORATED V BOARD OF HEALTH Food/Kitchen L D� Septic System • 400 THIS CERTIFIES THAT ......... ,,,,,,,,,, BUILDING INSPECTOR ........ . . . .......... PERMITI&T .. ..................................................... has permission to erect .... buildings on .11 .........�,�Q. � Foundation 00 Rough tobe occupied as ........... Ir`. . .......... ........................®..................................................................... 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 EXPIRESI 6 MONTHS ELECTRICAL INSPECTOR in LESS CO SRCTIO T T Rough Service ................. .. ... .......... ............................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final YY No Lathing or Dry all To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street, Building 20, Suite 2035 North Andover,Massachusetts 01.845 Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print "2 DATE:_ —) JOB LOCATION: C 011)'& Number Street Address Map/Lot IIOMEOWNER' ,, V �' C�CC X C, -0 Naine Home Phone Work Phone PRESENT MAILING ADDRESS evs­k"'�5 City Town State Zip Code The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two family dwellings and to allow such homeowners to engage an individual for hire who does not possess a videci that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who awns a parcel of land on which he/she resides or intends to reside,011which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 CMR Section 110.R5.1.2) The undersigned"homeowner"assumes responsibility for compliance with State Building Code and other applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that lie/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 APPROVAL OF BUILDING OFFICIAL Revised 8.2015 Form Homeowners Exemption WARD OF APPEALS 688-9541 CONSERVATION 638-9530 414ALTH 688-9540 PLANNING 688-9535 The Commonwealth of Massachusetts m. ' Department of IndusWal Accidents n 1 Congress Street,Suite 100 Boston,AfA 02114-2017 •,..- :�. �c www.mass.gov/dza OiM syy� yy'ovke&Compensation Insurance Affidavit:Builderjs/Contxactors/Electricians/klumber"s. TO BE MED WITH THE PERMITbNC AT7TIIOILI�Y, Please Print Le 'bl A ''licantXnformation Name, (Business/6rgariization/Individual); t 11.;� C �" „ � �” .. � Address: City/State/Zi (.) 1`��' "Phono 4: r Type of�projeet(required): rare you an employer?Check tiie appx"opxiato box: em to ces fill and/or part-time).' 7. Q N6w'donstriiction 1.E]I am a employer with P y 2. I ani a sole proprietor or partnership and have no employees working for mo in $. R emo delhig any capacity.We workers'comp.insurance required.] 9. Demolition 3, am a homeowner doing all work myself[No workers'comp,insurance required.]t 10 []Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will l l Fj Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole � [�l'IUmbing repairs OZ addition$ proprietors with no employees. 5.❑I am a general contractor and I have hired the sub-con(motors listed on the attached sheaf. 13.,0 Ro6f repairs These sub-contractors have employees and have workers'comp.insurance 14 Q Other 6.[:]We are a corporatzozi and its,officers have exercised their right of exemption per MGL c. 1.52,§1(4),and'we have no employees:[No workers comp.insurance required] Any applicant that checks;bbkitl rririst also fill.out the section below showing their workers'compensationpolicy information: t Homeowners who ukb�S hoxamMuat attached an additional it indicating they are sheegshowing the all work andname of theen hire contractotside rs and state wrs must heth t ar or nowt those, have such, tContractors that employees. If the sub-contractors have employees,they must provide their workers'comp.policy number, X ane an employer that is providing wrsorlceI compensation insurance fog°my employees. Pelow is the pal'icy and)0h site information. Insurance Company Name: Expiration Date: Policy A or Self-ins.Lic.#: City/Statemp: Job Site Address: ompensation policy declaration page(showing the policy number and expiration date). Attach a copy of the workers' c Failure to secure coverage as required under civil enalties2nthe form of criminal OP25A isxWORI OEDER and a fine of up to $2olation punishable by a fitib up to 00.00 a and/or one-year imprisonment,as yr p day against the violator.A copy"of this statement may be forwarded to the Office of Investigations of the DSA for insurance coverage verification, p fp y • f p- above is tare and correct. Date. d c rt nd enalties o er car that the information provided Ido her•e�iy e cfy under tliP ins a Si ature: Phoneff: Official use only. Do not write in this area,to be completed by city or town official Permit/License City or Town: #Z issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Cleric. d•.Electrical Inspector 5.Plumbing Inspector G.Other Phone#° Contact Person: SilentFax @Jackson Mar 02, 16 11:07 From:Janet Maglia To: 19786889542 Pagel no allami on Anli AARW RM low offiri Im Im ME go IS N am= = M aw its rkso WWWWWO '90,hosm AL 11i II ["J"' ESIGNS Facsmile Cover Sheet This message is intended only for the individual or entity to which it is addressed and may contain information that is privileged confidential or exempt from disclosure under applicable Federal or State law.If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient,you are hereby notified that any dissemination distribution or copying of this communication is strictly prohibited.If you have received this communication in error,please notify us immediately by telephone and return the original message to us at the address below via regular U.S.mail. Thank you. RE: DATE/TIME: PAGES Mar 02, 16 11:07 2 TO FROM Janet Maglia COMPANY COMPANY Jackson Kitchen Designs FAX NUMBER FAX NUMBER 19786889542 19786857771 URGENT FOR REVIEW PLEASE COMMENT PLEASE REPLY PLEASE RECYCLE COMMENTS ATTN: BRIAN LEATHE Hi Brian, I am working with the Coletti's (117 Cotuit Street in North Andover) and Tanya has requested I forward you their kitchen floor plan. If you have any questions, please don't hesitate to contact me at 978-423-6829 Thank you Janet Maglia SilentFax Qa Jackson Mar 02, 16 11:07 From:Janet Maglia To: 19786889542 Page 2 277 212;; 24" 401," 122=" 2" 112- 4 12" 40;" 4;" a7 1 ���°-� CABICC ESSENCE 12'22" 40" FRAMED CABINETS ',. UpaR.ADE TO FRAMEL'DRAWERS§SOFT CLOSE DOORS COLOR:LATTE MAPLE-DOOR OP RON r1HE 110 d 42.1:f Y 024;flu--- HANGING 4T x7',IYITH Sod ALL CROWPi) UNISHAOIS8 FOR SHADE DAIi(:RW04S6 FOR GROhN �, ............................ .......... . .. ........ .. .. .. .. .... 1-NIr'H_,ROLLOL T,HAY. � 4 O Q Rk OOKCAZE MODIFIEU In 51.1OK PER SHANNONIaCABICO'I i-VWTH sIN•3LE PULLOUTIAASH OP-SoW '.. 4-WITH FLUSH TOE KICK.MODEL c M mh/ '.. :m o N O EPOISP2-7h! EPOlSP2337O1 I,',,.. ........ ... ......... ...... . .. - __ . .. B24f2B � :'A BjD'�4 M WdGI524 , I 122=• I'L e4• 30•�f-_24'- -36" :37r' 83 �f 121_." 122:" -L-21 243" All dimensions xire de,\ignatinn LTSA TORRTST This is an roil**final design and must Designed: 1/27/201f given are subject to veriCication un JACKSON not be released or copied unless Printed:2/1/2016 job site and adjustment to fit job XITCITEN applicable fee has been paid or job conditions. DESIGNS order placed. COLLETT-KTTCHEN v3-FTNAL JAII Drawing#: 1 Scale:0 1/4"= r l JVwtrt yr Nut to r.Anaover 'ayment Date Wednesday, March 02,2016 )eposit Number 1603021 )perator Counter pc 1 1CR(MISC DEPT REVENUE) $180,00 0 'otal Paid $180.00 ;ash $180.00 'hangs $0.00 lecelpt Number gov00004571 1/2/2016 8:52:21 AM lame BUILDING/FRAME PERMIT FEE-117COTUIT ST :ashier Id. treascoll-17 t