HomeMy WebLinkAboutBuilding Permit # 3/22/2016 E V2ORTH
BUILDING PERMIT 3r oL
TOWN OF NORTH ANDOVER ® e n
_ APPLICATION FOR PLAN EXAMINATION a
Permit NO: L ��' Date Received * °
Date Issued: f SACHU✓�
ggI RTANT:Applicant must complete all items on this page
LOCATION t (C
PROPERTY OWNERe � $ c
Print
MAP NO: _PARCEL:'14f9 ZONING DISTRICT: Historic District yes„`n
Machine Shop Village yes o
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑New Building One family
A ition ❑Two or more family Fi Industrial
Iteration No.of units: ❑Commercial
❑Repair,replacement ❑Assessory Bldg L Others:
U Demolition F1,Other
❑Septic ❑Well ❑Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
•r,It..E (fit { �"e'F: j" '-trfCE! 6u, ",. K-.C-ti`,"��..'e"_t c'� it R -7)m,`7c,, a,,, I1 J
Identification Please Type or Print Clearly)
OWNER: Name: Phone:"-74—_)J(—0C,
i
Address= 1, t � cx 2 ' - a k
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECTtENGINEER5!(�/ r sv {ir .a,c ;S Phone icy S5
Address: ,°° k .j�. ��41 ^,A Reg.No. t
FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$425.00 PER S.F.
Total Project Cost:$ lk-�,7,n o FEE:$
Check No.: I Receipt No.: 1
NOTE: Persons contracting with-rr�ter ntractors do not have access to the guaranty fund
r
Signature of Agent/Own Signature of contractor
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NO R Tiy
-town of Andoyer
2 [. :.' '.r6 L
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41?16 °oma »<»ew h * ver, Mass,
p�RA7E0P M I PPP` ly
U R " BOARD OF HEALTH
Food/Kitchen
_ ILU Septic System
THIS CERTIFIES THAT.......... ;-b"04.. ' BUILDING INSPECTOR
L&
�s
has permission to erect........................buildings on.......�.... �. .. .......... .�'!4'�.Fwr. Foundation
Rough
................................................
to be occupied as............ ...1... esi..... .... 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 MONTHS ELECTRICAL INSPECTOR
UNLESS COSTRUCTIO RTS Rough
Service
.................... "`.................. Final
BUILDING INSPECTOR
GAS INSPECTOR
®ccupancv Permit Required to Occupy BuRough
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.
Smoke Det.
Final Construction Control Document
To be submitted at completion of construction by a
d -
Registered Design Professional
for work per the 8th edition of the
Massachusetts State Building Code,780 CMR,Section 107.6.4
Project Title:Tarbell Residence Date: March 21,2016 Permit No.
Property Address: 41 Cedar Lane North Andover,MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description:Temporary partial window&non-bearing wall removal&reinstall,required for MRI equipment
removal,from V floor specialty room.
I,Paul F.Kirby,MA Registration Number:35313 Expiration date:June 30,2016 ,am a registered design professional,
and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and
specifications concerning':
Entine Project Architectural XX Structural Mechanical
Fire Protection Electrical Other:
for the above named project. I certify that I,or my designee,have performed the necessary professional services and was
present at the construction site on a regular and periodic basis to determine that the work proceeded in accordance with
the requirements of 780 CMR and the design documents prepared by me and approved as part of the building permit and
that I or my designee:
1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other submittals
by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
Enter in the space to the right a"wet'or _'.•
electronic signature and seal:
_t
e RI?' I r-
�r
Phone number:603.583.2453 Email:pkirby814Qgmail.com
Building Official Use Only `
Building Official Name: Permit No.: Date:
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen.
provide a description.
Trial Version 10 09 2012
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All dimensions size desi
gs given are This is an original design and must not be Designed:3!/212616
subject to verification on jobob site and released or copied unless applicable fee-has Printed:3112!2076
adjustment to fit job conditions. been paid or job order placed.
jg3 tarbell.kit AlI Drawing#:t
II
BATH ROOM II
(E) 203 RA RS @16" O.C.
IIF
(E) 2x6 CEILING JOFS-016 O.C.
II 200 RAFTER
KITCHEN REINF. (TYP.)
U
BEDROOM
DINING ROOM
3
-2x4 POSTS IN 1ST
FLOOR & BASEMENT
LOS
WASH ROOM RG WALLS {SBM.BM.
CEII
BRG. (TYP.)
NEW 3 1/2" x 9 1/2" L (E) WOOD 400 TO REMAIN
F--
EXIST. WALLS TO BE REMOVED
AFTER INSTALL. OF NEW BEAM, 2-2x6 HANGERS
HANGERS, BLOCKING & CEILING W/ 2-2x6 RAFTER
JOIST HANGERS BLOCKING
ASSUMED (E) WOOD
BEDROOMLIN, POST BELOW TO BE
REMOVED AFTER
INSTALL. OF NEW
(E) 2AI CEILING JOISTS 016 D.C. HANGERS(TYP.)
CLOSET (E 200 RAFTERS 016" D.C.
BEDROOM LIVING ROOM
_3
CLOSET
-3-3
TAR ELL fRESIDENCE
RST FLOOR/CEILING SUPPORT
Seacoast FI
41 CEDAR LANE NORTH ANDOVER MA
ROOF/CEILING FRAMING PLAN 5 D"...Road PREPARED iDR
—,NH— KEN TARBELL
= 1'-0" Structural (603)383-2m33
CEILING/ROOF FRAMING MODIFICATION PLAN
Engineers
SKS-11 16-001
SKS- 11
03/15/161—1/4-=1'-0- I--PFK
2-2x6 Wj PLYWD
EXIST 2x10 RAFTERS 016" O.C.
ID �. .� . SPACER @GIRDER
HANGERS (TYP.) —_ -
CL
� I i I ii
2x6 GIRDER
HANGERS (NP.}
9 d
REINFORCE EXIST. '
RAFTERS Wj CEILING
2-2X10 Wj
GIRDER HANGERS T! PLYWOOD SPACER
Wj2x10 (TYP.) I Wj LU410 JOIST
2-2x6 HANGERS WJ HANGERS (TYP.)
SECTION 1 2-1j2"0 A307
THRU-BOLTS TOP &
Y4"= 1:-O" BOTT. REPLACE EXIST. COLLAR TIES
Wj 200 NAILED TO EXIST.
NEW 3.5x9.5 LVL. HANG RAFTERS Wj 6-16d NAILS
EXIST. CEILING JOISTS EACH SIDE (TYP.)
Wj 2-TS12 TWIST
HANGER STRAPS EXIST. 400
$/p �P~Stip SPACER OD GIRD RI PLYIND WiS SELLING
HANGERS (TYP.) ^
RQylS SSP ';� rt FS
jrr
Z OG
2x6 GIRDER
HANGERS (TYP.)
ji t5
SECTION 3 <
REINFORCE EXIST. " '
RAFTERS Wj CEILING I I 3.5x9.5 LVl 3/4 = 1 _Q
GIRDER HANGERS CEILING GIRDER P
Wj2x10 (TYP.) SIMPSON TS12 t
TWIST STRAP TARE LL SIDENCE
HANGERS (TYP.) Seacoast FIRST FLOOR CEILING SUPPORT
41 CEDAR LANES NORTH ANDOVER MA
B Dogtown Road PRdPAREO FOR
SECTION 2 Structural Eh", NN 03833 KEN AND D L
vnana(e03)x3—zls3
Y4"- 1 —��� SECTION AND DETAILS
Engineers SKS—2 s� - 16-001 SKS—2
onrz 03/,5/,6'1/4"-1'-0" 1 PFK
TOMS OF NORTH ANDOVER
7 OFFICE OF
BUILDING DEPARTMENT
( 1600 Osgood Street Building 20,Suite 2-36
_ North Andover,Massachusetts 01845
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: /
JOB LOCATION: . t �, Li„I&AI �C .�/_`' �
Number Street Address Map./Lot
HOMEOWNER
1r (cr 1 i %c
Name Home Phone Work Phone
PRESENT MAILING ADDRESS U�( to t-t-
G X11 i
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 he/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 rad that he will tapfply with said procedures and
requirements.
s
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Rerised 102005
Fonn Home—ers Exemption
The Commonwealth of Massachusetts
Department oflndustr•ialAccidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.massgovldia
Workers'Compensation Insurance Affidavit:BuilderslConkractars/Electricians/Plumbers.
TO BE FILED WITH THE PERNHI TING AUTHORITY.
Applicant Information Please Print Le ibl
Name(BusinesstOrganizationifndividual): 1111 E p
Address:
City/State/Zip: '�_)c.i`ire 4 y6. _,
Are y.0 a.employer?Check the appropriate boa: Type of project(required):
1.0 I am a employer with ..play—(fulland/or part-time)< 7. ❑New construction
2.❑I am a set.proprietor.,partnership a.d have no employers working forme in $. Mlemodeling
any capacity.[No workers'comp.insurance required.] -
3. Ira shomeawner doingallwork self. vorkers'wm nsumnce re a-ued.t 9. El Demolition
❑ n y INo r p.i 4 7
10 E]Building addition
4.®`I am a home.rmer and will be hiring contractors to conduct all work on my property.I will I
ensure that all contractors either have wodcers'compensation insurance or are sole 11.� ictrical repairs or additions
propriamrs with no employees.
12. Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed an the attached sheet. 13.❑Roof repairs
lbaso sub-contractors have employers and have workers'comp.immance.t
6.F]We am a c.rpomtion and its officers have exercised their right of exemption per MGL e. 14.❑Other
152,§t(4),and we have no employees.[No workers'comp.insurance required.]
+Any applicant that checks box#1 most also fill out the acetic.below showing their warous'compensation policy information,
I
Home s who submit this affidavit indicating they are doing all work and than lure outside contractors must submit a new affidavit indicating such,
tContracha s that check this box must attached an additional sheet showing the name of the subcontractors and statc whether.,not those entities have
employees.If the sub-contmetors have employees,they must provide the¢workers'comp,policy number.
f am an employer that is providitig workers'eonipensntion irrsuraizee for uiy employees.Below is the policy and job site
information.
Insurance Company Name: ',
Policy#or Self-ins.Lia#; Expiration Date:
Job Site Address: City/Statc/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 a 152,§25A is a criminal violation punishable by a fine up to$1,500.00 '..
and/m'one-year imprisonment,as well as civil penalties in the form of a STOP WORK 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 DIA for insurance
coverage verification.
I do hereby cyat y_under Ili gincs' enalf' petyruy that the information provided above is true and correct.
Siena t s s/ -✓ G� Date:
Phone#-
Official use only.Do not write 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 ft: