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Home My WebLink AboutBuilding Permit # 4/5/2016 TORT y BUILDING PERMIT 01�ILED '6�b� TOWN OF NORTH ANDOVER 0�:��: APPLICATION FOR PLAN EXAMINATION14 Permit No Date Received 4 �� s ATEo P��S �CHU Date Issued: I PORTANT: Applicant must complete all items on t1f1s page ✓ OCT / � / / r / / // / /r 1, / /r ✓,r ,. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family L1 Addition Li Two or more family [I Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other F- DESCRI7TION ORMED:OF WORKTO13E PERFORMED: Identification- Please,Type or Print Clearly OWNER: Marne: r-, , Phone:c:—)Ci)-- 51 °. Address: .r � r r / r r / >l ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE erson contracting ith unregistered contractors(Io not have access to the guaranty fiend ignature of gOwner Signaftare of corifractor I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On � Signature_ COMMENTS h1 ► YU \t CONSERVATION Reviewed on r' 3 Siqnature'`�4 -,Cj COMMENTS UJO 1� ��t�. \�.c.L . (amu` tip^ �-oC �raw HEALTH Reviewed on Siqnature COMMENTS_ ' i ZoningBoard of Appeals: Variance Petition No: Zoning Decisionlrecei t submitted PP 9 p Yes Planning Board Decision: Comments Conservation Decision: Comments "Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street t �1 � ,y, r r �% rr.a�ru ,,,� '��✓x } �':t �+s) �ff;,e,„..,� '�`'��;�v<rt ;,w7� m f ,`5';:fir, � rrr!£f�'� rvt�rf:'; ;Y4.reF ,r��,�cr r`,��.� rl�,r i%/� f F .�-. ./f�.; l� ,-..: .-t �s ,<✓�„. ;., aF, ” iu.,... „ ,,,.rr"�r f .�x r/�, z:. V ,�?xar,,�; rx 4 r �, F r„f F�, .:.:t t� .:rm*J� u'-�� / ,�.? �'.r f r.,l ;+�i';rs. ,•is s. fi f. �`: y r*' t ::S ':'i P i Lr-.��r G ✓:; .r� 4',M� sv}slf ,.,�. l=> �, "xd?. .-ka -,f:.a?.rr �' F?r';y,+ ��,:, r +�;:.: ✓. k'.ri 5# r , -'. r t u.l. :e �. ,r- ' C ,,. ..s � r(ffi�rJ.. r x✓,fir /,.�5 t g�rr.. P,, g fr ✓x r r r f r f r f r F % 7 / { tkORTH Town of Andover ® _ w' M � z % : LATh , ver, Mass, '�' COCHICH@WICK 1' °RwrEo PI? U BOARD OF HEALTH IL I Food/Kitchen M VW Septic System THIS CERTIFIES THAT ............................ BUILDING INSPECTOR ......... . . 11T . . . . ........... .... ............ ........ ......... ® ... has permission to erect.......................... 'Idings on ... . .... .. ... . . .. .. .. ............... Foundation Rough tobe occupied as ..... .... ... ........ ................. ..... ....... ....... .... ...... . ..... .. .... .. . . 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 � Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final EXPIRESPERMIT MONTHS ELECTRICAL INSPECTOR UNLESS I STARTS Rough �/ Service ...............:..r ,::? .......................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buillcin 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. Smoke Det. NORTH TOWN OF NORTH ANDOVER OFFICE OF O� ,° , p BUILDING DEPARTMENT MENT 4 c 1600 Osgood Street,Building 20, Suite 2035 °* eP``5 North Andover,Massachusetts 01845 �1SSwCHus��c Telephone(978)688-9545 Gerald A. Brown Fax (978)688-9542 Inspector of Buildings HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: 1 lsz JOB LOCATION: � Number Street Address Map/Lot. I � II � HOMEOWNER W �,1 ��r, Y ex(- � Phone )3 3 Name Home Phone Work Phon PRESENT MAILING ADDRESSQ✓ 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 license, rop vided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,oris intended to be, a one-or two-family dwelling,attached or detached structures accessory to such use and/or faun 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 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. WAA, HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 8.2015 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 : The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston,MA.02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Clectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. ,Applicant Information ( Please Print Leizibly Name (Business/Organization/Individual): ' . -0,°`n Address: �`�= V��•Tc dV� City/State/Zip: Aar l Phone#: ��• '3� Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.E]I am a sole proprietor or partnership and have no employees wonting for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.NJ am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 []Building addition 4.Q 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.❑1 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.# 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we have no.employees.rNo workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i 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 mustattached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-confraclors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for•my employees.' Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: fob 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 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 certify under the pains andpenalties of perjury that the information provided above is true and correct. �inature: Date: : Official use only. Do not 4prite 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 Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i r 3 i I i i North Andover MIMAP March 22, 2016 i 083.0-0420 083.0-01445 ---•..,,, f 494 0 004 4=X14„kN�'�"A1:I�N 48 � �, 069.0-001�>Z/"l OUND"TAINS N>8 // � � � p84.0-00�«4 2 FOUNT IN DR 084./0-003362E h4I( f{ t 1[8d4 R / �Ct42C:4tE422h4C 80,r, 11 FOUNTAIN 042 4 FCb9�4�TAINB 4�4� ill / f-64 c 60:0=002(J 8,F014dNV!" IN ? l 084A-441962 PiI W LING/ D 17 FOUNTAIN PR �i 626 64ICKERIN G aNBCD � wle � ��)ca A 21 F4)41Nd"TAINwd Cly 6'�Ti'CHICKEN ING,RD 23 FOUNTAIN 0F� 61 FOUNTAIN DR 0840-0009 �� -RI S�Cn afJr oc9.a-00x5 61,4 -1 CK -N0 42Ci G A ' 27 FOUNTAINS DR % 612 63HICKERI4�Cq ��I v,v t 0 621 ijIC4CFftIN4C1 N2CD 9 FOUNTAIN C�42 a7p0-0002 084.0-a„00535 41UN14t4 424424 4. 5T � r 084 a 0009 ��31 F0UN4TAIN4 4d42, a8,4.o-004,1f Ja y 30 FOUNTAIN DR ZO-00- Ir Df” r, At 33 FOUN4TAINd 4142 32 FOUNTAIN 08 ��h 35 FC7UN�1`AINJ 0C2� 36 FOUNTAIN DR /r i1�/z 38 FOUNTAIN 00 �� 45 F(7UNl"A24 47 70.01-001'7 51 F(41N4TA24Y 47.8 149 PLEASAN ST 070.1 070.0-0050 070.0-002'0 074.0-0025 73 DAVIS ST 1.57 PLEASANT ST 1704 N"4.FASA4A4T 5 07.9\LIN 0 ��Tr 070.0-0032 �LIq�4C074.NJ 17 LINdCC1L4k ST f . ` 1 1 070.0-0034 4 LIh4 01LN1 : 4 170 F'LEAf 25LINCOLNST 070.0- 070.0-0033 70.0f070.0-0033 074.0-003617,1 N'LEAS N"T ST p7( 070.0-003171.4 LI COLN ST 070.0-0023 1'6:LINdCOLN ST 0 MVPC Be Zoning Overlay Zoning 0 Municipal Boundary Adult Entertainment Distric Busine s 1 District c. b NJachlue Shop Village Ove Susine 5 2 District -- Rail Line Gr) Watershed Protection Dist AN Busine s 3 Distdct Interstates 0 Historic Mill Area IN Busine s 4 Distdct 'AORT" ..,.,.. I [:1 Medical Marijuana M Genera Business District —. SR [� Dovmt-m Overlay District F�' Planne Commercial Dev tiy, ��4<� ••e f Roads [t Historic District Corrido Development Dist Osgood Smart Grwith (4 "> Conido Development Dist p Easements ;Hydrographic Features N Conido Development Dist M E) Parcels Industd I1 District ,� Streams Industd d2 District Wetlands` Industn 13 District fir, SPC M Industn IS District q4.°r.^" Aw'*' Exempt Lends Residei ce 1 District �✓,9 Qh41D M.y4"t�G Residece 2 District '�SACNU'�� R—ide ce 3 DWnet de ce 4 District 1" = 142 ft IS Distric8 Districtidentlal District tZIBUN KER"IL4 084.0-0004, Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83, Meters Data Sources: The data for this map was produced by Maaimack Valley Planning Commission (MVPC) uslog data provided by the Tovm of North Andover. Additional data provided by the Executive Office of Environmental AffairslM—GIS. The Information depicted on this map is for planning purposes only. It may riot be adequate for legal boundary definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION orth Andover MIMAP MVPC Bo Zoning Overlay Zoning March 23, 2016 �. Qj Municipal Boundary Adult Entertainment Dlstric Machine Shop Village Ove 10 METHUEN AVE s 1 District s 2 District Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83, 073.0-0011 0173.0-0039 M Busine s 3 District Meters Data Sources: The data for this map was produced by Merrimack Interstates Historic Mill Area 0 Busine s 4 District pQRT11 Valley Planning Commission (MVPC) using data provided by the Town of IM Medical Marijuana R Genera Business District 073.0-0004 North Andover. Additional data provided by the Executive Office of — SR 0 Downtown Overlay District 402 SUTTON :ST Commercial Dev 6 may, �6� r6 b� Environmental Affaim/MassGIS. The Information depicted on this map is 073.0-0033 Comido Development Dist 073.0-0038 for planning purposes only. It may not be adequate for legal boundary Roads rr'"r EasementsHydrographic Osgood Smart Grovdh (40 Features V Corrido 6fdi Corrido Development Dist Development Dist 0 . — ""` to 16- %� ca Industri I 1 District 0- 15 WOOD AVE ❑ Parcels StreamsIndustri il2 District rK s .i # v h Wetlands P` Industri 13 District r} an y< 4 073.0-0034 '. • Exempt Lands M Industri Reside b„ ' pa"Too - THIS INFORMATION 1" = 50 f ' 304 SUTTON ST 073.0-0062 �, e 14 WOOD AVE Thr = ' D k*s- 073.0-0036 073.0-0036 080.0`003 R4 10 WOOD AVE 356 SUTTON STn 073.0-0064 t , 8'WWOOD AVE 073.0=0026 k r or :M -tom 073.0-0070 JO 391 SUTTON S g 066,0-0049 073.0-0065 370 SUTTON ST 387 SUTTON ST,, 073.0-0066 364 SUTTON ST 066:0-0051 385 SUTTON ST MVPC Bo Zoning Overlay Zoning Qj Municipal Boundary Adult Entertainment Dlstric Machine Shop Village Ove Busine 11 Busine s 1 District s 2 District Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83, — Rail Line Watershed Protection Dist M Busine s 3 District Meters Data Sources: The data for this map was produced by Merrimack Interstates Historic Mill Area 0 Busine s 4 District pQRT11 Valley Planning Commission (MVPC) using data provided by the Town of IM Medical Marijuana R Genera Business District 41r `Ito r 1, North Andover. Additional data provided by the Executive Office of — SR 0 Downtown Overlay District N Planne Commercial Dev 6 may, �6� r6 b� Environmental Affaim/MassGIS. The Information depicted on this map is 0 Historic District Comido Development Dist ,L for planning purposes only. It may not be adequate for legal boundary Roads rr'"r EasementsHydrographic Osgood Smart Grovdh (40 Features V Corrido 6fdi Corrido Development Dist Development Dist 0 . — ""` to 16- %� definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING Industri I 1 District THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY ❑ Parcels StreamsIndustri il2 District rK s .i # OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT h Wetlands P` Industri 13 District r} an y< 4 ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF '. • Exempt Lands M Industri Reside if S Distdcl4 ce 1 District ' pa"Too - THIS INFORMATION 1" = 50 f Reside "r. Reside de de de ce 2 District ce3Districl ce 4 District ce 5 District ce 6 District „,� +�'U"CHus