HomeMy WebLinkAboutBuilding Permit # 6/10/2016 BUILDING PE! � �o�r�, �
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TOWN OF NORTH ANDOVER
PPLICATION FOR PLAN EXAMINATION _
Permit Flo#. * ,"' Date Received 9
Date Issued:
IMPORTANT: applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
Print I 100 Year Structure yes no
MAP PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑ Two or more family ❑ Industrial
Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO DE PERFORMED:
cyan•
Identification- Please Type
Print Clearly
OWNER: Name: i �,L, C .&/ F FZt gr/I , r ��
_
Phone: �� � '
Address: ��.._ -.. & �;. 'I W' ,
Contractor Name: Phone:
Email:
Address:
Supervisor's Construction Licenser _ a Exp. Date
Horne Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ ! 0 0 FEE: $
Check No. Receipt No.: m
NOTE: Persons contracting with iniregistered contractors do not have access to the gz aranty fund
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Plans Submitted ❑ Plans Waived 1:1"" Certified Plot Plan ❑ Stamped Plans El
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art F1 Swimming Pools 11
Well ❑ Tobacco Sales 11 Food Packaging/Sales 0
Private(septic tank, etc. El Permanent Durapster on Site F1
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
LANNING & DEVELOPMENT Reviewed On'�- SignaturJ1 N)wpt-
COMMENTS
6ONSERVATION Reviewed on "-J Sig nature
ry
COMMENTS
HEALTH Reviewed on Siqnature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/signature & Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
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Food/Kitchen
PEMMIT T LD Septic System
THIS CERTIFIES THAT .. ....... .... .. BUILDING INSPECTOR
has permission to erect .............doft............. buildings on .. ... .. .......T.ON.........No........... . ..o...... Foundation
Rough
to be occupied as �. ..../ery
.. .. Q r�.. ........... Chimney
provided that the person accep ing this permit shall in'e 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 I ELECTRICAL INSPECTOR
UNLESS CONS TI N S Rough
ice
.. .. .... ............ ..... Final
BUILDING INSP OR
� GAS INSPECTOR
Occupancy Permit Required to Occupy Buildin Rough
Disl,,ay in a Conspicuous Place on t ereses — ® of Remove Final
No Lathingr Be®
Wall o Done FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
Scope of Work.
Remove old bulkhead from back of house and install new bulkhead on side of
house.
Set back is 20 feet. House is 33.7 feet from property line. Unit (Type-E) will stick
out 95.5 inches. That leaves about 5.7 feet to spare.
Remove old bulkhead:
• Drill holes in existing opening walls and floor for rebar.
• Pour a new basement wall.
• Demolish old stair unit to 16 inches below grade.
• Drill drain holes in bottom of old unit.
• Fill with gravel.
• Construct a roof over unit below grade, insulate and water proof.
• Fill with dirt and then gravel for last 6 inches to grade.
• Repair siding on house.
Install new bulkhead:
• Dig hole.
• Cut hole in foundation wall.
• Inspect and repair any existing drain around foundation footing in the
disturbed area.
• Drill mounting holes in foundation wall.
• Apply sealant to vertical face of new unit and install.
• Pour concrete around unit to prevent sagging over time.
• Back fill
• Landscape.
• Install new door in foundation wall.
• Install new door on top of unit.
• Repair siding on house.
ire
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PLOT PLAN 0"OpNs
#145 JOHNSON STREET U�°� P TER gcyo�
NORTH ANDOVER, MASS. /t\ dover GOODWIN
Prepared for consultants .N•
� -o No.48133 1.
WILLIAM & JULIE CROCKER inc. 9� r
A(LAN
SCALE: 1 of=40' DATE: 11-5-13 11East River Place, Methuen, Mass.
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T TYPE-S TYPE-A _ TYPE-B _ TYPE-C
19 '
52"
30" 22"
f � 74r'
{ 66"
/0"
4fl 60,. 68" 76 i
T
r WIDTH 55X/ WIDTH 55eWIDTH51 '
FINISHED BASEMENT FLOOR 2" ABOVE BASE OF CASTING
TYPE-D TYPE-E TYPE-f
_ 22'' "—
22"� yg 30_
22" � �2r, /WIDTH58"
III_ /WIDTH58"
84,. 93,rWIDTH 551"
FINISHED BASEMENT FLOOR 2" ABOVE BASE OF CASTING
/ 1811,
MIN
MIN
S = 72" MOX
AE,F - 96"
PER
E,F = 120" 12
/
FOUNDATION-j
COATING
Y
84" -)
601,
REQUIREMENTS FOR WARRANTY:
1. KEEP FOUNDATION SEALER A MINIMUM OF 12" FROM OPENING. EXCAVATION REQUIRED
2. POUR A MINIMUM OF A 111" STEP IN BULKHEAD OPENING AS SHOWN.
3. KEEP FOUNDATION OPENING A MINIMUM OF 18" FROM FOUNDATION CORNER,
4. ROOF DRAINAGE MUST BE DIVERTED AWAY FROM BULKHEAD OPENING. HOW TO ORDER:
j DETERMINE DIMENSION FROM TOP OF 1 5. PROPERLY INSTALLED PERIME*R DRAINAGE TO DAYLIGHT REQUIRED. FOOTING TO PROPOSED FINISHED
6. BACK FILL MUST BE CLEAN GRAVEL WELL COMPACTED. GRADE. REFER TO TYPES AVAILABLE
AND SELECT SIZE. TO ASSURE TOP
7. TOP OF CONCRETE CASTING MUST BE A MINUMUM OF 2" ABOVE GRADE. OF STAIRWELL WILL BE 2" TO 6"
GRADE AROUND BULKHEAD MUST SLOPE AWAY FROM FOUNDATION. ABOVE FINISHED GRADE.
HEANero Zaglaads Piea�ie�P�ecaster —� BULKHEAD INSTALLATION
w 800-696-7432 (SHEA)
CONCRETE PRODUCTS www.sheaconcrete.com RECOMMENDATIONS
IONS
773 Salem Street 87 Haverhill Road 160 Old Turnpike Rood Page: AC2
P.O. Box 520 P.O. Box 807 Nottingham, NH 03290 '���
Wilmington, MA 01887 Amesbury, MA 01913 bhinstal.dw 12 O1 2009
Specifications subject to change without notice
r
NOTES:
1. CONCRETE: 4,000 PSI MINIMUM AFTER 28 DAYS.
2. HEAVY DOUBLE LEAF STEEL DOORS.
3. OPTIONAL DOOR LOCK AVAILABLE.
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END VIEW SECTION VIEW
BASEMENT FLOOR
HEIGHT
W L HA HB HC WEIGHT ITEM
TYPE (WIDTH) (LENGTH) (TOTAL)(PRECAST) (DOOR) LBS NO.
S 511/2 45" 95" 43" 52" 2,400 BH—S
A 51%" 60" 90" 60" 30" 3,600 BH—A
B 551 " 66" 90" 68" 22" 4,800 BH—B
C 551,2" 74" 95%" 76 19%" 5,500 BH—C
D 55%" 86" 106 84" 22" 6,200 BH—D
E 58" 95%' 115" 93" 22" 7,800 BH—E
F 58" 1 104" 123" 101" 22" 9,000 BH—F
-A
it/ecv E�g/ands Premier Precasfer SHEA
Fbi 800-696-7432 (SHEA) BULKHEAD -
CONCRETE PRODUCTS www.sheaconcrete.com
773 Salem Street 87 Haverhill Road 160 Old Turnpike Road Page: A4.1
P_0. Box 520 P.O. Box 807 Nottingham, NH 03290
Wilmington, MA 01887 Amesbury,, MA 01913 ulkhead.dwg 12/07/2006 "PIC H
JUecificatlons subiect to chanue without notice
TOWN OF NORTH ANDOVER
OFFICE OF
x BUILDING DEPARTMENT
1600 Osgood Street,Building 20, Suite 2035
North Andover,Massachusetts 01845
Gerald A. Brown Telephone(978) 688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE: 3 l— c2 C/16'
JOB LOCATION: `f )H N 3 UN S'l
Number Street Address Map/Lot
HOMEOWNER WILL 16:1, l CR0C W< Ila' 68'6 3x77 7?( 0132 ) 38-a
Naive Home Phone Work Phone
PRESENT MAILING ADDRESS
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, 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 IIO.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.
HOMEOWNERS SIGNATURE f L z
APPROVAL OF BUILDING OFFICIAL
Revised 8.2015
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANWING 688-9535
The Commonwealth of Massachusetts
r , Department oflndustrialAccidents
d
I Congress Street,Suite 100
Boston,MA.02114-2017
www mass.goh/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers-
TO BE FILED WITH THE PERM[TT1NG AUTHORITY.
Applicant Information Please Print LeWbly
NaMe(Business/Organizationgndividual): (A/i LI I-i H z c,-VZ o c,,V,ri62
Address: U Hy4 S ON �51 1/�
City/State/Zip:J\), /3-c�l 0 ckA--,,VZ l2 tit 1# of w:5_ Phone#: OL 72r 68"6 '3�a 7 7
Are you an employer?Check&e appropriate box: Type of project(required):
l.❑l am a employerwith t employees(full and/or part-time).* 7. ❑New construction
2.❑I am a sole proprietor or partnership and have no employees working for me in S. ❑Remo delhig
any capacity.[No workers'comp.insurance required]
• 9. El Demolition
3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
10 Cf 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 1 L[1 Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
❑ 13. Roofrepairs
These sub-contractors Have employees and have workers'comp.insurance)
6.F1We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§1(4),and Nye have no.employees.[No workers'comp.insurance required.]
c
*Any applicant that checks box#i must also fill out the section below showing theirworkers'compensation policy information.
Homeowners who snlimiE tfus affidavit indicating they are doing all work and then hire outside contractors must s4bmit a new affidavit indicating such.
TContractors tbat 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 tave employees,they must provide their workers'comp.policy number.
Iain an employer that is providing ivorks'compensation insurance for my employees.'Below is'the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins,Lie.#: Expiration Date:
Job Site Address: 1 ( City/State/Zip: 1 ��
Attach a copy of the workers'compemation 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 DTA for insurance
coverage verification.
I do hereby ify under the ai s dpenalties ofpeiYuiy Haat tlae information provided above is flue and correct.
Si nature: Date:
Phone#:
Of use only. Do not•write in this area,to be completed by city or torten official..
City or Town: Permit/License#
Issuing Authority(circle one): ;
1.Board of Health 2.BuildingDepartm.ent 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
North Andover MIMAP May 2, 2016
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Interstates Horizontal Datum:MA Slateplane Coordinate System,Datum NAD83,
--I Meters Data Sources:The data for this map was produced by Merrimack
--SR t&ORT►t Valley Planning Commission(MVPC)using data provided by the Town of
Roads O� ,r4to 'qM North Andover.Additional data provided by the Executive Office of
< �6Y 4 Environmental AffairsfMassGIS.The information depicted on this map Is
Easements +� e O for planning purposes only,It may not be adequate for legal bounds
yr' G P 9r regulatory
Y Y Q g boundary
Parcels 4 �� � � 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
ATS. THIS INFORMATION
CHUS��
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