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Home My WebLink AboutBuilding Permit # 8/19/2016 %AORTH BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ;e�7 Date Received 0, Date Issued: us IMP RT1"+T: Applicant must coni fete all items on this page LOCATION 61 _Esslx Street, PLANS IN FILE Print PROPERTY OWNER: Steven N. and Anna L. Gesinci MAP NO:_103 PARCEL- A A Print ZONING DISTRICT: RI Historic District yes X no Machine Shop Village yes X no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building X one family Addition Two ormare fam ily Industrial Alteration N o, of u n its Commercial Repair, replacement a Assessory Bldg Others: Demolition J Other LXJ S a P tic LXJN�ll I FloodplainL-JWetlands _�Waed tersh'Distri'ct ewer . ... ... Remodel within the footprint: Creating an open floor plan for living room; dining room; new kitchen and adding 1/ bath. Structural engineer has submitted structural support plan for new bearn support following a portion of wall removal. We will require Electrical and Plumbing Permits. Contractors will apply directly for these permits, ,�Vi 11 apply for.,additional,perii*approval for-an--added-Farmei-'s Pore h in,.front.,of,,the.110 use(8-"-W ?8'-L)at future date- ' o The Roofing Contractor will apply for.Roofing.Permit when Project scheduleall-1-olws for roofing to occur on total house ,and_FarmersPorch.- A-plot-Plan,WULbe..50milted atop with the-Deck-a-nd--Fariiiets",Porcli��,pennit'appi ication., Identification Please Type or Print Clearly) `,�JNER., Name: —Steven N. Gesina 617-633-1968 (Mobile) one: 978- -5580 H Jdress: .61 Essex Street North Andover MA 01845 CONTRACTOR Name: Home Owner Phone: See Above Address: 61 Essex Street No, Andover MA 01845 Supervisor's Construction License: Exp. Date: Home Improvement License: TIP Exp. Date: ARCHITECT/ENGINEER: Julie A. Johnson— Phone: 978-470-2990 Address: 124 Main Street AnrinVer, MA Reg. No. 20_0_7_0_� FEE SCHEDULE:BULLYING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIPATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 114 500FEE: $ Check No.: CIII)L' Receipt No.: — NOTE: Persons contracting with unregistered contractors do not have access to the 9 aral f Sionature of Aaent/Owner,/k\X0','AA,1L Sian i i rp of nrt n+rn rfn r Plans Sulbrnitte�di Plans Waived El Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE Dl§]-?-OSAL public Sewer ❑ TaniiWg(Massago/Body Ad El Swfi'o� 'ng Pools Well Tobacco Sales El Food Packaging/Saks El Private(septic tank, eft. pelmianeiat Dwupster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF a U FORM PLANNING & DEVELOPMENT Reviewed On signatu A exkA-r COMMENTS x Si natur Reviewed on CONSERVATION ('e. ........ COMMENTS HEALTH Reviewed on Si nature COMMENTS Zoning Board of Appeals:Variance, Petition NO: Zoning Decision/receipt submitted yet Planning Board Decision: Comments Conservation Decision. Comments Water & Sewer Connection/Signature& Date Driveway Permit Tows Engin Signature: Located 384 Osgood Street Signature' FIRE DEPARTMENT Temp Dumpster on site yes no ocated at 124 Main Street OJJ A Department s! to COMMMEN ,... 46 Plans Submitted 0 Plans Waived o Certified Plot Plan Stamped Plans L� TYPE-OF SEWERAGE DISPOSAL Public SewerN ATartning/Massage/B dy Art 4 Swimming Pools A Well [� Tobacco Sales Food Packaging/Sales A Private{septic tank,etc\ 0 Permanent Dumpster on Si A THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ -� COMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ �_ x COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con nection/Sig nature& Date Driveway Permit Located at 384 Osgood Street FIR � �" er aurnsins#e +�s � p J %AORT#y '9 own of a s ,.' 6nd0ver llt -j617 � s OLAKE h ver, Mass, &Xks+ 2 COCN[CM('WK:K S � BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT Nr..,.. BUILDING INSPECTOR A *A3. Foundation has permission to ect .......................... buildin son WAA..... �. .... ��. .,....,... to be occupied as . ....�.. �!.!!� .. ,.. �..� �.�..� ... I�►' . .r�!�1 Chimney Rough e provided that the person accepting this permit shall in every respect conform to the Arms of the appl tion Final on file in this office, and to the provisions of the Codes and By-Laws rely " to the Instion, Alteration and Construction of Buildings in the Town of North Andover. 11- ateecol N� Rough PLUMBING INSPECTOR r �,COIM 5 f� Final VIOLATION of the Zoning or Building Regulations Voids this Permit. �� Final PERMIT EXPIRES I 6 NT ELECTRICAL INSPECTOR.- . UNLESS CON I Rough Service .. . ........ Final BUILDIN ECT GAS INSPECTOR Occupancy .hermit Required t® OccupV Bu Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina' No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02114-2017 wlvfv.mass.gov/dta Workers'Compensation Insurance Affidavit:Builders/Contractors[Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Anolicant Information Please Print Le ibl r Name(BusinesVOrganizationllndividuai): ,'7 — as,3rt3 i ss %4? Address: e ° City/State/Zip: 9,, k0gofeQ jig Phone#: jq1Cf -� '.�i � Areyou an employer?Cheelt ilia appropriate box:_ Type of project(required): 1.[]1 am a employer with employees(full and/or part-timo).* 7. ❑New construction 2,E]I am a sole proprietoror partnership and have no employees working for mo in 8. '®Remodeling any capacity,[No workers'coup.insurance required.] 3.01 am a homeowner doing all work myself.[No workers'comp,insurance required.]1 9. ❑Building Demolition IO[]Building addition 4.XI am a homeowner and will be.hiring contractors to conduct all work on my property. I will ensure thutall contractors either havc workers'compensation insurance or ore sule 11.D(Electrical repairs or additions proprietors with no employees. 12.M Plumbing repairs or additions S.F�I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs Those sub-contractors have employees and have workers'comp.insnrance.t 6Q Wo arc a corporation and its officers have exercised their right of-examption per MGL a 14,[]Other 152,§1(4),and we have no employees.[No workers'camp.insurance required.] *Any applicant that checks box#1 must also fill outthe section below showing their workers'compensal ion policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hiru outside contractors must submit a new affidavit indicating such. tContraotors that check this box must attached an additional shcet 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'camp,policy number, I alit all employer that is providing 1vorlrersI compensation insurance for my employees. Below Is 11te polley and Job site irtforraatiort. Insurance Company Name: Policy#or Self-ins,Lie.##: _ _. Expiration Date: Jab Site Address: City/Stale/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 e,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 WORIC 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 lrereby cerlify larder the pains al d parrot i of per jrtry 1ha1 the inforvrrallort pravfderia is erre rued correct, r'' Si nature LL Date: 2ab Phone#- Official use only. Do not/pure In this area,to be completed by city or tolvn official. City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.Citygown Cleric 4•Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT m 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 B UIDING PERMIT APPLICATION Please print DATE: f /� JOB LOCATION: Z �� -- Cm Number Street Address Map/Lot HOMEOWNER (� e(),r, 6v�._ Name Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip ode The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two fancily dwellings and to allow such homeowners to engage an individual for hire who does not possess a license,provided 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 farce.structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 Cwt Section 110.85.1.2) The undersigned"homeowner"assumes responsibility for compliance with State Building Code and other applicable codes,by-Taws,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 APPROVAL OF BUILDING OFFICIAL Revised 8.2015 Form Homeowners Exemption BOARD OF APPEALS 6389541 CONSERVATION 688-9530 HEALTH 6889540 PLANNING 688-9535 -� The Commonwealth ®f massachusefts DOPaftment of Rre Services ;�: mice Of the State Fire Marshal 1',0.Box 1025 State Road,Stow,MA 01775 APPLICATION FOR PERMIT Date: Permit No City or Town (If Appliaable) Dig Safe Number In accordance with the pzovisionsofM.G.L. Chapter.. . 10 as roviderlin Section 5 2 7 CMR 3 P application is hereby made Startbate by 5-t--e j — G e.c, n (Full mune ofperson,Firm or Corporation) tate clearly Address �' L S' St�i e--r Wpose for Ofreet or PA Box City or Town) ,hichpermit Forpermissioato "Locate- dumpster for construction/renovation/demolition requested of structure Comments: dumpster must be 25 ' from structure or covered when not In use at (Give location by street and m,or describein such manner as to provied adequate identification oflocatiou) . Name of competent operator �� Q Cert No, (If Applioable) Date Issued rejected, ,, By '(Signature ofApplioant)~ Date of expiration 36 Fee Paid ✓ Dw _. ----------------- &X The Commonwealth Of Massachusetts d Department of Fire Services 040 ft- an Office of the State Fire loll frahal UV P,0.Box 1025 State Road,Stow,MA 01775 N61-f-11' �`�� - PERMIT Data: lu Permit No city of Town) (lf pplieable) Dig Safe Number In accordance with thoprovisions of UG..L. Chapter l Pas provided in section 5 2 7 CMR 34 This Perxwit is granted tn: Pxill name of Tarsen,FirmFirmox Corporation Sart Date Permission to locate dumpster for construction/renovation/demolition of structure Comments: dumpster be 25 ' from structure or covered, with tarp or plywood Restrictions: at end of w o r k d a y at (Give location by street and no.,our describe in such manner as to provied adequate idemcation oflocaton) Pee Pairs S Tilos Peixnit will expire ign4ture ofofloal gran g pexmrt (Title) TWIA PRIM[' MI 1CT'9LF l 0N.gt:71t'_I Ins ICI 'br Pn.QTPn (lPnM "P WP PQ1=U1CFq