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Home My WebLink AboutBuilding Permit # 9/14/2016 ,40RTH BUILDING PERMIT .. 00 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINA40N,, is 3 Date Received Kwrra 0., Permit NO: Date issued'. tµ4 ant must co ms on than a e I PORTll 'Ar.ff T PR I PR VEMENT USE Residential Residential New Building I-] One family [��Ifw" o or more fami Li industrial i-�i Addition L] Commercial A No. of units: Alteration u Others: Ll Repair, replacement [J Assessory Bldg i I Other 577�7117/ 7/ &,shed,,/,D1s nq,:,,,,/- i- Demolition 1 j7f-"7 777 ,Ale t-u fie,,40 -(k e -Y eel( ee If 414 lzea,. ev c it /4' ' /Poo —r z 13 yl Clearly) OWNER: idion-ificat 7 3 Phone: OWNER: Name: Address". 1-D"V/Pzv, C r7l T 77 2 0 "41 . ......... ARCH ITECT/ENGINEER Phone: Address: Reg, No. FEE SCHEDULE:SULDING PERMIT.-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. FEE: $ Total Project Cost: $ - Receipt No.: Check No.: NOTE: Persons contracting with linregistered conti-actors do not have access to the guaranty fund Signature of Signature of Age YOwr),er �oRTH q own of �� ndover p 0% No. . 4 _ hn ver, Mass,6 '%01LOL LA'"41! "4! 1' Rare D S V BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT B-0.5.CIA4......... ............. L V BUILDING INSPECTOR has permission to erect .......................... b ings on A...�1A�... �............... Foundation .. • Rough E; to be occupied as &ro. „t4. ... . . N .. .. .. .....4 a,s�.11 ...... chimney provided that the person acceptng this per, shall in eve respect conform to the terms of the application Final on file in this office and to the provisions of the Codes and Laws relatin to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. . , p PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building.Regulations Voids this Permit. ��%fta j 4)j p�� ® Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS G®NST TI® Rough Service .. ........ Final BU �6�ATOR GAS INSPECTOR Occupancy Permit Rgguired to Occupy BuiidiuRough 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. Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ TanningWassage/B ody Art ❑ 8whulningPools ❑ well ❑ Tobacco Sales ❑ Food PackaginglSalcs ❑ Private(septic tants, etc. ❑ Pennanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConnL1Gt10nISi nature & ®ake Drivewa Permit DPW Town Engineer:eer: Signature: Located 389 Osgood Street FIRE DEPARTMieNT - Terrjp,Dempster on-site -yes. o Located af',1.24 MainStreet - : Fire$Departmen sign-date COMMENTS o�c, r C �d T ':`- .:; er" 9 �+U VV �1 t. C� a l � ' C ,. � A203 2 EXISTING STAIR EXISTING STAIR E - Zti r ; � CL Azo3 CCSMMQN77, 2 Azoz �M FAMILY ROOM UNIT 1 s ��i , f?AICfTION' L NEW SMOKE AND CARBON MONOXIDE DETECTORS;TYP.IN �} x .•.• �, ,� , c. y' ALL UNITS. EXISTING STAIR 1 32 VU X k O 4 vu l vi�Ovv A2o2 NEW PARTITION EXISTING PARTITION 3�i r AREA NOT IN SCOPE SMOKE DETECTOR CARBON MONOXIDE DETECTOR 1 PROPOSED BASEMENT RENOVATIONS z� 118"=1'- BOGDAN ANDREYKIV No. Description Date a CONCISE DESIGN GROUP 1 PROJEC7RENOVATIONSET 06.26.2016 PROPOSED BASEMENT PLAN o 7 KENT STREET#4 2 UNION STREET,N.ANDOVER,MA project number 16.001.02 0 BROOKLINE,MA 02445pate 160808 Al 00 _ 617.285.0872 Project Title Drawn PROJECT RENOVATION SET Checke y Author hecked by Checker Scale 418"a 1'-0" � m NORT11 TOWN OF NORTH ANDOVER F;°4� �"w eMooaOFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 4 °'� North Andover,Massachusetts 01845 ��SSACHU`�e��y Telephone(978)688-9545 Gerald A.Brown Fax (978) 688-9542 Inspector of Buildings HOMEOWNER LICENSE EXEMPTION Please print DATE:_ JOB LOCATION: , �ar f 'v S11 Number Street Address Map[Lot HOMEOWNER �d � iS/ �GC/Z� �f`�! � velo 72 31 game Home Pho e Work Phone PRESENT MAILING ADDRESS ve IA,-Wo Gee lz- 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 and that he/she will comply with said procedures and requirements, HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIA u Revised 10.2005 Form Homeowners Exemption 9530 HEALTH C88-9540 PLANNING 688-9535 BOARD OF APPEALS 688-9541 CONSERVATION 688- The Conanolrlvedth Of Aftissaeltusett Department oflrrllustrlalAccielents 1 Congress Street,Suite 100 Boston,MA 02114-2017 ►vivev.nrass.goy/ilia Workers' Compensation Insurance Affidavit•, Builders/Contt•itetors/Iillectricians/Pluinbers. •:t'O BE FILED WITH•I'IIE PERMIT17ING AUTIIOIZX'I'Y. Applicont Information p Please Print Le lb1 Name(13itsiness/Orguniratiorbgndividual): Address:.,,_- City/State/Zip: 1AIA9 WP /W,4 Pltane# Are you a1 employer?Check Elie appropriate box: Type of project(required): I.0 1 ant a employer with (full and/or part-timo).t 7. Q New construction 2.Q l am a solo proprietor or partnership and have nu emptayecs%"Eking for mein R, Q Remodeling �jawjnn capacity.iAto walkers'comp,insurance rewired,] 9. F1 Demolition hamcowner doing nil work myself[No workers'camp.insurance required.]t 10❑Building addition 4,Q I am a hotucowner and will he hiring contractors to Conduct all work on lily praperty. t will i 1.❑Electrical repairs or additions that all contractors either have workers'compensation insurance or asol re e proprietors with no employees. 12.Q Plumbing repairs or additions s,E]I am a general contractor and I have tilled the subcontractors listed on the attached sheat. 13.Q hoof repairs Tticsc slab crnmtractars have employees and have workers'comp.insurance t 14,❑Other ___--_ (,Q Wo are a Corporation ami its oMcers have exemcised them right 0f exemption per MGL e, 152,§1(4),and we have no cmployecs.(No workers'comp,insurance required.) 'Any appl(cant ilial checks box 11l must also fill utit the section below showing LIiCIC 1M1Ylrkefs'Canlpensatton policy inf0fluatlon. t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a ttcw affidavit indicating such. tContractors that check this box mast attached on additional sheet showing the name of tine sub-contractors and state whether or not those entities have employees. It the sub-contractors have employees,they must provide their uxrrkers'comp.policy number. I erre err ernpinyee'that is Irrav7d}rig trnrlrerx'corrtpurrsatlnrr lrrsrrrrrucefor rtry erlrproyees. Below Is Ute policy alaiJab site Worn:atlon. Insurance Colnpany Name: - Policy#or Self-ins,Lic,l/:.,,__.._.r __ -___..._.____� Expiration Date: ,f M.._.-_�_._� t Job Site Address.. - —Cit /StatelZi � ` , ' y 4 �L Y p=_..._ Attach a copy of the workers'compensation policy declaration page(showing rte policy number and expiration date). Failure to secure coverage as required under MGL c, 152,§25A is a criminal violation punishable by it fine tip to$1,500.00 azul/or one-year imprisonnicnt,as well as civil penalties in the form of a STOP WORK ORDER and a fine of tip to$250.00 a day against ilia violator.A copy of this;statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I v ragev ificatti rr. Ebro pains r td p altles of petfrrry Ural the lrtforniallon provlrlerl above is biro marl correct. Sin it • � 11110110M - Offlelal use only. Do not write ire flits area,to be completed by city or fown official. City or Town: Perniii/License fit issuing Authority(circle ono): 1.Board of/Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector G.Other Contact Person: Phone ti: i i I