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HomeMy WebLinkAboutBuilding Permit # 11/16/2016 BUILDING PERMIT �oRry Q�,S41..ED Ig _'Y TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ o Permit Nod: ' . Date Received coc ,. �� . "� Date Issued: IMPORTANT: Applicant must complete ail items on this page LOCATION . Print PROPERTY C)WNER„ PHfit 1 o(7,Year S#r""acture yes na MAP .. -PARCEL,'/',7' ZONING DISTRICT: Historic District yes o Machine Shop Village yes - - ._......... -- - —------ 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 IiAssessory Bldg — ❑ Others: ❑ Demolition ❑ Other FJ Septic ❑Well ❑ Floodplain 0 Wetlands atershed District Water/Sewer DESCRIPTION OF WORK `i°Q DE ERFORIV1ED: � ate` , �t�_- � ,Jc%S _ - 7 _ _.._.- Identification- Please Type or Print Clete OWNER: Name. i C. 0-e_ ti S C Phone: � . � Address: Bri+tr- /ld®t aas t . 1 Contractor Name: P gon Ae: ddress: Supervisor's Construction License: Exp. Date. Home Improvement License Exp Date:. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BUL:°DI1V6 PERMIT:'$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. o al Project G st: FEE: $ . Check No.: _ Receipt No,. � NOTE: Persons contracting with unregistered contractors do not have.access to the guc rarity fund �grature of AgentlOwner °mm ___ Signature of contractor r� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ -Ty- 'PE'UF SEWERAGE DISPOx SAL Public,Sewer Tanning/Massage/B ody Art ❑ swfinming Pools ❑ wean ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Penmanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN 'OFF - U FORM PLANNING & DEVELOPMENT Reviewed OnSignature_ COMMENTS CONSERVATION Reviewed an I Signature COMMENTS HEALTH Reviewed on Signature COMMENTS---jqj �f� Zott; lg Board of Appeafs: Variance, Petition No: Zoning Decision/receipt submitted yes Plarhing Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Si nature& ©ate Drlvewa Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRL DEPARTMENT' - Temp Ddmpster on site yes no Located at 924 Main Street Fire Department signatureldate COMMENT -imension Number of Stories: ) Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop`,'requiires approval of Electrical Inspector Yes No ®ANGER,SONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) 1l IL I f _21 43) AN I e e. ❑ Notified for pickup Call Email ate Time Contact Name Doc.Building Pennit Revised.2014 F tjORTH own of ndover Q K try No. C, ��K. h ver, Mass, •� �� �L COC-91 MWICK jgs 44.r J"f�,��(5 U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT Y.JA.f..*.&........ `..,5 � BUILDING INSPECTOR has permission to erect ......... buildings on ..Au. Foundation Rough to be occupied as �� ....... Chimney ........ .... .............. ..,.......,.......,.........,........,........, . .....,................. provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT19WART Rough Service ........ ... ,. .....,................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. f rORTH TOWN OF NORTH ANDOVER �� �•iT`" �°6"4` OFFICE OF BUILDING DEPARTMENT _ 1600 Osgood Street, Building 20, Suite 2035 North Andover,Massachusetts 01845 4SS/l[HUS�� Donald Belanger Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: �.__ /9D 1 JOB LOCATION: j Q A W j A f tr 5+. /0 4e C 7 Number Street Address Map/Lot HOMEOWNER A/rhst,ef R1.:w1;,ez-- (97$) 49,-915-7&5'4 eel/ &3;729,59 Name Home Phone Work Phone PRESENT MAILING ADDRESS 15'a 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,provided that the owner acts as supervisor. DEFINI'T'ION 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. (7 90 CMR Section 110.85.1.2) 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 J � 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 IndustrialAceidefats N Cong�'�ss,5`t eet,xS`Oe 100 .Boston, _ �•F MA 021142017 www.mass.govldia a^M y�v 'workerComipen�satiorr�uauc6 Affidavit'Builder,s/Cantxactnxsl�+�ectricxa�slPZum�exs. s° TO BB FLED WiTHTAE PT�'RN�[T]1NG AUTHOI Y. Blease krint Le 'bl An ant or'mation usiness/di amz tionJxrodividwl): Noma CB g a ' Address: /9vg r /�j�av� ,M� •J8'SF�anc�: '7&' $'3 77 City/Mate/Zip: Axeyou an employer?Ch ecictIie appropriate box: Type op rorect(]required); em to eesfullandlorpart-time).* 7. Ne4�4doristii7Cf1o71 1.[J I a-a employer with p y 2.❑Iav�asolepraprietor orpart€�ersbipandhaYenflempioyees�lorksngfor mein g. nRe��lode.9 any capacity-P"Workers,comp,insurance required.] 9. ClD emolition. 3.�1 am.a homeowner doing all workmyselt jga workers'comp.insurancerequired]` 10❑Building addition 4.Q I are •homeowner and wsll be hiring contractors to conduct all work-my property. Twill 11,n Elee�04i-al�epalTs at ati ditios ensure that all con'traotbts either have workers'compensation.insurance or are sale � j :Plumbing repairs or additions proprietors with,no employees. 13.[ Roof repairs 5_❑1 am.a general contraotnr and 1 fiavelriredthe sub-couteacinrs iisEed ontbe attached sheet. ��� 'I'heso sub-contractors leave employees andhave workers'comp.insurance 14.1ther S,❑We are a corporation and its,offiic6m b,ve exereased their right of exemption per MGl,c. 14.1 � 152,§1(4),and ire have no�rupldyees.lNo workers'comp.insurance required] *Anyapplieantthatch.0?:;6b>'#j?nll�tiso outtheax blah rkandthunhireoutsideccontracozsmustsu[bmis ewaffidavitSndicatiaagsuch i Hameovvners who submit this affidavit indicating they tcoutractors that cher-kthis boi£must'attached an additional sheet showing the name o£#hascb-contractors and state whether of not those entit es ave employees. Tfthe sub contractors have employees,they mast provide their workers'comp.pokey number am an employer that isproviding 'or ers'corrzpensatio11 insurance for nay employees. Pelota is the policy and joh sits information. Xnsurauce CoxapaaryName: Expiration DOo, Policy#or Self-ins.Uo-if. City/State/Zip: lob Site Address: Attach a copy of thewgrkexs' coxMpensatiorrpo]zey declaxatiarzpage(slro�vmgthepolicyb beaairieuptn �500-00). bailuxeto secuxo coverage as xeclrxiredundexMGTJ e.152,§25Ais a criminalviolatzonpurrs y and/or orle year imprisonment,as-wbe fazvvarded ell as civil penalties iu the form to the of a STOP WORK of the DIA fox irasuran o a day against the violator.A copy of tbis statamoaxt:may coveraga verification. Ido hereby cert underr tlzepains andpenalties ofperjury that the inforrnatior2 provided above is ixue and,correct. Data: Si afore: Phone#: official use only. Do n0t-write in triis area,to be completed by eery or town official. ' �Erm�t/�rC0R5e�` City or To-WH: Issuing Authority(Circle oxre): cut 3.CitylTowa Clerk 4.Electrical Inspector 5.Plambintgbspector 1.Board ofI[ealth 2.BrxfldirrgDepartnr 6.Other Phone#- Contact Pexson�: Ponderosa Pines Shed Specs. 14 x 20, New Englander 4"x 4" pine post and beam wall frame 1"x 12" pine board and 2.5" batten siding 2" x 6" rafters, 24" o c, 10 — 12 pitch 1"x 6" roof and floor boards 2"x 6" ceiling joist 16" o c, 1"x 10" pine board ( loft) 2"x 6" p t floor joist, 16" o c with 4"x 4" p. t. runners (4 ) with blocking 4" concrete blocks 48" o c Arch. Shingles (30 year warenty) 72" double door, pine ( gable wall ) 4" header 2 — double hung windows 4" headers 2 — 12"x 12" louver vents on gable walls Hot dipped galvanized nails and hardware 2"x 6" p t ramp North Andover MIMAP November 7, 2016 103.0-0014 20 FERNCROFT CTR 103.0-0100 103.0-010 11 103.0-0031 135 SOUTH BRADFORD STI.," �rC/o 239' 1qq, 134 SOUTH BRADFORD ST 103.0-0030 103,0-0105 103.0-0013 103.0-0106 25 FERNCR©FT CIR 145 SOUTH BRADFORD ST /J 7 i 104.0-0008 120 WINTER ST 104.0-0007 i 10s, 192 WINTER ST 104.Ill 0-0010 104.0-0006 104.0-0005 202, 210 WINTER ST 263 1�sr 177 WINTER ST Wipter Stroet 151, 104.0.0041 187 WINTER ST 104.0-0094 104.0-0097 104.0-0095 104.0.0096 197 WINTER ST 104.0-0098 0 MVPC Be ©Mun€dpai Boundary Horizontal Oalum:MA Stateplane Co,riinale System,Dahl.NAD83, e Rail Line Meters Data Sources;The data far tha map was produced by Merrimack €nterslales AOR'rh Valley Planning Commission(MVPC)using data provided by the Tovm at •� Interstatetlf ij�%a ,4 gytl North Andover.Additional data provided by the Executive Office of Major Road = g6 a O Environmental A€fairs&!—GIS,The formation depicted on this map is RoadsC for planning purposes only,It may not he adequate for legal boundary O A definilion or regulatory interpretation,THE TOWN OF NORTH ANDOVER C.Easements }' MAXES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING ©Parcels it - rF THE ACCURACY,COMPLFTENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Hydrographic Features f ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR WSUSE OF qp<a<-•c.r.. Streams .� oydrsa„ ,�g THIS INFORMATION Wetlands SACHUS�� Exempt Lands 1"=85 ft ' 79 6- CERTIFIED PLOT PLAN Scott L. Giles R P.L.S. LOCATED 1N NORTH ANDOVER, MASS. Frank S. Giles R.P.L.S. SCALE:1"=40' DATF•3/17/2003 50 Deer Meadow Road North Andover,Mass. WF MC ALLIS oR 95' N/F DAWSON 0"E �: �,SSV�uT AREA S 580."-fi'? �....�- •-.�. f � � _ (Ell 0 ASSESSORS MAP-104C, REL 7 0 N PLAN#3002 N.E.R.D. . DEED BOOK#5931 PAGE# 43,681 S.F. - U � z c_v la Fron 6dl�r� � EXIST: SEWER G"Seotc- lire.�9'off Fpun66},vn _ m S M EASEMENT HSS GAP• u= ND. 2 26' 71'+� P co CJ1 � s 19 8.49 Ja-63'33" w 0. 83 ` N 57*25140"W .. . 5TR� YV WINTER Wrxftr51 0 csF� i-S s4 ire,-+, oak 4rcc F, 'CA o 'fro� ,S�-rcafi 1 CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE 0i THE OFFSETS OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY AND SUCH USE 1S FOR THE WITH THE ZONING S `� DETERMINATION OF ZONING , •15072 �4 BYLAWS OF NORTH ANDOVER CONFORMITY OR NON-CONFOWITY spq,AL WHEN BUILT WHEN CONSTRUCTED. Fr f;-