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Home My WebLink AboutBuilding Permit # 12/6/2016 pORTN BUILDING PERMIT oFtztEo aq TOWN OF NORTH ANDOVER 32 APPLICATION FOR PLAN EXAMINATION ' opgo Permit No#: 04aO�RTANT.: � Date Received i RSSACHU`'E4 Qate Issued: Applicant must complete all items on this page JOCATION Print PROPERTY OWNER � -3- print "160 YearSKructuee yes` nQ MAP.1 'AROEL._ ZONING DISTRICT.`. Histone DisEnct yes Machine SISop Village ym no TYPE OF IMPROVEMENT PROPOSED USE i�CK1O idt Residential Non-Residential 0 New Building ( ane Family 0 Addition 0 Two or more family ❑Industrial 0 Alteration No.of units: 0 Commercial 0 Repair,replacement 0 Assessory Bldg I 0 Others: 0 Demolition 1 0 Other 0Septic 0 Well 0 Floodplain 0 Wetlands 0 Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: /PNl D ADY-k( ►C Phone: tt Address: le WI UG�4 i NO /VQCHa �i Contractor Name: ��1 E ice'14 A�51P-hon C{;1 ltd K. Address:'1ffg 6-Lew,0140 A-0 A 0 IC?-2-1 Supervisor's Construction License,-0901 Ct 3 Exp. Date: J a Home Improvement;License:' ©� 5 Exp. Date:: ' �f ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERUIT:$12.00 PER§9000.00 OF THE TOTAL ESTIMATED COST BASED ON$225.00 PER S.F. rotal Project Cost:$ SQ slc� FEE:$ Check No.: ` J ReceiptNo,: NOTE: Persons contracting with unregistered contractors do not have access to the guar anfj7 fun Signature_ofAgent/Owner �s _ Signature of contractor 'T'own of Andover No. W61- ��14 - W, *a �0h ver, Mass, A� ^ . 1. 7q Areo PPPK.(� aS tI BOARD OF HEALTH Food/Kitchen PERMIT T ILD yy. /� 1 e Septic System THIS CERTIFIES THAT..[ .A.C.k.11'.!�..�.......lz.0.6.�!!:.Q.V.. .. .!�. .C.0 O BUILDING INSPECTOR d la 1,,.",.'........... Foundation has permission to erect..........................buildings on.....1..�....4�!!.�...�.�.......�!+.../. t Rough to be occupied as.........o!3'�4 tt�........IL�J.� a..............! ................................ 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 CONSTRUCTI TARTS Rough Service ........ .... .4.1(-................6 BUILDING INSPECTOR Final 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. I �N .9,AZ Ali- 090) (Jl„80) let i 1 O'Z € t '? I 1 t i spool � O. it — t� t CKs_ 1t��tt �Cit �e1� ti89 0 �drJ tov {y r. tit j WOOD STOVE INSTALLAI]ON CHECKLIST ri a Permit A building permit is required for the installation of any sold fuel burning appliance.The building permit and installation Inspection are limited to the stove installation and not to thestove construction. Stove - 1 A.New Used B.Type/radiant A Q1 Circulalblg C.Manufacturer y i ab.No. � Name/Model No. T Cnitar siz Dimart`sianslHaight _I_ongth T Width l Chimney A.New r .. _Exisling - - S.Size(flue area) C.Other appliances attached to flue(Number and flue size!_ 0''Prefab(Manufacturer—name and type) �t E7�G8�StOS E.Masonry/lined _..—.Flueliner a Unlined F.-Height(refer todiagrams) cap � ovER p l�lot ( I Q4'E.- 12'1 Nut � 2 f. MIR 4 MIN. Z rt!!• T UtN. '31 zi- ytCE) HEARTH CHIMNEY HEIGHT Hearth(non-combustible) A.Materials B.Sub-Moor construction -11-4 Ft 0 VINO C,Minimum dimensions(refer to diagram) t Clearances and Watt Protection(see stove installation clearances chart) A.Type of wall protection provided S f4v !Lftitl t^s4•� S:Clearances(refer to diagrams) - - - 1 FIREPLACE CORNER WALLlCENTER fihe commonwealth of Alassadiusetts _ Department ofZndustr'ialAecidents I Congress Street,Suite 100 Boston,MA 02114-2017 vvww.mass.go P1dia �gflkers'Compensationlnsaranee AffidaviP� r� A aetrieians/llnmbers. T BEFIGF+DwrI`El „MeasePrint L •'bl A� A"licantlrrformation i Namo(Buri omiocguiizanon/Iadivida l): . AddYeS3: CitylSta elZip. fid`ff tl)(j ltt2{Phone#: 'v ,Iiea ro riatabos: Type ofxpraiect()VegaiYed): �yon an exnpIoYez'-Checic` RB R I. famaemployer with_-, ___ p3oy:,es(lull andlorpaittime).'` 7.[]Navr'cnnstrncifon andhaveno amployses Woddng formein $,❑ ❑Re1TfOde]7Tig r—(I am ostia pmprietorar partnersbip 9.II Demolition any capaesty.[I3owaTkers'camk.iusnrance required.] 3.❑1—�ho neon-•uPs doingall;vorkmYsa7f.[Nn woakers'�mg.iasozanceZecvkid.]t 10❑Building addition 4.0I am ahameewnea andwill beh;xing contraa!urs to condnatall woric onmypropedp-'wilt 11❑FIectriaal repairs or additions er�mathat atl coatrac�ors eiSrerhavawarkeas'comPensa`tion insucanee or an sole 12.Q.p(umbing repairs or additions pzopxietoss withno esployees. ''.. 5.❑I am agenexal co-niractorandI}xvehiredthasub-conkaafors lisiod onf6e atrached sheet. 13.QRoofrepairs 'Ihesesnb-contraetors]saveemployeos andhaPewasker•'comp.insurancet 14.�Other' . o`.❑We axe aaoxgordionand itgaRlaemhaYa exrscisadtlaeirrignt oi'exemphonperMGL e. 152,§I(4),and'we have no amplo'yeas.[No workus'comp.insmanae regimad.] . *.�nyapplicantthat ahea} lwz#I?uu§t slsb a. at to.s tionbelowshowing*dreirwarkers'compenrnti�.poIIcyin£omration: .Homeovtnerswho submi ttd.?,:F£idavit md'� e3'aze doing all xnrkand Stonhire ociside contractoismust sibmitanewa ore enitres,'agav tContracters th,,t aheokihis I%i must at'.achad'an additional sheet showingthename o£the sub--ft—b amp(ogees.Iftha sub-rnnhactors bane ampleyees,tSey mutprovide then wo kCW comp.Pc Hey . Zam an etnployet t&at3sgrovid rgworkers,compensation insrarancefor my erVloyees. Betow r tlzepoZicy andjab site information. Insluanoe Company Name: I-k—,"Ohm FxpirationDate_ Polioy#or Self-ins.Lic.#: z 1 r � , � � �•� t'�" t`Jy� l��b✓��'•.city�stat:�zin: N�'2zt-� a��c',�IZ rpt Sob Site Address: showing the Policy number and expiration date). Attach a copy of the workers'compensation polity dedaratxonpage( Failure to secure coverage as required under MGL e.152,§25A is a criminal vil3Mon puni%bablo by a fide up to$1,500.00 dayJag oa nst the imprisonment,cpY s well as Givil oftb s sfiatementnmay be forwarded n the Ofd a OfTnves tions of tho DIA for nsuranc a covexage verification. £do hereby Gerd r epa ns andpenuZt es ofperjury tizat t72e infonnadon provided above r true and correct Date' j Si afore: Official use only.Do not-write in ibis area,to be conpteted by city or tortvn off tial. PermitlLiconso# City or Town' LsningA.uthority(circle one): I.Board of wealth 2.Building Department 3.Cityll'ovrn Clark 4.Electrical Inspector 5.Plumb ng Inspector 6.Other Phone#: Contaet Person: