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HomeMy WebLinkAboutBuilding Permit #312-15 - 101 SHERWOOD DRIVE 9/25/2014 NORTH BUILDING PERMIT Q�tSyED TOWN OF NORTH ANDOVER F0 2t APPLICATION FOR PLAN EXAMINATION * ,� Permit No#: Z-- Date Received �P" gSSACHU`��� Date Issued: Z� IM OR ANT:Applicant must complete ll items on this page LO-CATIONS - nnt' �- -- - - -� PROPERTY OWNER, l-_ _— y Print �� _4 100 Year structure yes. MAF ( c!- °PARCEL (� ZQNING DISTRICT _ -Hi`storc District yes �In Machine ShopVillage? yes 4..�.m_-- _ - TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building eOne family ❑Addition ❑ Two or more family ❑ Industrial 2'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic, Well ❑ Floodplain, ❑Wefl._ands 0+ Watershed istnct ❑,,Water/Sewer: YJIL -- DESCRIPTION OF WORK TO BE PERFORMED: � I 46 Identification- VleasYType or Print Clearly OWNER: Name: Phone: Address: Contractor,.{Name Phone:_/ Address: r,`z/ CV1 t4n-k S _C2 - - Supervisor's ConstructionLicense. G_S `o�a/� Exp. Date: Home ilmprovement,License: __� .�d g ffi_�� -_ - 'Exp pate: 9? f� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �b oo FEE: $ Check No.: Receipt No.: � NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own 1� Signature of contrac rte _mt i Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑. Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed onSignature COMMENTS HEALTH Reviewed on Signature x ,r:OMMENTS �J� 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 FIRE D'EPARtTMENT' Temp+bumpster on site ,yes Located at 124'Main,Street FireDepartment signature/date jC0MMENTS I Dimension 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 requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) s W)6✓'T -e-w, rr 4:6-t�al c . ❑ Notified for pickup Call Email 3 Date Time Contact Name Doc.Building Pen-nit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. a Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) t ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit D Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location/W '-- No. q �S � - Date v c r . - TOWN OF NORTH ANDOVER e Certificate of Occupancy $w Building/Frame Permit Fee $� .� n Foundation Permit Feb $ ' � Other Permit Fee $ TOTAL $ Check# _ 28069 � uilding Inspector -The comp monived1z of ffassarOusetts Office of.Aves igations 600 Washkgtoxzriteet Rostov,1A 02111 WQxk,,0x,q't ompomatio:ra bguxance. xcl-avit:J n c erg,ICo ac ox l icy re czax l' ixso iex ,(�.ppixcab.� Namo(Br�siztessldzganiaation/nd idva : �r-e�/`v �d, �i-©U ��� Address: 5�y Ci Ce, IM)ASS OIYNI mono it. Ara you an emPloYer?Check the aWroprzato)box: Typo ofproject(xeguixeco).' 1. am.a employer with_- 4• E]I am a general confxactor and I 6, []-New constxadloA e ( rllandloxpax time}.T ha�venod�the sub-contract�a mployees li7. axemadeling 2.��am.a st�lepxopxietox oxparfn.ex~ ned ontha atcaed sheet ch ship and`havena.employees These mb-comxactoxshave S. []Demolition. woxl g foxme iu any capacity. workers'comp.insurance. g, �]Building addition ENO worl<exs'comp.insurance S. ❑We axe a coravo oxatioxo ancieir At]Electricalxepairs ox additions xec,�uixed.I o�zGers have exercised.theiz� light or exem tion ex GL ll,. [1'lumbingrepairs or additions 3.Q X am a homeowner doing all work . p myselr'.uloworltexs'Gomp. c.1.52,§Z(�},andwehavon.o t�,�]�.aofxe�airs . ixlsarancexecluized.� employees. ItTowoxkexs' 13.[]ptliex comp.insnxance xegaired.� A applicancthai checks box ZrnusEalsoillonxfbese�Eionbelogrshoxingthe vtorkers'compensat[ou.pagyinfomation. affidapif i Homeov Hers who submit this aifidavitmdreafingihey 'to dping allworlt andfhenhire outside conira�fors muss sn7�m anew i�dicaii$g srzc&, x�oniracfors�,ha�c7�eckflus ho�mUs�af�ached an.additional sheeEsho�2ngtheuamo of she sulk-coAEracfors andthei�workers'coup.policyinfomiaiion. ctrl exn �ayNt�icr � avicir�g7oe 'co�npelaatxonznsr�racefbxxr�yernployees;, SeTotvrz�iepalacytrjoa, m in,�oamatiorz. lsr suxauee CompanyName;. �o7icy r or�e�"-ins..�xc.#: E�pix�tlonDa�e: .. Iola�ite.A.ddxess: City/State/.gip. ' Affadx a copy cif t ewnxSxers'compensation.ToRcy declaration page(showing•thopolicyunmher aunt exflixati00[late}. y'aITUre,to secur covexage as xeclnixedttndex Section 7,5A ofMGL o.152 can.lead to the impositiaxc o�cximinalliexiaXt[es of a fie up to$1,500.00 and/or oxte-yeax imprisonenEx aswe eivilpenalties in the foam o7 a S�Og Vv ORIS ORDE7 an d a Fate ofvp to$250.00 a day againstiho violator. Be,advisedthat a cagyofft stateMentxnaybe foxwarcledto the 0face-()f• Investigations cfthe M i ox insurance cov'exage vexificatien. Otto lZe e y cer zf uric e tXz4aing ce.�4enaf ieg o v0 jrlxy tXia rZe i o axiox�,provic�ec�a roYE zs z cine ant correez`, Madure Date: phone#: O ielal use oilly, .Do r 0t viie Al 61S area,to be coxaz Ued by city of form o�eic�I CUg or ,'own: ermzt/Licezzse# fssaing.c nthorRY(circle one): 1.Board of 7ffealtb.1`.BrxildingDepartmed 3.Ci1YMOTM Clerk 4.WeetricaUnspectox 5.VHMbh'93 tspecfor 6.Other. Inform tion and fastructions Massachusetts General saws chapter 152 xe , Puxs g�ir�s all employers to pxovzdewoxkexs emPwation sok Eek emPZoyees. t7arit to this stafate,an ern,pToyee is defrtned as",.,evexgperson hi fhb gardce of another under any contract ofhixe; • express orimplied,oral oxwxitten." An.er lays defined as"anindividual,paxinexshfp,associatzoxt,corporation ox otherlegal entity,ox anytwo oxxitoxe. ofthef`dxegongengagedinanointenterprise,and iucludingtzelegalxepxesenfativesodarleceaserlein RIO yex,.ortbe receiver ott7zstee o an individual paxtaexshfp,assn ciation ox other legal,entity,employing employees. xowever the owxteroi adwe7lingbousehavingnotntoxe#ba�xthree apazEments andv�baxeszdesiltexein,oxthe occupanfofthe dwo"ng house ofanother who employs,persons to do maintenance,consfxuction oxxepaix wo*on such dwelling housse aronthe grounds orbuilftappu�enamttheretoshallnot because ofsuch emplopxnentbedeemedtabemploye MGL chapter 152,§25C(6)also states that"every sfate or total 9c-ensing ageney,shall wit&kold the issuance ax renewal of a license ox pemft to operate a hushless or to construct haffftgs in,the eon MDWealth for any applfeabt who has xtot produced.acce�ttable evzdeztce of compliaxtee with the hzsuxartce coverage xe�; zxed;' Additionally,MGL chapter 152,§25C(7)states"Weither the commonwealth nox any ofits political Mb(61, shall enfexinfo any contract for the pexfoxmance oi�pubHowotkuntil acceptable evidenoo of compliance with the xnsurmce requirements oftbfs chapterhave been.presenfed to the co afracting authority," Appliemtts Pleas 0PH oil f.the workers'compensation affidavit completely,by checking the boxes that EpI)fy to yoDr situation and,if necessary,supplysub-conftactox(s)name(s),addxess(es)andphono.number(s)along with theix extwcate(s)of insuxauce. Limitedf fability Companies(LLC)orumitedLiabilftyParinexships AP)vTithno employees othexth m the Members oxpartners,axenotretlaixadto caryworkexs'compensation.fi=u nce. IfanLLCoxLTI'deshave employees,a olicyisxecluixed. Beadvisedthat a,Mdavitmaybesubmitiedfo;hel7eparfinentof Tudustrial [�cciden iox cont tm&n.ofinsurance covexage. .�,7so See luxe eo si and date the of clavi bexetammcdtothe city ortown.t ef.M6applfcationx"oxfhepem1itorlfaenseisbeingxeeluesfedyxto tbeDe affidavitshould of WusfralAccidenfs. Shouldyoahaveany quesfzonsregardingthelaw oxi youaxexeclaimdtoobtainayTattno' compensation,polfcy,pfeasecall a epaxfinentatiltenumberPubedbelow: Self~' ecleo self insurance Rcense number on thea xo xzate line, rn�trr mpani�should enter their PP P City or Tom Officials Pleasebesure thattheafitdavitiscomplete-audpxintedlegibly. TheDepaxfinenthaspxovidedaspaceatthebottoxn of the adavitfoxyeutaIl outinthe eventfhe Office oxSnvesfigafionshas to confactyouxegardingthe apvlican Pleasebe-suzetoa�Itin.thepe�t/Ilcensenwnbextvhfcb.willbeusedasaxeiexencenutnber. Zvaddztion,an,aPplzcant tliatustsubmitmultiplapermif/1zcee a licaons in an ' e PP iv n ear need y g y onlysubmit o z ne d olxc into cc affidavit culZe2tG P nnaizon » g Gy ( necessary and under JoTa Site - �� ) Address the app7icantshouldwxzfe alllocationsin ,�(cityox town)".�:copy of'tlie aiddavftthathasb�en o�ciallysfainped oxmarkedbythe city oxta�vnmaybepxov-ided totlte applfcant asgboftbatavalidafrtdavit. onfde�'ox�5xttuepermiisorlfcenses. nevi aif�zdavitmustbeftiledouzeacb Year.MUD a home owner or citron is obtaining a license ox-emlit not e Ili (Le.a doglfcense oxpexmitto burn leaves etc. s ' p x lafedto anybusiness ox com7nexcial venture azdpersonrsaTxequirecltaaompletetbYsafdavz: The Office of Investigations W'OWd Eke to that&-you in advanca,fox youx cogpexaflon and should you have any gtxesfions please do uo hesitate to give m a call. _ , ' TfLaDepartment's address,telephone ai.d faxnumber, ne,Ow-Mon.w.ce t 0 "P e Oft-a 600 Was&nQla. xe Td-0 617H77- ,4900 Q 40,6 Qx 1-877MASSAM Revised 5 2605 FR# - www maw,gQvf(ia Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 1,5,,{,0,00.00 m $ - $ 180.00 Plumbing Fee $ 22.50 Gas Fee 100 comm. $ 1.00 00 Electrical Fee $ 22.50 Total fees collected $ 325.00 101 Sherwood Drive 312-15 on 9/25/2014 Finished Basement to Code NORT#1 Town of ncll" over No. * _ 1 � sh oLAKI h ver, Mass, CC)C we"t CK 'L1,9 A°R�reo �PP,�gS S U BOARD OF HEALTH Food/Kitchen PER IT T Septic System THIS CERTIFIES THAT .......... �ri .�i/............. w.�.......... .,,,,,. ...... BUILDING INSPECTOR ccFoundation ' has permission to erect .......................... buildings on ...I.V..�......4?... 00viapA. .....D-Nj......�� Rough to be occupied as 6.191111� 'fi Illr.. ..................... ... 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 CONSTRUCT19QTA Rough Service ................ ... ...... ...... ..... ............... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall 1'o Be Done, FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. ju r�{L0 Q�7?�)71Y7�;YIJ6Q 11 Ci,V'��{cvmaL1Wf JCffi 1. I I�F Office of Consumer Affairs&Business ftcgutahon ! OME IMPROVEMENT CONTRACTOR I" TYpe: egistration: 156608 m xpiration: 7/1812015 Individual GERALD GOULET, GERALD GOULET 54 MIDLAND ST g—= � LAWRENCE,MA 01841 Undersecretary Massachusetts -Depart - ment of Public Safety Board of Building Regulations and Standards Construction Super icor License: CS-072216 a GERALD R GOULIT 54 MWLAND STS + Lawrence N1A 01$41 Commissioner Expiration _ -- - 07/19/2016