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Home My WebLink AboutBuilding Permit #083-12 - 111 FRENCH FARM ROAD 7/30/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 12 Date Received 2I111 Date Issued: 7ZSL IMPORTANT:Applicant must complete all items on this page LOCATION `` Print � PROPERTY OWNER �t`�`e- JC:.� � Unit# Print MAP NO0360 PARCEL:00 9 1 ZONING DISTRICT: Historic District yes 0 Machine Shop Village yes no 100 year-old structure yes no 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 ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑Floodplain 0 Wetlands 0 Watershed District 0 Water/Sewer DE�CRI\,L' ON�OF WORK O wT�E p, t�X ' &.iegw2 L Ay�c (Ideflification Please Type or Print Clearly) OWNER: Name: Co. ekw.e. Phone: CPS000- `771 01 Address: Cey�cln t�� ' ��, VAh�W4_,_ iy4 CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: 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: $ 9000 FEE: $ /000- Check No.: / 72 Receipt No.: a 1yz a NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owne&4—S LLk-5 4- Signature of contractor r Location No. � Date „oRTM TOWN OF NORTH ANDOVER 3?0••,`•o •• 0 * _ ; , Certificate of Occupancy $ CNU;tt�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 2 !,, 'Building Inspector 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 DATE REJECTED DATE APP OVED PLANNING & DEVELOPMENT Elja '�/d // COMMENTS �ePfrexl ZO e - /vO 9;� lre r CONSERVATION Reviewed on Signature ` COMMENTS YJ b � ) LNL\ ( OE� F54,u.L w 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 Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ 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 ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ 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 ❑ 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: Doc.Building Permit Revised 2008mi FORTH TONM Of oAndover .. No. 0OV3 E` LAKE O• � � lover, Mass., '7/y �COCMICMEWICK A. 7�AERATED ti BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System n BUILDING INSPECTOR L � THIS CERTIFIES THAT.......... �'*`��.�'. '��...-�c..... l.�..:!/ ..................... Foundation .may pQ has permission to erect........................................ buildings on ......................................................... .................................... Rough to be occupied as �y lz ��- Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 CONSTRUCTIO TARTS Rough ......................... Service ........................ . . .... ............... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIRE Smoke Det. F-- µoRrH TOWN OF NORTH ANDOVER 6"o OFFICE OF a 0 CL BUILDING DEPARTMENT q 1600 Osgood Street Building 20, Suite 2=36 �y�$q,np:•^{ts North Andover,Massachusetts 01845 0 SgG►+uS Gerald A.Brown Telep one(978)688-9545��' � Inspector of Buildings Fax (978)688-9542 HOMEOWNER-LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE:_ _, I JOB LOCATION: III -YY6-1G R:4r V1 Coco( Number Street Address Map/Lot HOMEOWNER(b{ Aeflf/ e kly)i � . �� Dix ;R Name Home Phone Work Phone PRESENT MAILING ADDRESS �y4+) 4A�L%Q _ "YY City Toon StM+e 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 Awns 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 OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 - I North Andover MIMAP 111 French Farm Road July 1, 2011 -w-f- .7 .......... 035.0- C 035.0-0075 035.0-0076 035.0-007 035.0-0078 035.0-0079 035.0-0074 149' 15 7' Int' 151' 152' 150' French Farm Road 156' 15v,' 153' 165' 35 0-0090 035.0-0089 035.0-0088 035.0-0087 035.0-0086 035.0-0085 035.0- 8-, 035.0-0005 035.0-0004 03 .0-003C 035.0-0038 035.0-0011 035.0-0051 035.0-00577 035.0-0040 —Rail Line Wetlands Interstates Exempt Lands Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Interstate WSP Z neA Meters Data Sources:The data for this map was produced by Merrimack Major Roads -0 Roads WSP-ZoneB 14ORTst Valley Planning Commission(MVPC)using data provided by the Town of Of,,,go North Andover.Additional date provided by the Executive Office of Ci Easements WSP_ZoneC Envlronmental Affalrs/MassGIS.The Information depicted on this map is C3 MVPC Boundaryfor planning purposes only.It may not be adequate for legal boundary O la definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER 0 Municipal Boundary ~ MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING 0 Watershed THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Watershed Sub-basin ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF 0 Parcels THIS INFORMATION Hydrographic,Features Streams Floodplain 0 100 Year Floodplain 106 ft f-:500 Year Floodplain North Andover MIMAP 111 French Farm Road July 1, 2011 r�'W ti•' .` Hrench�l?ar R adj fr , r T* • x ` ff .w r . 1 ty Interstates —Interstate —Ma)or Roads Hodwntal Datum:MA Stateplane Coordinate System,Datum NAD83, Roads Meters Data Sources:The date for this map was produced by Merrimack C.Easements f ,NORTH Valley Valley Planning Comm,salon(MVPC)using data provided by the Town of c »�, North Andover.Additional data provided by the Executive Office of C3 MVPC Boundary ? ��t� �6 OO Environmental Affairs/MassGIS.The Information depicted on this map Is Parcels •;' L for planning purposes only.It may not be adequate for legal boundary -•-• '` A definition or regulatory Interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING ♦ - A THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY f t ^ ♦ OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT 'w off+ v ♦ ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION SSA�MUSt 1"=106ft CERT( FIEG :0LC- ALA�.1 � 5 . LOCATED 1I-- NO R-TH ANDoy F M/� ::S"CAI..E ►''� DATE � � - z� - 84 .'GHRISTIA!`1SEJ�J F-KJGIQF-ERIKJG IUC. ;KEIJOZA A\/E . HAVERHI L.L_ MA. • �. +":,'.:�::r 4 9.41 _ _ �� N L OT K- O C-1 27 35+ - F-Y.5ITINGs &C01'r 7/ o L .� . GILE N 9No. )2 F_ TE N S U 1V b5.1-7 tZ E tvc 1-4 t=P\, 17 CLI ENT i CERTIFY THAT THE OFFSETS SHO\VKJ ARE FOR THIS LOT E3UILOfQG 5HOWQ GQ TH15 ZOQIKJG OETERMItJATIOKJ IS Na' 11.1 PLAI'-J COUPORMS TO THE ONLY A1.10 ARE t,JOT TO BE A FLOOD ZOKJIkiG BY LA\vS CP THE USED TO ESTABLISH PRO — HAZARD `rc�wnl pF NC)I;z ANDovF- R PERTY LIKJE5 . ZOKJE. — DATE: -7- z5 -84 CERTI FI ED .0LC:-7 PLAKJ MAR 15 LOCATED 1� NQRTI-; AN D0 F.f2 M/> . :SCALE I'' 40 ' DATE - Z - 84 `.;'.CHRJS_TIAKJSEI,.J E.KJGIKJEERIQG IQC. A'VF . HAVERHI LL MA- 2i 93, g 0 I " N L CT Lo T 25 �aafo 0 Z7 E •-� Z�CA(m CQ U DWELLIN(o OF sco II o L. a . GILE N �" SURv N J i [Z E N x. 1-4 t=P\ CLI EKJT I CERTIFY THAT THE OFFSETS SHO\V/ j ARE FOR THIS LOT E3LILC)IQG 9k4C)\\/Q C)Q THIS ZOKJIKJG DETERMINATION IS NOT II.J PLAIJ COQPC)RMS TO THE ONLY AQC) ARE KJOT TO BE A FLOOD ZOt JIQG BY LA\vS OF THE USED TO ESTABLISH PPO — HAZARD ' F0wnl pF No27t-1 NMDOVF 2 PERTY DAT -7- Z 5 - 4 L I►�!E S . Z.O KJ E . } �--- E Y atln1�v is Jcil cA c ��t.� •�+osc��t1� CIVIZ)II y F7 of x� 77777777 ------�. v �� os vo NA tea`' y �•o ,,'Il