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Home My WebLink AboutBuilding Permit #1162-2016 - 120 MILLPOND 3/9/2016 BUILDING PERMIT o� NORrH "w- �t LEU 16*"IO TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION:! - 7D "v2�l� Date Received Permit No#: �SsgCHV5B��y Date Issued: IMPORTANT: Applicant must complete=all items orr-this-page LOCATION !I1 Print PROPERTY OWNER V 1�c Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes. no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ O0e family El Addition ®'Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial L4-Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _El ❑ Floodplain Wetlands ❑ "Watershed District Septic ❑ Well 0 Water/Sewer DE CRIPTIO OF WORK TO BE PERFORMED: e6r F Identi cation- Pleaseype or Print Clearly OWNER: Name: LU ll rV 'Grh n'-2. t--- Phone: Address: d ��; 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4 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/Cross Section/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 OTE: 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 Buil 'ng Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculat;ons (If Applicable) Copy of Contra. 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 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 e U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I CONSERVATION Reviewed on Si qnature COMMENTS HEALTH Reviewed on Signature COMMENTS I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes y Planning Board Decision: Comments c Conservation Decision: Comments Water& Sewer Connection/Siqnature& Date Driveway Permit DPW Town Engineer: Signature: �..- Located 84 Osgood FIRE DEPARTMENT 3 Street ,.� cTernp Dump ster on siteti,.�yesriot.. Lo ted at 1�2q Main StreetF �. Faire a e m�tiJ Dsi «� prtlnarye/da#.,�,e�.�,.,. ..y COMMET�S'i Dimension Number of Stories: Total square feet of floor area, based,i'dwExterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Deter location, mast or service drap.rsires a Electrical Inspector Yes No _ approval of DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA-- (For department ease) ® Notified for pickup Call Email >- Date Time Contact Name Doc.Building Permit Revised 2014 Location No. � y ' Date V711" • TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#+7'-'2 7 .30341 /'by lding Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 71400.00 m $ - $ 88.80 Plumbing Fee $ 11.10 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 11.10 Total fees collected $ 211.00 120 Mill Pond 1162-2016 on 3/9/2016 Kitchen Remodel NORTH F � own of ndover No. % h ver, Mass, COC N1C"IWICu �qS R�reo �Pa��S. U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ....................................................................//....................................................... d �fl� aU� Foundation has permission to erect .......................... buildings on . „e�?......�......................................... Rough to be occupied as 1..:.�. �ti�. ...................................... 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 CONSTRUCTIONS ARTS Rough Service .................... ....................................... 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. Ofi'' of�oitsumer Affairs&Business Regulation ' �fl IMPROVEMENT CONTRACTOR ' egistration, 120199 Type: 4 Expiration: 1111/2017 individual DAVID GULEZIAN i DAVID GULEZIAN 428 PLEASANT STS t NORTH ANDOVER,MA 01845 —�— I Undersecretary Massachusetts Department of Public,Safety Board of Building Regulations and Standards license: CS-001821 Constrticticn Supervisor -' DAVID P GULEZIAN frop , 428 PLEASANT STo l�" � NORTH ANDOVER MA 0184}5 Expiration: Commissioner 10/02/2017 y 0". 1�6 06:56a 7813735920 p.1 � KawrH 1 0 9 Town of North Andover Y } Building Department 400 Osgood Street North Andover MA 01845 Tel: 978-688-9545 CV10 �9PTION � 1 Please print. DATE G- S JOB LOCATION '1° � �" yvN I v-- • ` ^ , Q� v* �� Section of Town "HOMEOWNER C ° d` U� —J —- 3- �9 CSG NO ` �S Work Phone PRESENT MAILING ADDRBt �� State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow such c homeowners to engage an individual for hire who does notossess a license,se,provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which helshe resides or intends to reside,on which there is,or is intended to be, a one to six family dwelling,attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner'assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner"certifies that helshe understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures andM��29 ements. HOMEOWNER'S SIGNATURE �n,�^ ( � APPROVAL OF BUILDING OFFICIAL Note:Three family dwelling 35,000 cubic feet, or larger,will be required to comply with State Building Code Section 127.0 Construction Control. ;�y 0l'..1`6 06:56a 7813735920 p.1 V NarrrH, Town of North Andover • . Building Department --- 400 Osgood Street North Andover MA 01845 TeL 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Number Street Address Section of Town l7 t' "HOMEOWNER � h)m pa-)d _7TL—- 3--59 0C, Number Home Phone Work Phone PRESENT MAILING ADDRESS I A 17, .-� - N , City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six 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 109.1.1) DEFINITION OF HOMEWOWNER: 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 to six family dwelling,attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance 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 No,Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures anduirements. ' yn' HOMEOWNER'S SIGNATURE_'_) APPROVAL OF BUILDING OFFICIAL Note:Three family dwelling 35,000 cubic feet,or larger,will be required to comply with State Building Code Section 127.0 Construction Control. 697 East Broadway P 0 Box 497 South Boston,MA 02127 BALTIC INSURANCE •'�.' Phone(617)268-6030• Fax(617)268-7032 1 AGENCY, To:l 1c'-e'I4l 'Fra'J4 From: FZlxs79 (o 5 pages, Phones Date: Re: ❑Urgent ❑ For Review 17 Please Comment ❑Please Reply ❑pteps;o Recycle.''. \-,A ' I ' i► A 697 East Broadway•P 0 pox 497 South Boston,MA 02127 BALTIC INSURANCE , Phone(617)268.6030' Fax(817)268-7032 AGENCY, Fax To:/ I'Ex�/ C�r c�.I� � i� From: Fax, q (o ( 5 JL, paBeal Phone, Date: j ❑ Urgent ❑ For Review Q Please Comment Please Reply ❑please Recycle I i • I .