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HomeMy WebLinkAboutBuilding Permit #180-2012 - 1260 SALEM STREET 9/1/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ✓ ��- Date Received 0 - 1 Date Issued: /1 YKIPORTANT:Applicant must complete all items on this page LOCATION ( Z�O S(�LZr'\ S1 • �o. �Od RIH/1 Q,�/}S 1JPrint PROPERTY OWNER D_A flr1 1 hMzQPPo< Unit# Print MAP NO: l t`I PARCEL: 61PZONING DISTRICT: Historic District yes no 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 DSeptic ❑We1T 'T ;TW Tan.�0=Wetlands` N ❑,Watershed District r DESCRIPTION OF WORK TO BE PERFORMED: t (Identification PAease Type or Print Clearly) OWNER: Name: urfP p, 6, Qr4lL Phone: Address:_ m© SA-Lt . 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$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. ov Total Project Cost: $ �i Oa© 0 CD FEE: $ ��-- Check No.: S Receipt No.: ;;2 � S 33 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 4Sianature of Adent/Ow;ger ,..� Si nafure of cont�ac�or- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools ❑ Tanning/MassageBody Art ❑ 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?APPRO ED PLANNING & DEVELOPMENT ❑ El— COMMENTS COMMENTS CONSERVATION Reviewed on Si nature . r COMMENTS _ r�..�LJ L — � S CC e HEALTH Reviewed on Si nature COMMENTS �71Z_ r / Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receiptsubmiited yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit th, 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 fn 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 Doe: Doe.BuiIding Permit Revised 2008mi Location /"2 n SA LPi7j No. ��D 00/1 Date NORTN TOWN OF NORTH ANDOVER pi�t� o .o�:yG 0 w A • s Certificate of Occupancy $ s,A�MUsEt� Building/Frame Permit Fee $ 30 oc Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # m 2 `T 5 6 Building Inspector r • •-ase 1 .. ` 1 "1 u► ' 4v c, .c NORT►� TO" Of over No. dower, Mass. • Y Q '- LAK � COCMICMEWICK 7,95 RATED P' 'C� U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR ............. .......... l•s . ..................................................... FoundationTHIS CERTIFIES THAT ...... .....z . ............................ . buildings on .. ..��. � .. Gly .....5 .............................. Rough has permission to erect.......... g � .... to be occupied as.............. ... ..f.:' „al✓'G. ....... fCl. .�.... � ....5 ..., ��......................................... 4' 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 f Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TARTS Rough j ........ .�G ............... 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. TBurner Street No. SEE REVERSE SIDE Smoke Det. t%ORTW 61 o O p COCMK«ewit■ �• �SSACHUS�� CONSERVATION DEPARTMENT August 25, 2011 Community Development Division William Czerepak 1260 Salem Street North Andover, MA 01845 RE: VIOLATION of the Massachusetts Wetland Protection Act (M.G.L. C.131 § 40) and the North Andover Wetland Protection Bylaw (C. 178 of the Code of North Andover) at 1260 Salem Street Dear Mr. Czerepak, During a site inspection to review the wetland resource area related to the building permit submitted for the removal and rebuilding of the front steps and stoop at the above referenced property, I observed unauthorized dumping of soil, stones and bricks within the 100' Buffer Zone to jurisdictional wetland resource area. According to C. 178.2 of the Bylaw, "No person shall engage in the following activities: removal, filling, dredging, discharging into, building upon, or otherwise altering or degrading the wetland resource areas..." including any 100-foot buffer zone. As such, The North Andover Conservation Department is hereby issuing this Violation Notice requiring that you cease the aforementioned activities within the jurisdictional resource area and remove all stockpiled materials by September 30, 2011 and relocate them to an area outside the 100-foot buffer zone or properly dispose of them off site (the town brush dump on Sharpener's Pond Road is an approved location). Please inform this department when clean up is complete. The front steps and stoop are near to or just outside of the 100-foot buffer zone on the opposite side of the house from the wetland and therefore the building permit has been signed by the Conservation Department. Please do not hesitate to contact me should you have any further questions or concerns in this regard. Sincerely, NORTH ANDOVER CONSERVATION DEPARTMENT Heidi Gaffney Conservation Field Inspector 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web www.townofnorthandaver.com North Andover MIMAP 1260 Salem Street August 18,2011 106. 106.4-0181 106.A-0182 .���' ,i,-•:c:.:-:_:-...:, /l 106.4-0175 106.4-0088 `t l `= 106.A-0179 -_ 106.4-0183 -ii"=:i 106.4-0041 106.4-0178 ,,i;. - 106.4-0180 " 106.4-0176 1 .A-011 All 106.A-0184 '. 106.4-0119 ' 106.A-018.5 .,_i 106A-0073 ♦ ` 106..4-0186 - .__:.. ♦106.A-0133 =•••�• '"-----A&•:=•• ....... 106-%x0134 106.A-0187 I' 104A-0040 du.:.:.. ♦ auu ...a, .:_ 1i.:.. 1 106.A-0188 -0148 al.(t. .:_:.••: OS� `eA ,A106.A-0074 06.0 _0 Gj ♦ 106.A-0158 ' 106.A-0122 ♦ 106.A-0160 106.A-0078 ♦ ,. 106-A-0159 106.4-0123 ♦ 106-4,0076 106.0-0067 ♦ 106.A-0161 106.A-0124 106.4-0162 —Rall Line Interstates Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —Interstate Meters Data Sources:The data for this map was produced by Merrimack Ma)or Roads NQRTH Valley Planning Commission(MVPC)using data provided by the Town of Roads Ct r�,�C North Andover.Additlonal data provided by the Executive Office of Ci Easements ? �s *� a Environmental Affairs/MassGIS.The information depicted on this map Is — Tralls3 Z for planning purposes only.It may not be adequate for legal boundary F 9 regulatory Interpretation.THE TOWN NORTH ANDOVER C3 MVPC MVPC Boundary MAKES NOOWARRANTIES,EXPRESSED OR IMPLIED,CONCERNING O Municipal Boundary t • THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY i ^y OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT D Parcels •o+� ti • ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF Hydrogrephlc Features .� o� v �` THIS INFORMATION •so C� Streams s$ACMUSE Wetlands Exempt Lands 1"=169 ft "�` r r• . The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/d'ia Workers' Compensation Insurance Affidavit: Builders/Contiractors/FIectri.cians/Plumbers Applicant Information n Please Print Legibly Name(Business/Organization&dividual): Address: City/State/Zip: No. A-9&,'k ,MIIF Phone#: 47 -5706 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its quired.] officers have exercised their 10.E]Electrical repairs or additions 3 Tam a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' comp.insurance required.] 1311 other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeovyners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new-affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DTA for insuran coverage verification. X do hereby ce 110y un e t a e alties ofperlury that the information provided bone is true and correct. Si ature: Date: Phone#: 03—19( 70(=, Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitUcense# Issuing Authority(circle one): L6.Other rd of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector ct Person: Phone#: V F- µORTH TOWN OF NORTH ANDOVER L OFFICE OF a ° CL BUILDING DEPARTMENT L � p^ 1600 Osgood Street Building 20, Suite 2-36 a North Andover Massachusetts Ol 845 �SSAc►+USE� _' ZL .GLC( o Gerald A.Brown Telep one(978}688-9545��'Y�'� Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERNUT APPLICATION Please print DATE: II JOB LOCATION: 1260 ST. Number Street Address Map/Lot IJOMEOWNER_ Lba:i,�ORM-E-PfflL q73-Z(-3-1865 6C6-"1--S-706 Name Home Phone Work Phone PRESENT MAILING ADDRESS 18 C''+y Tow n. St�te Ztp 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 under s the Town of North Andover Building Department minimum inspection procedures andnrirements and that ,- e 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 - ------------------------- ------------- 40-tv Of A/A i i j ....x,.�..,,,,x......�_..�����..���_���..�.�..�._..x.��.„x..�.......�xx.��...��.v����w..xx...�..�...�.............x���.x.....�..xxx...........i�.�x..��....ra...e�.x..v......x.....x........�x.........x....�.��...�.xwxxxxx...x.�....x�i..x..xx....x.....�...x..��x���.�������xx.�x.�..��.....x..x�..�..,,.....�.�..,..."....,.�����.��x.":_.�x�...�....�.............xx..�....x�..xxx. i i �6 i 1 5 �q-nl QRS } i 3 i i i i 2 P 3 3� E } z 4 i i 3 t E i i i i R ° i 1 i 3 i i t i i j i r i i i i � t •' lI 1 J a 1 i i 7�L1� , i � i 4 i 2 3 3 3