HomeMy WebLinkAboutBuilding Permit #205 - 127 BEVERLY STREET 9/13/2007 pORTM
BUILDING PERMIT "o
TOWN OF NORTH ANDOVER F
APPLICATION FOR PLAN EXAMINATION
Permit N0: �� Date Received 4`�
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Re ' ential Non- Residential
❑ New Building V One family
❑ Addition ❑ Two or more family 11 Industrial
❑ Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: 1 Phone:
Address
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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: $
FEE: $ 7.6 �—
/Check No.: . ,L
NOTE: Persons contrac ing ith unregistered contractors do not have acce s o the guaranty fund
S�gnatureo'cfontractor.
Signature of Agent% caner w.
Location &6&65
No. r- os� Date 6�
"ORT" TOWN OF NORTH ANDOVER
* ; , Certificate of Occupancy $
C
ttBuildinglFrame Permit Fee $
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Foundation Permit Fee $
Other Permit Fee $ `"
TOTAL $
Check #
2053
Building Inspector
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanni.ng/Massage/Body Art ❑ Swimming Pools
Well ❑ Tobacco Sales 11 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 APPROVED
PLANNING &-DEVELOPMENT ❑ ❑
COMMENTS
�. - E JECTED DATE APPROVED
CONSERVATIO
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
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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
Located at 384 Osgood Street
=FARE DEPARTMENT Temp Durnpster'en`site ,yes Do
Nreepartmenit,signatureldate
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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
C'jT -I) mac, L
❑ Notified for pickup - Date
.................................................... ........................................................................................................._................... ;
Doc.Building Permit Revised 2007
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
a NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
'I ❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit -
o 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
s� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers f
Applicant Information Please Print Le ibl
Name (Business/Organization/Individual): DIVA a /ald a
Address:
City/State/Zip:�a41," dhone #:
Are you an employer? Check the appropriate box: Type of project(required):
L❑ I am a employer with 4. ❑ 1 am a general contractor and I 6. A New construction k
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. + E] Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition i
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
rquired.]
officers have exercised their ME] Electrical repairs or additions
3.�1t:ama homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs
insurance required.] t employees. [No workers'
comp. insurance required.] 13.❑ Other
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am 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 may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby c i under the pain nd pey f perjury that the information provided ab ve is true and correct.
Signature: Date: /
/4 le5�q_
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
` .NORTH '9
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dover, Mass., D �
T Q LAKE 1• T
COCHICHEWICK V
�d ADRATED
S BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
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# 1; 0BUILDING INSPECTOR
THIS CERTIFIES THAT........ ......... .........................t .I..... .. ..................................... Foundation
has permission to erect........................................ buildings on .....1429... .... I........................... Rough
to be occupied as.4/!rX.Z.r..... ..40..0...L................ �..�... .....�. -. 6 Alit6:
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eprovided that the person accepting thi permit shall in every respect conform to the terms of the 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 MONS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTI S Rough
...... .. Service
BUILDING I �MCTOR
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 SIDE Smoke Det.
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06 September, 2007
To Whom It May Concern,
We have been informed of the proposed renovations to the property at 127 Beverly Street
in North Andover,MA. This letter specifically refers to proposed replacement of a deck
which sat at the edge of the property line between the address above and our property.
The proposed renovations are an improvement to the edge of the property that runs along
the lines shared between 127 Beverly Street and our property at 6 Perry Street.
We certify the following:
A: There has been a deck abutting our property at the above address since the time of our
purchase of said property, and:
B: We do not oppose the construction of a new, safer, smaller,properly-fenced deck on
the site of the old deck.
Signed,
1,
Andrew and Carrie Graham, 6 Perry Street,North Andover, MA
The oval Harvest pool fits any size yard with its buttress-free design!
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Features Available Sizes
Liner - All-Weather EZ Hook Metal Diamond 15' Round Deck Options
Print Liner 18' Round
Wall - Harvest Designer Steel Wall 21' Round Two-piece
Top Seats - 9" Deluxe Ribbed Steel 24' Round Fantail Deck
Verticals - 7.5" Deluxe Contoured Steel 27' Round
Tracks - 1 " Steel Universal Top & Bottom Rails 30' Round
Seat Cover - 2-Piece Resin Seat Cover 24' x 15' Oval
JWT,YM0. Plates - Steel Universal Top & Bottom Plates 30' x 15' Oval
mmm� 33' x 18' Oval
6 Gloom NamcoPool.com
N°RTq TOWN OF NORTH ANDOVER
4.°t 4'UND 'G. OFFICE OF
BUILDING DEPARTMENT
gat r : 1600 Osgood Street Building 20, Suiten-36
North Andover,Massachusetts 01845
1sswcNus�t
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please priest
DATE: !3
JOB LOCATION: ® a�
Number Stred Address Map/Lot
HOMEOWNER fdjf 11
Name Nome Phone Work Phone
PRESENT MAILING ADDRESS z
. , `
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less
and to allm 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 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 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 and that will comply with said procedures and
requirements.
Of
HOMEOWNERS SIGNATURE
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APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Form Homwwws Exemption
130ARD OF \PPE:\I.S 633-9541 CO. SER\".\TIO`633-9530 1TEALTH 633-9540 PLANNING 633-9535
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CERTIFIED PLOT PLAN
LOCATED IN NORTH ANDOVER, MASS.
SCALE.1"=20' DATE:8/30/2007
Scott L.Giles R.P.L.S.
Frank. S. Giles R.P.L.S.
50 Deer Meadow Road
North Andover, Mass.
BEVERLY STREET
95'DEED
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PORCH 211+/
2+/
#127
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EXIST. HSE. FND. Cn
v 20'
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mPROPOSED DECK o
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PROP.ABOVE
GROUND POOL LOTS 16&17
N 15x25' PLAN 024 7 N.E.R.D.
9500 S.F.
ASSESSORS MAP 5, y
PARCEL 36
m
m
95'DEED
I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE tri OF
THE OFFSETS OF THE BUILDING INSPECTOR ONLY
SHOWN COMPLY �
AND SUCH USE IS FOR THE
WITH THE ZONING DETERMINATION OF ZONING .13872
BYLAWS OF CONFORMITY OR NON-CONFORMITY �fC►gEEttEO
NORTH ANDOVERWHEN CONSTRUCTED. LAO
WHEN BUILT
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