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HomeMy WebLinkAboutBuilding Permit #431 - 14 GLENNCREST DRIVE 12/18/2007 BUILDING PERMITof"°RT"qti TOWN OF NORTH ANDOVER `° o APPLICATION FOR PLAN EXAMINATION Permit NO: / 0 1 may~ Date Received q0 V C - ��SSACHUS Arno Date Issued: IMPORTANT: Applicant must complete all items on this page L0CATION Pnrtt - PROPERTY'OWNERY,t1 Print MAP NO T `f. 'PARCEL: ZONING DISTRICT.1 Historic District yes ages s 1Aactine Shop ye 1/ i . o . 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: emoli io Other c Weld FloodplainWetlands UVa#ershedYDstrict Water/Sewer �C d✓L DESCRIPTION OF WORK�O BE PREFORMED: ry Lt-v c_ Identification Pl ase Type or Print Clearly) OWNER: Name: rY4� L< .r ,�,r,,,, a Phone �7 7�y`���� Address: /�` ,�- /1/e M c)( ���-(� COl\ITRAC -0 Narrme: _!/�+ �.� ,r Phone: Address:--a5.: s %�. Supervisor's Constrtactlon License: .�. C,�7 2 - Exp. Date: U7Zt2 00 Home Im rovement License ` Exp. Date.- P P l T2.Go ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ' © C." FEE: $ ��0 Check No.: 4 Receipt No.: -2y�- 4e -' NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fu d �gnature'of Agent/Owner Signature of con#Tactor _ - _ _.,- . Location I ! lT��h Cr—� T — No. Date NORTH TOWN OF NORTH ANDOVER 3?O�t•`•o •,BOOL � 9 Certificate of Occupancy $ �'�s''•' ttt' Building/Frame Permit Fee $ '�CNUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ . Check # 20E, Gt 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 APPROVED PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION 0 COMMENTS &0 DATE REJECTED DATE APPROVED HEALTH 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 Drivewav Permit Located at 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 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 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _ u I Address: City/State/Zip: 0144c.,tV- /V H 031(ft Phone #: 3 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ew construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ emodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' ❑ g [No workers' comp. insurance mp. insurance. 9. Building addition required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1.I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.❑ Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. .i.Homeowners 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance./or 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 u t g p o$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. do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: 1 -4— Date• �oZ" 3U Phone#: (q a 91 y Of 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#: ��:s. � a .r ,.F L M z ts� "��,v- .S� � a ,i q :.:r � r ��,✓x 'rA ,: � .& � c� `: 3-( 7 F` c � s r v, $, .a' .+. �. Fri �' ?��, r '-,yR f4 .,`� '' •� t... ,">\ r x ry ri `:i s .1 l'.`Y-�' +moi.`£'e��'rf, 'y`�-:. 4"�1 ,e.':l�'u;• `+c ., < '.'�,..5�"u.a�?aE- � '�'r"�'vTi4 ;: -1 e-a�.•yK.+ -v;=""` r'L'-..�a `y�`-"7.. ,; ��e`� .r> -r ,,, �� * r.__ra>... m � VrvW ci ar � ���z<'`� .far i ,� �, a �, -�� k..a- _ ,?• .S .-� `1'x`4• -'k €'" .., `dl r, '4 s4.. '.�,t �Ps ,a:;�i ��'.�.^�K���� � �.. 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If found return to: i• HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration, 157815 One Ashburton Place Rm 1301 Expiration: 1.11/2009 Tr# 261261 Boston,Ma.02108 lg Type: Ind vidual PHILIP CUMMINGS PHILIP CUMMINGS: ��" i -- --- 44 COLEY RD �tvalidithout signatu e EPSOM,NH 03234 Administrator `"3s,Y.'Tt "� ,PN `sem' , a .F.`._�1. +• 4 '15 n snR 'r,r �f tai^ '�-."kr > d .'�'iz', o '+ ',�,ter v�•�,.s a.�. ray' 'gG"mx '�'4S-z4 `.q .w�.c�„F._ .mss^ t'a = 'k -'• ..1,�ta:..,s � n x .'y ,a�r--�:.� .:� � '�:...� c.� �'���.fi,�"- J�. � Z �M�e �' ! r�,{y ��� .,��..,���.,.�'"' �rw^s'+�.� s-�t .}� �"F 9-. �.�:. .c `y ",, _f.,,..s�c`•-�^�.e^r`� r "� a';:-s'd 3+ ^yti..:J-F_5 a::.�.35•''y+e$s=3+�.,.!^ ar r �, �"aesL '�i s Jsr "t .^ xc' ,�=c,,. ,� w'� z �, a s �s c - ,ti-..:? - f;-�, xa .�:�• r _7:� <..,:5 �aL.:.,4 :..:y'z-r �_��d-s-:. � '..r27"�..�- ,,ev S�. �':e, ;-' �+:'�' .re�.e ,^'a�+5e?_�` �a.r,:�:s.� ,''�"r fi3; y .,ala.�� �'�',E�"•+ �Aic� -�h"'x rc�_ ;:y' �_„.e "�#;e�i:� •2. s=:•':"cr. k;..'.2F:v..,,,* ri di a'-'F�.� � '.;.c i��Ci.�r�''g '�C;f�:a_,, ye�`�"...'w ,,t3n� m,�'�'g..�+_ ."�'.+t'. ^fit:, �s sr,"�v�;,�'.3�'-- U.•� �+�f+- �:as.�,•�^�a." ,� -s�'.•-�.et�-v v �e-"?� �e .��''Yt3� '�...a,-`1.�h �, ':-.,/` .,�.:.., ..h..�•=• '��+'e&��' `�` ., -',-:.*r a'.�i-':'%�' ..z,::.. 4 �i. 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PHILIPG CUMMINGt x4 w>1'psi rti x iu ` 5 r an a iA3tZ,bit rt ,�'' r4¢C t''`r°+r�ti,.ms c s r ? s�.:.� Town of North Andover 010IRTFf r Building Department - 1600 Osgood Street North Andover MA 01845 Tel: 978-688-9545 Fax: 978-688-9542 0,pCoc�iMa 14 q v1` DEMOLITION OF BUILDING AFFIDAVIT 0 rEo �,Pa �g �SSACHUsti� DATE OWNER'S NAME &ADDRESS L,- LOCATION LOCATION OF PROPERTY TO DEMOLISH I q r;l e„n t r 4 7' drye- DESCRIPTION dt-o o e ;tf,S, CONTRACTOR'S NAME &ADDRESS T, n/I j3,;, DEPARTMENT SIGN-OFFS y DEPT. OF PUBLIC WORKS -WATER: SEWER: s ' DEPT OF CONSERVATION HEALTH DEPT: Septic 0 Well 0 � r GAS o1v/�,— ELECTRIC kjL� TELEPHONE l✓1,F' CABLE D TAXES PO ICEel, 4�47 [n FIRE EXTERMINATOR DUMPSTER-ON/OFF STREET fe/ i l r-D r b urn pS�rr DIG SAFE NUMBER !ZOO ? L/90 t,12 /e DATE REC'D BLDG. INSPECTOR Doo.form demolition of building affidavit Residential Property Record Card PARCEL_ID:210/104.A-0040-0000.0 MAP:104.A BLOCK:0040 LOT:0000.0 PARCEL ADDRESS:14 GLENNCREST DRIVE PARCEL INFORMATION Use-Code: 101 Sale Price: 212,500 Book: 03999 Road Type: T Inspect Date: 05/23/2004 Owner: Tax Class: T Sale Date: 03/09/1994 Page: 0190 Rd Condition: P Meas Date: 05/23/2004 Tot Fin Area: 1456 Sale Type: P Cert/Doc Traffic: M Entrance: X CORDIMA, FRANCIS J CORDI M CORDIMA Tot Land Area: 1.12 Sale Valid: Y Water: Collect Id: RRC EILEEAddress: Grantor: BELANGER,MARILYN Sewer: Inspect Reas: M j 14 GLENNCREST DRIVE Exempt-B/L% 0/0 Resid-B/L% 100/100 Comm-B/LM Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: RR Tot Rooms: 6 Main Fn Area: 1456 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R1 Story Height: 1 Bedrooms: 3 Up Fn Area: Bsmt Area: 1404 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value Class Roof: G Full Baths: 1 Add Fn Area: Fn Bsmt Area: 392 1 P 101 S 43560 1 230,868 Ext Wall: WS Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0.12 960 Masonry Trim: Ext.Bath Fix: Tot Fin Area: 1456 DETACHED STRUCTURE INFORMATION Foundation: CN Bath Qual: T RCNLD: 188199 Ste Unit Msr-1 Msr-2 E-YR-Blt Grade Cond%Good P/F/E/R Cost Class Kitch Qual: T Eff Yr Built: 1965 Mkt Adj: PT S 234 1988 A A W89 1,300 Heat Type: HW Ext Kitch: Year Built: 1962 Sound Value: SE S 288 1999 A A ///96 3,900 1 Fuel Type: O Grade: AG Cost Bldg 188,200 PA S 452 2000 A A /50//48 3,500 1 Fireplace: 1 Bsmt Gar Cap: Condition: A Att Str Va11: Central AC: N Bsmt Gar SF: Pct Complete: Att Str Va12: VALUATION INFORMATION Att Gar SF: %Good P/F/E/R: /100/100/77 Current Total: 428,700 Bldg: 196,900 Land: 231,800 MktLnd: 231,800 Prior Total: 407,000 Bldg: 196,500 Land: 210,500 MktLnd: 210,500 Porch Tyne Porch Area Porch Grade Factor E 132 SKETCH PHOTO 26 54 676 S Ft. 26 26 E b ' 2 102 Sq 2 4! - 14 GLENNCREST DRIVE i Parcel ID:210/104.A-0040-0000.0 as of 12/14/07 Page 1 of 1 I z� The commonwealth of Massachusetts Depart meat of Fire Semces Office of the State Fire Marshal. P.O.Bom.1025.State Road;S.toW,IYUk 01M - . PERMIT" Date: North Andover Termdt No Dig Safe Nnm er (City of Town) (If Applicable) In aceordaccc with the provisions of Nt L14 8.Chapter 10 as.provided in section 5 7 7 f'NIR 34 / 3tatt Date •-.This-Permit isgracted to: ��.� �-��y�_ .1 L� , Full name of person,Finn of Corporation Permission to locate dumps.t'er for construction/renovation/demolition of building- ..Cornmentz dumps.ter must be . 25 ' from structure if unable to place with required Restrictions'clearance dumps-ter must :be covered with plywood or tarp end of 'work -day (Give location by street and no.,.or descn-be in such manner as to provicd adequate identification of location) E41 ecPaidS 50 .00 'Fire Chief This Permit will cz irc ffW Si�rtatuce o o ica antro unit ffical anon trout P !mss v�(� ( b } Pc ) ! gP (Title) I II I AORTH Town of 0 K: Andover No. -- col o. over, Mass., 12- 1 — oQL A It. COCMICKEWICK V 0RATEO BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System C.0.e BUILDING INSPECTOR THIS CERTIFIES THAT....1...�a.n.�=.... . ......................................................................................... Foundation has permission to erect........................................ buildings on ....1... ........6.-IC .K..Cti ..1-.....ST-....... Rough to be occupied as.......................�. . .MQ .. . =X�sfi .� V �-'.�'� Chimney p .. . ... . .. ...........................................................................:....:.. provided that the person accep ing 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 1 &0, PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ST TS Rough K�7 ...: . ..................... .............................................. ............................... 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 SIDE Smoke Det.