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HomeMy WebLinkAboutBuilding Permit #178-2016 - 14 PERRY STREET 8/10/2015 NORTH BUILDING PERMIT of 61t LEU 64�� TOWN OF NORTH ANDOVER o� APPLICATION FOR PLAN EXAMINATION b Permit No#: Date Received4q 41'"K" / �Rt7ED Date Issued: u IMPORTANT: Applicant must complete all items on this page LOCATIONM4 O► �`� Print PROPERTY OWNER (AQ Print 100 Year Structure yes no MAP PARCEL:(,y ZONING DISTRICT: Historic District ye no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building AOne family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial .Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic p Well. ❑ Floodplain p Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: \AC-R. t Identification- Please Type or Print Clearly OWNER: Name: 6&U �r,�!�.�b L\04- Phone: Address: Jq egg Contractor Name: Phone: ' Email: Address: Supervisor's Construction License: Exp. Date: k 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$125.00 PER S.F. Total Project Cost: $ P c V . 6 V FEE: $ Check No.: !/� Receipt No.: 7i� ( ( -2— NOTE: NOTE: Persons tracting with unregistered contractors do not have access to the guaranty fund - - 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 4 Building Permit Application 4.. Workers Comp Affidavit ;i. 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) :rE 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 Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code 4, 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 S 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 ❑ r Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature d� COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes [Manning Board Decision: Comments :!Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FI E D PART NT pDumpsteonsitees `':�;t,unox iCiocated at'124 Mains eet t G, . r Fire IJe artment si atureld to n a �•.••.: T',Fly ., - z: ;#': 4*,p1b r#'•`4'1`. [ � 'R' T a �t:M4 •-r * _ .fi COMMENTS � - N - 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) LJ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 Location 1 � No. 1 t 2A Date O t • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ a Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ r TOTAL $ '� Check# i; Building Inspector F NORTH own Of 2 EAndover IIW- 20(v 2 h ver, Mass, aZ"5' O L11116 1. COC NICNl WICK Q�RATEO )I'-" � S U BOARD OF HEALTH Food/Kitchen P E IT T D Septic System THIS CERTIFIES THAT ., e.114.. ,� T_S�j(' r's4" G 7<— BUILDING INSPECTOR . ...................................................................................................... S� Foundation has has permission to erect ....... .. ' ..... buildings on h ,,� Roug to be occupied as ............. f /...... �5...�..,�... .. /!1..... ....... �.....G�.�.1i/ti►�CS'.... 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 CONSTRUCTI TARTS Rough ` ........................... Service ........... ...... .. .. Final BUILDING INSPECTOR 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. r A/03 M 48 FAX 978 837 3336 NORTHERN ASSOC NICOSIA &ASSOC Q001 MOIRTCAGE INSPECTION FLAN NORTHERN ASSOCIATES, INC. . 401 SOUTH 8ROADWAY,LAWRENCE MA.01843-3522 TEL-(978) 837-3335 FAX:(978) 837--3336 MORTGAGOR: DAVID J * PAMELA M 5WARJ5RICK Dl:F-p REI=: .4518123 LOCATION: 14 PERRY 5TREET PLAN REF: 173/600 CITY,5TATE: N ANDOVER, MA SCALE: 1"-20' DATE: 5/27/03 JOB #: 203.06140 s 50' 511 ED LOT 10 .4,572 5.1=. LOT I I ly � I D> CK _9 5 2 ORY / . WOOD #14 PORCH PERRY 2u�3 V CERTIFIED TO: GUARANTY RF5IDENTIAL LENDING INC Flood hazard zone has been determined by scale u.•».d is not necessarily accurate.Until definitive lvlans n_ro dccvnd by FITIA and/ar a v,77ftCO2 Cn7d7 of sup-nev J'ti ORRICE OF 1600lot Qsgood tzeeE$uilding 0,• t� 36 s. °A� ��p • •NcdliMdovarb Massachusetts 01845 �'r�f3C{itSS�� Gerald A.Brown TeleA(me,(9 79)688 954-5 Ynspeutorof)3i;ff fto -Fax (978)689-9542 MMMP!ION 3 Cx)?FW.MTA° LICA.TION please pmirtt ' DATE: 16 T , Number Street ess _ 1Majolot . 1502VMGWNBR -"36( -68 )(f' . Name. Homo 1hone Vorkmaone c nr �f3fP• - gyp GSo,A The eurrent exemption for"�ozneow�?exs°' vas exte ukd 4o iclricaow..er-oecripxed dvai,,,8s o o uuifs or:Ds5 and to BED')v RUZ h homco„+.ueis Lo engage a�?`nci Vadsal•for h?re vino does sol possess a Jicf me,pxovided that t-hhe oWues acts as snpazvTsor). Stato-DO,ding (Code Section DIF.IT`ION OFHO.iMEOVMR. , Person(s)who fawns aparcel of:'lamzd on lvhlch 1i e(slme resides or Mends�o reside,an T3 mch there 79,oris i afeAded to 7��,aoneor o ao�ifysfzuetuzes. A.persmvAocomtmetsmom t7iatDnehomexn;atwa-yearperzodshall notbo considered alzomeDwnez Tfte underszg.ed"�Zo�neowner°'asstmzes?-esponszblli€y�'o_z-comp7iaz�ces watt.�.e State Building Cone and o�.ez• Apylicable codes,by-law.;rules and-xeguxatiom. T�.endersigned"fzomeovanex”cexl fies that he/sheunestaz Mc Town o�'ND.-db,.AudovezBuif&g Delia-twout minimum.impeetion procedilros andz-eis de yyz]I comply With;sazdpzacedures and r'egalrenjr,uts, 110MEOMIMS SIGNATURE &PPROVAL OF 33UXDWG OFFZCfL 2eyised 7.2009 _ �o�n.�Someowners Fs�emptidn . DARDOFAPPBAM-688-9541 CQhrSmIJYAnoN58b-9530 The Commonwealth of Massachusetts Department of IndustrialAccidents ", tl X Congress Street,Suite 100 Boston,MA 0.2114--2017 www mass gov1dia 5y Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERAUTTING AUTHORITY. Apolicant Information Please Print Legibly Name(Business/Organization/Individual): b 4V 1_=- 's rim- l id��(AL Address: —I S City/State/Zip: /iaM Au`Alyt.. Phone Areyou an employer?Check the appropriate box: 'Type of project(gquired): 1.L]I am a employer with___:__ employees(full and/or part-time).* 7. E]New construction 2.]I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 3.I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. El Demolition 10 E]Building addition 4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.I]Electrical repairs or additions proprietors with no employees. 12.F1 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.! 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have nu employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit#his 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 state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. dam an employer that is pi•dviding workers'compensation insurance for my employees.'Below is the policy and joh 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 MGL c.152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. X do hereby cerd d lie p ins and penalties of perjury that the information provided alcove is true and correct. Si nature: Date: I x Phone#: d667 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of Hire, expres's or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or lepair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a licensb or permit t6 operate Shusm'ess or to construct buildings in the commonwealth for"any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill-out-the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub=contractors)name(s),address(es)and-phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents foi confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you.'are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating cuixent policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel.# 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia North Andover MIMAP August 10, 2015 d .. s � r r > ;3 eCrY Street r R6 Crxy 1 = , I t 6� � �` �� • ,,,tea � 1*��^ b�y I , (D +^ ` dd`esle Street 0 MVPC Bo Interstates _I Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —SR Meters Data Sources:The data for this map was produced by Merrimack Roads Cr N0RTN q Valley Planning Commission(MVPC)using data provided by the Town of 411�p North Andover.Additional data provided by the Executive Office of t Easements �. b° °�°�0 Environmental Affairs/MassGIS.The information depicted on this map is Cl Parcels 3 L for planning purposes only.It may not be adequate for legal boundary 0 •—• 9 definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING # r{ THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT 09 M ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF 719'00°�r�o'SSA THIS INFORMATION SSACHUS� 1"=39ft w�° North Andover MIMAP August 10, 2015 I 5 BEVEF2L�17, G 0056--.00.liQ) OQ5:0=,00'11 005 O;�QO11> PE@3Y STf PERRI(ST Q05�g,D,U011 005 13;PERRY 5TH 49 00550,x'00`15 45` 74` 3�1 PERRY; 49` PeC�y Street 94' y � 49` 1-0— (01P PERR1f,ST� +�2�PEFiRY�S 97` 005x0=,'0022 i °R�4� l0`05d0=0023 PER it gTj 1�8 PERRY 5J� OQS"0=0024 t t t 005,cdQ03'6 005�0-0035 "n Q05`0�.;003�2 O 5 0 0034} 3"17 MIUULESEX ST �::OQ5.0':Q033) N :323 T1.IDDLESEX S;T 9T rn 3r2<7,MID L]ESEX ST' .33*111 MIDDLESEX S � 0050 X0037 ( MVPC Bo Wetlands Zoning Busine s 1 District [}Municipal Boundary O Exempt Lands R Busine s 2 District Horizontal Datum:MA Staleplane Coordinate System,Datum NAD83, Rail Line 0 Busine s 3 District Meters Data Sources:The data for this map was produced by Merrimack 0 Busine s 4 District Interstates NOR71� Valley Planning Commission(MVPC)using data provided by the Town of —I 0 Gene Business District Of t�tc 'qa North Andover.Additional data provided by the Executive Office of —SR 0 Planne Commercial Dev ? ��+ ��'0 00 Environmental Affairs/MassGIS.The information depicted on this map is [:Comido Development Dist 3 L for planning purposes only.It may not be adequate for legal boundary Roads 0 Corrido Development Dist O definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER i r Easements O Corrido Development Dist F. 9 MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING D Parcels a Indus tri I 1 District # - * THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY D Indus 12 District 19 = w * OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Zoning Overlay 0 Industri 3 District * c 41 ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF 8 Adult Entertainment 0 Industri I S District 9^0 "'"" ' THIS INFORMATION 0 Downtown Overlay District Reside ce 1 Disinct �{' ++Ito ©Historic District C Reside ce 2 District S$�1CNl�$(G 0 Water Protection to P—ide ce 3 District 0 Hydrographic Features A de ce 4 District —Streams T'=39 ft eq p•de ce 5 DistncI YYY de ce 6 District e e esidential District North Andover Board of Assessors Public Access Page 1 of 1 NORTil North Andover Board of Assessors. n O ".SSgCHUSE` roperty Record Card Click Seal To Retum Parcel ID :210/005.0-0023-0000.0 FY:2015 Community : North Andover SKETCH PHOTO Click on Sketch to Enlarge Click on Photo to Enlarge Search for Parcels Search for Sales Summary Residence Detached Structure n Condo 14 PERRY STREET �J Commercial Location: 14 PERRY STREET Owner Name: SWARBRICK,DAVID SWARBRICK,PAMELA Owner Address: 14 PERRY STREET City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood:5-5 Land Area: 0.11 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 1497 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 301,000 297,400 Building Value: 155,000 154,600 Land Value: 146,000 142,800 Market Land Value: 146,000 Chapter Land Value: LATEST SALE Sale Price: 160,000 Sale Date: 02/19/2002 Arms Length Sale Code: A-NO-FAMILY Grantor: SWARBRICK,JAMES Cert Doc: Book: 06675 Page: 0238 http://csc-ma.us/PROPAPP/display.do?linkld=2614670&town=NandoverPubAce 8/10/2015 North Andover Board of Assessors Public Access Page 1 of 1 NORTk North Andover Board of Assessors ' F s t s IEW �7 qow+no•Po- It4 ".SS��►+ E`h roperty Record Card Click Seal To Retum MapBlock/Lot: 210/005.0-0023-0000.0 Parcel Address :14 PERRY STREET DETACHED STRUCTURE DATA Structure: Value �Msrmtl Msrmt2 Value Grade Condition Method Search for Parcels SHED- SQUARE- Z �� EQUPMNT 200 100 0 0 FEET AVERAGE AVERAGE Search for Sales POOL- F:IEEI=IFEETSQUARE-ABV-GND Summary Residence Detached Structure Condo Commercial http://csc-ma.us/PROPAPP/particulardetails.do?subAction=DetachedStructure&town=Nan... 8/10/2015