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Home My WebLink AboutBuilding Permit #753 - 140 COLONIAL AVENUE 5/25/2010 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 7 � Date Receive�� 1 Date Issued: IMPORTANT: Applicant must complete ems n.this page LOCATION PROPERTY OWNER > td �i�t'I�'r�tlf°�'> Print �_� MAP NO: J� PARCEL: I? ZONING DISTRICT. Histon`c"District yes n Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New BuildingOne Tamil i Addition Two or more family Industrial Alter No. of units: Commercial ��epairAssessory Bldg Others: C�t Other Septic Well Floodplain Wetlands Watershed District Water/Sewer Ke DESCRIPTION OF WORK TO B PERFORMED: e A 1 V a�1 -�.Gf�� ls- I e C RepotiV kk— Ad 11244it d O z rL Identification ea a Type or Prin Clearly) OWNER: Name: i 4 Rnn; fV hone:Q g (2?s 9?707 Address: )'qo ,t 1Ohlal Ave. )VD 3, CONTRACTOR Name Phone: Address: ' z Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: 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: $ 77 s FEE: $ Check No.: /6 7O Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner ; nature of contractor W� Plans Submitted Plans Waived ertified Plot Plan Stamped Plans Location No. 7-�r-3 Date NaRTM TOWN OF NORTH ANDOVER f 9 i Certificate of Occupancy $ Mus tt�' Building/Frame Permit Fee $ s�c Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check !f/620 232G5 � �Wlding Inspector 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 CONSERVATION Reviewed on Sign oti U zy COMMENTS V )-j a %---JA� OIV"-J S CAJ J"L � HEALTH Reviewed on Signature I COMMENTS S � . r 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 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 i 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 2008 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 Q 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: Doc.Building Permit Revised 2008 OORrk TOWN OF NORTH ANDOVER �2o6'ztfo 616 OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 SSS SGHUSE� Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: JOB LOCATION: I q 0 Co I D n I a lAve, Number Street Address Map/Lot HOMEOWNER M ithd&( gC[' lem 1901n I nj f'(5 85 T7 Name Home Phonee,,,, J AWork Phone I� PRESENT MAILING ADDRESS O W 1001&( �4- `Norm �QndlO�� /11�} �IB�g City Town State Zip 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 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 requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE 004ej APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 F NORTH TOWN OF NORTH ANDOVER �4, 0� '1._° 09 OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 �SSACNUS�� Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: a�7 JOB LOCATION: U 0 U Y'li Cc• Number Street Address Map/Lot IiOMEOWNER k'044 Ce er\ KL /I 47Ff COBS �S�� Name Home ne Work Phone .PRESENT MAILING ADDRESS N OA o[ � City Town State Zip 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 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 requirements and that he/she 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 ORTH O Of Andover . .......... No. LAK over, Mass., 1$ COC MIC HEWICK C7 ATED -S BOARD OF HEALTH Food/Kitchen PERMIT T/ D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... ........................................................./V,.. ........................................................ Foundation has permission to erect.................... ... buildings on ... �.......................... Rough to be occupied as................... ..... ......... Chimney .... .......................................................* provided that the person accepting this permit shall in every respect conform to the terms of the ap0cation 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 EXTIRES, IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough 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. PLAN OF LAND /N NO, A ND 0 VER IVA 55,, OCTOBER 10, 1.9.9,7 HAYES ENGINEER/NG, /NC. ► 60,T S4LEM STREET CML MCINEERS & WAMMEZD, MUS. 01880 LAND SURVEYORS M. (617) 246-2800 / CERTIFY rH4T THIS FOUND4770N /S LOC4TED ON THE GROUND AS SHOWN, AND THAT IT CONFORMS TO IME ZONING 8Y-LAWS OF THE MON OF NORTH ANDOVER. / FURTHER CER7/FY mAr 7J'IIS PROPE7?7Y DOES NOT UE WITHIN A AZOOD HAZARD AREA (ZONE A OR V) AS SHOWN ON 11OOD /NSIMNCE R4TE MAP COMMUNITY PANEL NUMBER 250098 0010 8. EFFE07IVE DATE.• JUNE 15, 1985 ,ok OF DAM OCTOBER 10, 1997 PETER --------------------- --- - -----4--- PROFESS/O LAND SURVEYOR OGREN #33604 Pv z � C Z C�1 I Ao ol 2- L ,3 Rol 6.v O TOP A10N a rouN0178.96 V N io. N N 12.4 t2.9 1 .0 pp ,2 EXjS IATION 0 FOUN tis wpE ,�'s�?'�� LOT 16 s 50 � �Il. so�s� 21,938 S.F. . R. oti 0 z ZONE.• P.R.D. (R-2) V R. MIN/MUM SET84CKS. FRONT = 20 �'�•�' SIDE = 20 (SEE SEC. 8.5.6.D. 1) REAR = 20' AN °XV a(d V .5.1!;0"!? -led CIX j _ --------- Sol _ __ �NlMA/V. I PLAN OF LAND /N NO,, ANDOVER. IWASS. SCALE.- I' = 40' OCTOBER 10, 1997 /AYES ENG/NEER/NG, INC. ► 60-T S4LEM STREET CML ENGINEERS & WAKEFIELD, AASS. 01880 LAND SURVEYORS TEL. (617) 246-2800 / CERAfY THAT THIS FOUNLWnON /S LOCATED ON THE GROUND AS SHOWN, AND THAT/T CONFORMS TO TH£ ZONING 8Y-LAWS OF 7HE TOWN OF NORIN ANDOVER. / FURTHER CERTlfY 72VAT THIS PROPERTY DOES NOT UE W/TH/N A ROOD H4Z4RD AREA (ZONE A OR V) AS SHOWN ON ROOD INSURANCE RATE MAP COMMUNITY PANEL NUMBER 250098 0010 B. EFFE077t2" DATE.• JUNE 15, 1983 01 144 DATE OCTOBER 10, 1997 PETERG --------------------- PROFESS/O LAND SURVEYOR J. OOREN #33604 ss Py qyb yC� V ><c 'S" Z � C Z C� v X73 46• OF TOP OO�N�riON B 96 G a y1 ti a 12.4 12.9 16 N J o G o XISTI TION 1h 1 N F m E �'so��?o ` NAL OT 16 s 50 . ssW. o. 21,938 S.F. R. Q �1 �o 0 Z w � � �s ZONE- P.R.D. (R-2) V.R. MIN/MUM SETBACKS.' sem, FRONT = 20' SIDE = 20' (SEE SEC. 8.5.6.D. 1) REAR = 20' �` North Andover MIMAP 140 Colonial Avenue May 10,2010 107.B-0133 107.B-0132 107.B-0150 :A, 107.B-0134 41 107.B-0131 ab 4 ven 107.B-0130 Ile 107.B-0135 107.B-0106 107.B-0129 901 77 107.B-0136 254' 107.B-0128 107.B-0137 107.B-0138 I 7.B-0139 107.B-01V 107.B-0104 :_:';t; ......";`•. .. 107.B-A'� SO& W& 107.B-0103 A& x. ........ Aw Aw. Rall Line Interstates Interstate Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Major Roads Meters Data Sources:The data for this map was produced by Merrimack I&ORToll Valley Planning Commission(MVPC)using data provided by the Town of Roads Nort Andover.Additional data provided by the Executive Office of y o 16, vIh Easements 6 Environmental AffalrslMassGIS.The information depleted on this map is Trailsfor planning purposes only.It may not be adequate for legal boundary 0 definition or regulatory Interpretation.THE TOWN OF NORTH ANDOVER C3 MVPC Boundary 11- MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING 0 Municipal Boundary IF 'MFIWMW- ry THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT 0 Parcels ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF Hydrographic Features THIS INFORMATION Streams A Wetlands 0 Exempt Lands 1"=95 ft t 1rre (.ommonrveaffh of M=aChUSefiN kf Depar�nret�zt of 1ndu0-W Accfderrts QN=e of InvesV adons 600 T�r,=11iR n Str � eat Boston, MA 02111 Workers, Compensation 1witrance ��v Affidavit:�vit: ov/die Ruilders/Contracfors/Deafrict$ 'cant Information 1ftw?1Qmber3 / / / Please Print Le W Name(&Wness/brgwi�ation/fndividdsl); �1 C�aC l `�4 If N �--- ' t—gHHtN Addres ' 114o Co t o w'a Awt K lkt city/ zip; d r o✓w Wyq Ph : . q7 �-G -71-7 7HM oyer?Cheek.the appropriate box: yer wifh 4. �] I am a Type of project( ageneral contzactor and I - -ull andlorparj-time).* have hid the sorb- 6• ❑•New construction contzactursroPnetor°r Pier- listed ship and have no employees .I.h `M. the attached sheet 3 7. (].Remodeling working for mein sui�.co�M have ani'capacity. workers' camp.insurance. 8' [�Demolition. (No work=' camP. Insurance S. Q We are a corporation and ifs 9' BW'lding addition ��]3•5;0rsin a hooff�ceza have rr�ccrcmeowneised their Electrical repairs or additions r doing all work right of, 10.(�. selc o war ' wtemPtton per MOL 1 I.�]Plumb' � � � � �' .G ��, §I(4),'.and•we have no �TePaira or additions msuran�.nq �].t repairs. -L[NO worke g' 12.J]Roof repairs *Amy aM1i- fiw �P• insurance rrquired_] 13.I].pmer checks bob#1 most also fm oittthe=06M blow ahowieg thoirworkart'eotapeesationpoficy►nfntmafion T Fiomeovurtdr� sebmit this aft-ft indi=ing prey,ars �j„��. _ #Cortftftrr that thea#this bmr nwr aftew ,d st additioasl doing a o and pian hits outside Conuaetotr rmt i submit.now�'+=rg•lite name ofi the rule- �.� Affidavit rndi�iing encu' I�art a rr workers' m fompioYer f�ap`is pmmd"rng:wor��' � ��saroncejor �•�.:..J mon. ' MY e+rw*eea: Br-10 axe jpb site . Insurance CompaltyName: Porgy#or Self-ins.Lie. Job Site Address: ion Date: Attach a copy of the workers' cam CitylStatelZTp' pensatiion Policy deCEar-atioa showing Failure to Be`cure coverage as required under Section 25A of . Page{ b the poficp number and e MC;tL c. 1S2 can lead to the i xpiraboa tfafe). . fine up 1D$9,50U 00 and/or one-year' as well as civil p=dfies in the form o osition of criminal penalties of a Of up to X250.00 a day against the violator. Be advised sMp WORK ORDER and a fine fnvestigaiions of the DIA for insurance coverage a copy of this.statement rnsy be forwarded tc)the 0{fice of erage verity"catiE,n. I do hereby certify under the pains endpen falties op A e*y J*m the informaioa Provided above ' tree and conreL 5i K Date: Phone#: . f O,fj'Iche use on*. do not write in Gds assn,ho be complete•,!by 'or Lowe.nfjrrra( Csfy or Town: # Issuing Authority(circle one): Permit/License 1. Board of Hmith Z Building Depwtneent 3.City/Town Clerk 4. �Ieetrical Inspector S PlumbingI 6.Otber ttspecfnr Contact Person: Phone#: Information a lid Inkructions- M&-I=hmtts General Laws.chaptm IS2 requires all amp foyers to provide workers' compensation for their employees. Pursuant to this statute,an eotpioyec is defined as"..:every person in the service of another under any contract Aim, fes. express or implied,oral or writtzn:" '. 1`. An emplayer is defined as"an individual partnership,association,corporatian or other Iegal entity,or arty two or mom of the'famping engaged in a joint enterprise,and includi"g the legal representatives of a deceased employer,orthe m elver ortrirstm-of an individual,partnership,associatiain or other legal•amity,employing employem'Howevathe own' -of a dwelling house having not more than th=spa rtmerft and who resides th or tate ore of the prem, upant dwelling'houso of another who employs persons m d6}meLimtm ince,construction or repair wri k cm such dweifthors or on theggrounds or building appuriznern theretri shaU,not b-..easier of such enipioyment be dec:ne.d to be:an employer." MOL chapt r 15 925C(6)iniac states that"every state o:rt-local„6cemmg agency shall withhold the ismance,or renewal of license or permit is operate a bdsmess or *e construct buMbigs in the commonwealth for any applicant who has not produced ecceptableevidencezir compliance with the insurance coverage required.” Additianajiy,WOL chapter 152,J25C(7)strips"Neither tie=mnsnwealth nor any of its polificgl subdivisions shall enter irrtoatry eoruract for the pecFornnntee ofpubiic voile urn-acceptable evidence of compliance with the insurance roquirsmerrrts.of this chapter have been presented to the cmrttractatg authority." • ApP6ceuta .. Please fill out the warkers'compensation.affidavit completely,by checking the boxes that apply to.your situation and,if necessary, supply sub-cotmactor(s)name(al addmss(cs):Erred phone number(s)along with their=tifimte(s)of insurance. Limitad*Liabik Companies(LLC)ar Limited Liability Pertnmships(LLP)with no employees otherthan the members orpartners,are notrequiredU aa=rywork='cc>rnpensation insormtre. Van LLC or•LLP dow.have empioyees,a policy is required. Be advised that this affickwok may be submitted to the Departzae nt of Industrial Accidexris k confirmefian of insurance coverage. Ain Eye sure to sign and date the affidavit; The affidavit should be returned to the city or town that the app iication for the ppb or license is being requested,notte Department of Industrial Accidents. Should you have aray questions regarding the law or if you arc required to obtain a workers' oompenmation policy,please-call the Dq a tment at the-nurmber.fisted below, Self-insured MM- panies should onta their selfirrsraa'liccnsc aumbw on d='appropriste lire. City or Town Officinks Please be sure that tho afndevit is compier~and printed hgibly. 71c Dqm rnent hes 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 tare pmmit/license numberwhich will be used as a refer•encc number. In addition, an appikent that must submit multiple pmmik license applications in any given year,need only submit one affidavit indi::ding•curmnt 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 saimped or marked by tate cityor town may be provided to the applicant as proof that s valid aifidink is on file for fita a permits or licenses. A new affidavit must be filled out each Year. Where a home owner or citizen is obtaining a lie'*neer or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves ate.)said person is NOT.requi red to•compieto this afndaviL 7hc Ofnce of inves6gsiions would lifce m thank you in ad vw=for your cooperation and:should you have any questions, please do not hesitate to give us a call d 77he Depmrtmont's address,telephone and fax number The Commotramp-1 th of Manachuse tis Department of Industrial Accide=ts Mce Of Investi--afions 600 Washington Stt Bokon, MA 02. 111 TeL #617-7274900 er-t 406 or 1-977-MASSAFE Fax 4 61 7-727-774Q Revised 5-26-05 VAM.Mngq gov/dia -' North Andover MIMAP 140 Colonial Avenue May 10, 2010 > +a at �; t a v enue 107.1-013 4' y� l!. Q -•:vim...�b�{�. .� � , _ r. 5M,"+fi p�i.- ��/ !3 _ ' t _ 016, - �A of r-M Interstates —Interstate —Major Roads Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Roads Meters Data Sources:The data for this map was produced by Merrimack NORT1y Valley Planning Commission(MVPC)using data provided by theTown of r Easements Or t`10 q� North Andover.Additional data provided by the Executive Office of 0 MVPC Boundary ? e°'r r0•°OO Environmental Affalrs/MassGIS.The Information depicted on this map is [-I Parcels3 L for planning purposes only.It may not be adequate for legal boundary O ••-• o definition or regulatory Interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING ♦ ; THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT • ^o' " .K� �� M ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION SSA�MUS� 1"=95 ft ~�° piTA PU CNUC A �. - - - - - coz 44�1 kjE,--Voj I So DO 50 I ,� � � / / GPa• / I � � � Q � "was`'. t�S R.®• �• �. \ �/ �j , , � it / � �\ �� ,' ��b\ / Q�L 69 17 50' PRD AZ.BUILDE.V5, zones Or J�1 %. N �� Na 1I�E-cUoN►� oeWIP� Q.sE. \�� 4� ��`�,