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HomeMy WebLinkAboutBuilding Permit #746 - 143 KARA DRIVE 5/15/2007 BUILDING PERMIT NORTH 9�� o`tT TOWN OF NORTH ANDOVER 03? �•,•1' r 3 Oto APPLICATION FOR PLAN EXAMINATION "ey � opq cocwu i:ocw . Permit NO: L Date Received oRATIo ° �5 ` CH Date Issued: IMPORTANT: Applicant must complete all items on this page } JtF� CAT,I F Pont" PC ' Print ; W iVIAPmNO: PARCEL. ZONING,_DISTRICT: ISTOIIt D1TRICT yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 5eOne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Q teptie © Welles, 8 Floodplain U Wetlands,, 0 Watershed Water/Sewer _ Vti � e DESCRIPTION OF WORK TO BE PREFORMED: ;t � r Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: .. , CtQ "TRACTOR Name. Address, ° Superviso s Constr.ictibn License: ��^ 'Exp.. Date —7-� c' Homelrn rovment License: Exp. 'Date:,,,L 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: $ 7 FEE: $ -7�Yo Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/OwnerSignature of contractor 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 ❑ ❑ COMMENTS 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 Driveway Permit Located at 384 Osgood Street F1R5 DEPAk1rMENT Temp Dumpster tin site yes no Located at,124 Main Street Fire Depir'trnent signature/date, � a C '3MMENTS 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 o 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) o 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 Location��y3 No. Date NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ s' Nus�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # U 204 U Building Inspector THE C0HV0NWE4LTH0FA1ASS4CHUV7TS ;� Use oi � DEP.ARTAMWOFPUBLICSVETY FPenmnitNo. BOARDOFFIREPREVEMONREGUTA770NS527CM12VO ncy&Fees Checked APPLICATIONFOR PERMIT TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DateQ C7- D Town of North Andover To the Inspector c The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) A13 9-"4 M f ve Owner or Tenant ] Owner's Address A Q Is this permit in conjunction with a building permit: / Yes No r7 (Check Appropriate Box) Purpose of Building �}C�t�l/GlV1>°� /C,� G' �{ P —f CC VW /t Utility Authorization No Existing Service Amps� �Vo is Overhead Underground No.of Meters New Service Amps / Volts Overhead Underground r--J No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work !(/[4W&c F Svc✓4-0 OM f %ftAill ghVe,4 n qpe No.of Lighting Outlets No.of Hot Tubs No.of Transformers To K` No.of Lighting Fixtures / Swimming Pool Above Below Generators KI and ound No.of Receptacle Outlets O No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch @nflurs No.of Gas Burners No.of Ranges No.of Air Cond. / Total FIRE ALARMS No.of Zones. Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW LocalMunicipal �} Other Connections U No.of Water Heaters KW No.of No.of Signs Bailasis Z—C gl-es No.Hydro Massage Tubs No.of Motors Total HP 2- OTHER-/' /Do RMP, aacl>!T, ��In/PC 7,vft�c PD 4L6PR4/eG,� iiy &Pory a th>Sstaatx;rCovrrage Ptustmt�d� prlsof�Genei-alLaws Ihave aamutlmbdtykmm=FbkymdndEngCompletOPWA=CowrdWortsmbsMUeWwalfft YES NO Ihawsttnr>rttedvalidpioofofsarnetotheOffice.YES ' )/' FymhawdrekedYES,pk=Jnd #rgecfcOmnga by �E 3 Bolam .... SP a ,) S! n--;M l",4//e_ flIYI 6, _ WciktoSbd 101.27/03 InspectimD&RequesIled Rough Si�ledurrler�iePet�tiesofpajtay: dvaleonecpW0 /rG i'C C CAt L FIRMNAME JJ 130A L 17- 1PAILI 51eC't,'GL"1L LicelmrT0. 6x26 Z' % =ice D�I�i(a 11✓ t,J 7. tC' lt,� Signature � �! IicatseNo s�'p1 tv �— BusinessTel No. 5��l y 7J--.rig� ads /AwO Aye. Aem4le,ti lk,4- d l,&y At4U-Nb 0 96 )WNER'S INSURANCE WAVER;I am aware that the Liceme does nothave the insurance cDwroge orits substantial equivalent as ffpned byMass�Ger>etal Laws rd that my signature on this permit applicalion waives this m9mmfnt Please check one) Owner O Agent Telephone No. PERMIT FEE Signature ot Uwner or Agent NORTH Town of No. 7 #to - C^ o� . �` dover, Mass., O COCMIC EWICK 1 V Ids RATED P'PG �5 7 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT......../�7/.. ... . ...... ........................f................................................................................................... Foundation has permission to erect........................................ buildings on ... Rough to be occupied asR 'e—t- Chimney provided that the person accepting this permit shall in every res ect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Lawsr ing 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 CONSTRUCTION ST Rough ........X........... .... .... ............... Service BUILDING INSPE 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. CHIMNEY SERVICE REPORT 6 0 5 7 6 8 SERVICE PROVIDER: CUSTOMER: AMERICAN CHIMNEY SWEEPS INC. Name STOVE SHOP Address_ N►CK GUERR�RA 62 PULASKI STREET 143 KARA DR PEABODY, MA 01960 City N.ANDOVER, MA 01845 978-532-9200 Phone(_ www.americanchimneysweePsinc.com E-mail Technician GG Directions to home Service Qate J Time SYSTEM INFORMATION ....... — -- .._....---- ------ CROWN Fireplaces,Number of............................ Construction.......... ............................ ❑Masonry ❑Factory-built ❑Modular Fireplace opening sizes.................... 1. " X " 2. " X 3. " X FLUE LINER Heating Appliances,Number of:....... Type......................................................... ❑Insert E�' rreestanding ❑Furnace El Fuel................................................................ ❑Wood ❑Coal 55�as ❑Oil ❑ Chimney Construction....................................... ❑Factory-built R asonry ❑Other Chimney height................................ y��:3-feet o0o SMOKE - SHEIf Liner....................................................... El'rlue tile ❑Stainless ❑Cast ❑Unlined DAMPER Flue sizes............................................... [18"X 8" 8°X13" ❑ 13"X13" ❑8"X17" ❑ 13"x17" ❑6" Round ❑8" Round ❑ Lpp o Last cleaned........................................ year(s)ago El Never El Unknown LIINTEL O COMMENTS FIREBRICK--fl v ASN DUMP C .............. LAV ANNUAL SPECTION INVOICE/RECEIPT The National Fire Protection Association(NFPA)recommends annual DESCRIPTION PRICE inspection of all fireplaces,chimneys,and vents.The next inspection of your system is scheduled for: CUSTOMER VERIFICATION ROo This report is the result of a visual inspection done at the time of cleaning.It is intended as a convenience to our customer,not as certi- fication of fire worthiness or safety.Since conditions of use and hid- den construction defects are beyond our control,no warranty is made for the safety or function of any appliance and none is to be implied. I have read this form and understand the apparent condition of my fireplace,appliance,chimney,and/or vent system.Furthermore I Subtotal of understand the limitations of this report as given in the paragraph above. Customer Signature Date �"2 - 1 Total ':4p 0.'Q? Item#99450 m 2004,CCSI THIS IS A SAMPLE FORM. ORIGINAL DOCUMENT MUST BE OBTAINED AT THE BUILDING DEPARTMENT AND COMPLETED IN TTS ENTIRETY t PRIOR TO BEING ACCEPTED BY THE BUH DING DEPARTMENT. "0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received: Date issued: IMPORTANT: Applicant must complete all items on this page LOCATION 143 K A R D Rt{ Print PROPERTY OWNER IV i 6_K Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Fesiden6all ❑New Building ❑One family !�! � ❑Addition ❑Two or more family U nklu al f 11Alteration No. of units: J �111 Repair,replacement IJ Assessory B49 1 mm ial ❑Demolition ❑Moving(relocation) t bh ❑Foundation only DESCRIPTION OF WORD B. REFQ ED l S t tr(. r l an 7e e* Ic eih cati6n P ea;e a 6r!Px t Cles r1i 1/ 918 r.87 Y053 OWNE 1)me] 1 Phone: 0�'4a Addres i s ,tore 42 CONT T N e - L- &1 11141 t _ Phone: g0 Address + f r , 1 7 ► Of Supervi or's ruction License: �° S O 7 3 8' Exp. Date: fl -,R 7 �>hZ :07 Home Im rovement License:_ 4a 3 Exp. Date: ` ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S F. Total Project Cost :$_A, qS2 0G0 x12.00=FEE:$ Check No.: Receipt No.: TYPE OF SEWARGE DISPOSAL Swimming Pools U F1TannTanning/Massage/Bodywmmng Tanning/Massage/Body Art ❑ Public Sewer Well U Tobacco Sales ❑ Food Packaging/Sales F1 ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped PI THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM I DATE REJECTED PLANNING& DEVELOPMENT ❑ ❑Water S ' > ial I it "' ❑ Pla - 1 Pe t I Y i her COMNENTS TE CTED D ROVED CONSER N Il El COMME I � DATE REJECTED DATE APPROVED El HEALTEl CO Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer connection signature&date Temp Dumpster on site yes—no_ Fire Department signature/date Building Permit Approved and Issued by: Building Setback ft. Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq.ft.: NOTES and DATA— For department use 7�1 Ji I u Page 3 of 4 Crated JMC.J=.2W6 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 ❑ Debris Removal Form ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application a ❑ Surveyed Plot Plan f ❑ Debris Removal Form J ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. , ses ❑ Copy Of Contract ❑ Floor/Crosse '� a I f o o ork trh ',S P. Hydra Ca 7�ati i l p o Mass k gy �i p t (Ifplacable New Cons Jon g � t, �ami I ' ❑ Buil e p ❑ Certi rl� ❑ Photo o i I uses ❑ Wo r rs V ❑ Tw ui Plans (One To Be Returned) to Include Sprinkler Plan And Hy cu ations (If Applicable) ❑ Cop ontract ❑ Mass c eck Energy Compliance Report 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:BPFORM05