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Home My WebLink AboutBuilding Permit #601-2017 - 145 BOSTON STREET 12/5/2016 BUILDING PERMIT / NoRTy TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION permit No#:60l dle/7 Date Received DR{reo / �SSAC Huse Date Issued: ")-0 b EVRORTANT:Applicant must complete all items on this page I �.�.�- a.a� mP�int+ �PR®PER_ �TY�0,1/1/NER` - y Pn 1D; e,, �arrrue re �yes PARCELL-,OaCT,_ _3 y_ Histor►c ®ist �dn �n�`' 9 Y` „..�..'t';7_-'� �t,.u�.�.a.�+�.,. .- �_:�.... ,...,3��..:.C!�`c�-� _u_ws .R'�...,�..� a.._�-=e...._-..._,__�.c.�-.,,.�,�..�.o:...^k-.� K'�.�- a�'�^�'-y�c�ax•.�4. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building jP-f rhe family ❑Addition ❑Two or more family ❑ Industrial JL4-/Creration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Se tic ti0°1Ne11 Floodplain ❑Wetlands ❑'Watershetl Distract 0°Water/Sew°_ DESCRIPTION OF WORK TO BE PERFORMED: `fir RNs 1 -3,o9S r 6^17' Identification- Please Type or Print Clearly OWNER: Name: rz- z, RR r50 LS le 1 Phone: Address: Contracfor Name.. Phone 'rt! ,� t L - ar .; r .S` .i moi,• J''}r�;'�x1, g,y4`i-�; r 1+-t' ura•. r h ,', E!_i� .� Y/S s"1 "* ia.. } - - '3 ) 4 - SypervlsorsCons`tructionLicenset > _ _. Extp� Daten �$ 3rr- q .. ��• Ti tit 4'?e'k. T` -.�,++ .J"�•= • i .fr' j L e..t' c�.' 7�..-ra ....{�_`� fl r "•k .*."`sY�- �Hornellrnprove ent License�,z ? :s ' 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. rotal Project Coit: $ 0 FEE: $ Check No.: 79' A Receipt No.: 31 NOTE: P o s o a ith unregistered contractors do not have:access to the guaranty fund S_ignature_of_ Owner` , Signature of contractor Location /4/5 9,9.57 0N STR E k 7- No. (0 61 20 Date l01 01 Es r • - TOWN OF NORTH ANDOVER K 3 y+ x Certificate of Occupancy $ Building/Frame Permit Fee $ 9� r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# : v Building Inspector r � i Plans Submitted ❑ Plans Waived Ell Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanning/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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature ill .r 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 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 t - limension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, roast or service drop.requires approval of Electrical Inspector lies No ®ANGER ZONE LITERATURE: lies No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email ate Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. r 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 o Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (if Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 40TE: 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 t Doc:Building Permit Revised 2014 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 81000.00 m $ - $ 96.00 Plumbing Fee $ 12.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 12.00 Total fees collected $ 220.00 145 Boston Street Basement finish 301-2017 on 12/5/2016 M12 RTH Town of E ndover 0 .... No. * t I � AILz o h ver, Mass, / VFW 0 0 coc��cNew�cw 1. ORATED I.P��,�5 Ll BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THATef.�e......;rs........psov&s.k..,, ,, , BUILDING INSPECTOR ..... .. ....� has permission to erect .......................... buildings on ....�.y�.... #,..�.. ....w.,....., .... .a..... Foundation Rough to be occupied as ... ffi�.O..........(......... ! ............................................... 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 CONSTRUCTIO RT Rough Service ............ .. .. .. ......................................... Final BUILDING INSPECTOR GAS INSPECTOR Oeeupaney Permit Required to Oeeupy 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. _ � I Q � SJR YTYM 019H E31 ,.The commonwealth of.Massachusetts De partmentoflndustrialAccidents 1 Congress S`freet,,5`itite 100 - d Boston,MA o2114-2017 www.rnasss go•v/dia •�•o1M SV1Y _WaVkers°Comp ensationfmsuraucdA.f idavit:Bnildexs/COA�ISOs - ciane/ lumbers. TO BE MED WrM THE RMUMT' IN BXeas e krmt Le ' I A licant Information ('� �D u CS ' ess/Oz af&atzonadividual): J" t Name(Basin g - Address: /30 ram j= ��v�v�� r�tl� a S Phone 4: � City/statelz p: Axe you an employer?Check tFie appropriate hox: Type of project(reclaired); anf•s- e 1 ees full.and/or part-time).* 7. ❑New eonsfriiction am a employer with mP°3' ( In I am a sole proprietor or partnership and have no employees-Working for me in 8. IJU_Remo dell p; any capacity.[Novrorkers'comp.insurance required] 9.f❑'Demolition I am ahomeowner doing all-Workmyse> [Noworkers'comp.insurancerequiredrtywill 10❑Building addition ¢• I am a homeowner and will be hiring contractors to conduct all work on my proper .I 11❑Elecixical repairs or additions ensure Flea all contractors ei#,rhava workers'compensation msrrance or are sole + 12. _ pl b g repa7xs or additions proprietors wifihno employees. 5.❑T am a general contractor and Ihave hiredthe sab-coufractors listed onthe attached sheet 1111]Roofrepairs These sub-contractors have employees and have workers'comp.insurance.} 1¢. Other 6.❑We are a corporai39n and its offices have exereisedthen-ri mPtionperMGLc.g�ofexe 152,§1(4�,and vte have no employees.[No workers'comp.insurance required] a hcantthatchecksbox#lmlost alsofMout the section below showingtheirworkers'compensationpolicyinfo>zuation' i Homeowners vrho submit•tbis affidavit mdicatmgthey are doing all workandthenhrre outside contractors 1,,,ct sabmit anew affidavitin thit ng sue tConiractors that checkthis box must attached an additional sh r�e their workers'ocome S o o nuumber�d state whether or not(hose entds=have empl°gees. Ifthesub-contiactorshaveemployees,ThheyrmrstP .• , X am arz employer that is providzng7vo.�keNs'cor�zpensation insurancefor r�ry errzployees. .$elow is tliepolicy arzdjo�i site information. Insurance CompanyName: ExpirationDate` Policy#or Self-ins.Lic.#:. C" /State/Zi �Y p: _ Address: number and e iratxon date). lob Site Addr anon page showing the policy numb xp At-tach a copy of the workers' compensation p oTzey declax p g ( 500.00 Failure to secure coverage as required underM e�naltxes��§th2e��ofxa��OP WORK ORDEkZal violation latid fine offup to $250.00 a and/or one imprisonment;as well as civil p 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 h;raby cern.fy er tl alas anclp aloes ofpedury that the information provided above is trr�e and correct. Date: Si a : Phone a" Official use only. Do rtotwrite ire tliis area,to be corrrepleted by city ox tolvn offzciaZ Permit/License# City or Tovvn- IssuingAnthority(circle one): actor 1.Board of Health .2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbingfwp 6.Other Pb.one#: Contact Person: I of pORTH 1 TOWN OF NORTH ANDOVER 3a e•'�`�'�`•6�� OFFICE OF BUILDING DEPARTMENT + :* 120 Main Street *441.��'.h* North Andover,Massachusetts 01845 SSS 1CHu5E� Donald Belanger Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Building Permit Application Please print DATE: JOB LOCATION: � J� p�/ Number Street Address Map/Lot HOMEOWNER FCIZ�X- 941%,L51<1 (19,e 69.2-aG57 6:791458-R/I/ Name Home Phone Work' Phone PRESENT MAILING ADDRESS /Y5: 30 .5Tor-i Abp 9,jo0-Vc1z-1 /.717R 0/8,v City Town State Zip Code The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two family dwellings and to allow such homeowners to engage an individual for hire who does not possess a license, rop vided that the owner acts as supervisor. 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 dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 CMR Section I IO.R5.1.2) The undersigned"homeowner"assumes responsibility for compliance with 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 proceduresand requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFIA� Revised 9/16 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535