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HomeMy WebLinkAboutBuilding Permit #727-11 - 145 JOHNSON STREET 4/29/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO -2L --J/. 2 Date Received Date Issued: ORTANT:Applicant must complete all items on this page LOCATION 57- Print _PROPERTY OWNER (3t/,t, GtRc�C.yC F:ri2 Print MAP NO: PARCEL- ZONING DISTRICT: Historic District yes o Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building )tOne family 11 Addition ❑Two or more family 11 Industrial [I Alteration No. of units: ❑ Commercial >�"-Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other fi(j�Septicx f7�We11; ,�-L��',-. `��I�,Yoodplaui� ©nWetlandsi E i ;®�yVatershecl�District,� . --'R �,-:._.., —�_._._.�.....<_� .....-- ---.—. i-.:`.L_91-__. ..,.....__ _�.__•._ .- ....-- - -- c �-�'_ G -s.:-�'a .,..r+, .:v[;i raj j� � ;`�-�* :.S DESCRIPTION OF WO TO BE PERFORMED: �,W I lit Nip CWSd© -5 S Identification Please ,Type or Print Clearly) OWNER: Name: f3( L `— GIGOCtKFK/` Phond•17V- 6S'6 Addressyr)l CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: t 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: $ 0 $_ Check No.: Receipt No.: NOTE: Persons contrac ng un r g' t e ntractors do not have access to the guaranty fund afure of A' Sig0h..- .wrier. a ure of:contracto n =---------=-g----•---_.-_.-_ - - .-- -----------=--__--r�� - - �'�: : r 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 ❑ 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 Signature COMMENTS HEALTH Reviewed on Siqnature 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 CO/INMNTS 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 i ® Notified for pickup - Date I 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 ❑ 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 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 ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals A the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording ist be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Location No. Date ,.OATH TOWN OF NORTH ANDOVER F • 41 • i i Certificate of Occupancy $ „'"'ASC' Budding/Frame/Frame Permit Fee $ s,+cNuse 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 24 , u Building Inspector ORTH Town of : . a. VA No. t1 LAKE O dover, Mass., � 1 COCHICHEWICK 7�AORATED BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..................... I.. C. ..�............ .�.�............. .... .............................. .................... Foundation has permission to erect..............: ....................... buildings of oks ...... ... .......... Rough to be occupied as �,,,�.� o c. ........... 4�16r*m* Chimney . . .. ... .. . .. . . . . . . . .. . . . . . . . . . . . ......... ..... ............ ....provided that the person accepting this permit shall in every 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT I ' S 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. j"* E tv NOS x. a - . µoRrH TOWN OF NORTH ANDOVER �Ot,tteo s6��O o� OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20 Suite 2-36 "yOVA9 North Andover,Massachusetts 01845 1 �SSAc►+usEi I Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE:_q 02 °7 02 a JOB LOCATION: TO ti rl C $ S Number Street Address Map/Lot HOMEOWNER r t,. Gogl,- `� 7$ 6W6 '3472 2 BI 013 7 !3� Name Hom Phone Work Phone PRESENT MAILING ADDRESS S 1+M l v City Town S* +.e Zip Code- The odeThe 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 To of North Andover Building Department minimum inspection procedures and re uirements and it mply 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 r { The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibl� Name(Business/Organization/Individual): (V C-VZV Cc,<,F� Address:- [ ' l'f 1\),s O t�,J J City/State/Zip: Phone#: c( 7 K $ 3 a 22 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time). have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet.# �• F1 Remodeling ship and have no employees These sub-contractors have 8. []Demolition workingfor me in an capacity. workers' comp.insurance. Y p tY 9. F1 Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their I 3. I a right of exemption per MGL 11.E]Plumbing repairs or additions m a Homeowner doing all work g p g o workers'comp. c. 152,§1(4),and we have no myself. [N x p12.0 Roof repairs insurance required.]t employees.[No workers' comp.insurance required.] 13.0 Other *.Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 Homeowners who submit this 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 their workers'comp,policy information. .t am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: 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 up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do Hereby ' up andpenalfies ofperfury that the information provided above is rue and correct. Si ature: Date: 40, 1 01 o i l Phone#: 2l g- 302 2 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 CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: � o d k a R as to ,...._...,. B Y + rvmwvm Ci a of i ------------- --------- IL [i t + 3 00, !ks ` a � l' I ea ..... ........ .......... 1A Bedrm I Marvin CCM2860 Casement Clad T-5 x 4'-11 5/8" Custom _arge hgt.of 9'g. k 0. 1B Bedrm I Marvin CCM2860 Casement Clad 2'-5"x 4'-115/8" Custom Enlarge hgt.of ex'g. PLO. 2A Office -Marvin CAWN3236 Awning Clad 2'-9"x 2'-115/8" 2w2h 2B Office Marvin CAWN3236 -Awning Clad T-9"x 2'-115/8" 2w2h —3 Office Marvin CAWN3236 Awning--- Clad T-9"x 2'-115/811 2w2h Enlarge hgt.of ex"g. PLO. Marvin CCM2036 Casement -Clad 1'-9"x 2'-11 5/8" 2h Enlgge-.hgt.of Wg.RO. 5 Entry Marvin CAWN3236 Awnin-a Clad 2-9"x 2'-11 5/8" 2w2h Enlarge ex'g PLO. - 6A Living Rm Marvin CQM2860_1 I Casement Clad 2'-5"x 4'-11 5/8" Custom Mulled_w/3"stud pocket 6B Living Rm Marvin CC 860 Casement Clad 2'-5"x 4'-11 5/8" custom Mullal w/3"stud pocket 6C Living Rm mm-wn CC 860 Casement Clad 2'-5"x 4'-11 5/8" CtL,;tom Mulled w/3"stud Pocket 7 Mud Rm Marvin CAWN dqstom Casement Clad 2'-3 3/4"x 2'-6 5/8" 2w2h Align casing w/adjacent door 8 Garage Marvin CAWN3236 Awnine Clad 2'-9"x 2'-1 15/81' 2w2h New KO. 9 Garage Marvin CAWN323Awnina Clad 2'-9"x 2'-11 5/8" 2w2h New R-0. Marvin CCM2460 Casement Clad 2'-1"x 4'-11 5/8" Custom Enlarge ex'g.PLO. N— Marvin CCM2460 Casement Clad 2'-1"x 4'-11 5/8" Custom Enlarge Wg-KO. 12Master Bath Marvin CAWN3236 Awning 1.4A Clad 2'-9"x 2'-11 5/8" 2w2h Enlarg ex'g R.O. 13A Master Bed Marvin CCM2860 Casement Clad 2-5"x 4'-11 5/8" Custom Enlarge ex'g R.O. 13B Master Bed Marvin CCM2860 Casement Clad 2'-5"x 4'-115/8" custom Enlarge ex'g R.O. •_14A Master Bed Marvin CCM2860 Casement Clad 2'-5"x 4'-115/8" Custom EnIggehgt. of ex1g. &0. 14B Master Bed Marvin CCM2860 Casement Clad 2'-5"x 4'-11 5/8" Custom Enlarge hgt.of eeg. Ko. 15A Bedrm 2 Marvin Cd2860 Casement Clad T-5"x 4'-11 5/8" Custom Enlar ehgt.of exg. PLO. 15B Bedrm 2 Marvin CCM2860 Casement Clad 2'-5"x 4'-11 5/8" Custom Enlarge hgt. of e;Cg. R.O. 16 Bedrm I Marvin CCM2860 Casement Clad 2'-5"x 4'-11 5/8" Custom Enlg&e hgt. of ex' R.O. ------------ -g.................. {iCY--•:-ii•�:.:'::::i:':iii:i+:::::3:irii: Ir!`'/J\\/`��'/ 105 Dining Rm Marvin CUIHIFMD2868 ult.in-swing fr. Clad 2'-10 7/16"x 6-10 1/21, 2w5h SPECIFICATIONS I- EXTERIOR CASINGS: Tyv: l"x5 1/2" actual dim-)PVC;Width varies for joined windows, see elevations 2.INTERIOR FINISH: Pine or poplar,painted 3.GLAZING: Low E IL with Ar on