HomeMy WebLinkAboutBuilding Permit #57 - 156 WAVERLY ROAD 7/25/2007 BUILDING PERMIT NORTH q
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TOWN OF NORTH ANDOVER ar '° o
APPLICATION FOR PLAN EXAMINATION «
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Permit NO: Date Received
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Date Issued: 7 2l o7
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ Qne family
❑ Addition &Two or more fames ❑ Industrial
❑ Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition 0 Other
��. QESCRIPTION OF WORK TO BE PREFORMED-
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Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ /'S000 , 00 FEE: $ %�� t 06
Check No.:
7 7 Receipt No.:
NOTE: Persons contr ting with unregistered contractors do not have access to ar f d'
Signature of Agent/Owner Signature of contract
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM I
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DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
1
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
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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 ❑
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
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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 2 1 A—F and G min.$100-$1000 fine
NOTES and DATA— For department use
❑ Notified for pickup - Date
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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
o Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
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✓
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
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
No. Date
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MORTM TOWN OF NORTH ANDOVER
f41
9
Certificate of Occupancy $
Building/Frame Permit Fee $ ,
s�►CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
255-7 7
Check #
20465
Building Inspector
HUNG ASSOCIATES, INC.
Civil/ Structural/ Management Consultants
19 Campbell Street Tel: (781)503-0241
Woburn,MA 01801-3605 Fax: (781)503-0247
July 31, 2007
Mr. Jerald Brown- Inspector of Building
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Building Department
1600 Osgood Street,North Andover, MA 01845-1048
RE: 156-158 Waverly Road
North Andover, MA 01845
Dear Mr. Brown:
This is to certify that the structural renovation for the above reference project complies with the
submitted structural drawings and the Massachusetts State Building Codes 780 CMR 1600.
If you have any questions please do not hesitate to call us.
Very truly yours,
e.
HUNG ASSOCIATES, INC. ��,PLOFMAssc
O� SIMON 9yG
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HUNG
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HUNG T4
STRUCTURAL y
n No.34002
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NAL
Simon J. Hung, IdE., Preside t
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THE COMMONWEALTH OF MASSACHUSETTS
Department of Public Safety
One Ashburton Place, Room 1301
Boston,Massachusetts 02108-1618
Phone: (617) 727-3200
Fax: (617)727-5732
J
ARGEO PAUL cELLUM
Gov=cr SECONDARY CONSTRUCTION CONTROL DOCU3IIEN7
KATEIEEN M OTOOLE
Socrd-Vy (for Professional Engineers/Architects responsible for only a portion of a controlled project)
Project Title: 3 UTA t.t �..E.S tDENT1I�L R R�[. /6 ,j_.?Lud t
Project Location' '196 vie v ST ./(. 19-N VOW t 0- MA
Scope of Project: -50 rL L Mk L rr_►t _ _.5 y( f T r4A
In accordance with the sixth edition Massachusetts State Building Code,780 CUR SECTION 116.0:
SAM 6 5 N .M c m-"Ara-14 - , Mass,Registration Number —3
being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans,computations and specifications concerning:
[ ] Entire Project [ ] Architectural (.3 Structural (. j Mechanical
[x) Fire Protection [ ] Electrical [ ] Other(specify)
for the above named project and that to the best of my knowledge,such plan's,computatiotii'ani specifications meet the
applicable provisions of the Massachusetts State Building Code,all acceptable engineering practices and all applicable laws
for the proposed project.
Furthermore,I understand and AGREE that I shall perform the necessary professional services to determine that the above
mentioned portions of the work proceed in accordance with the documents 1he building pennit.
EpLTH of
Upon completion of the work,I shall submit a final report as to the satisf �col letio'd, e aboN-e mentioned portion of
the work R All v2
Signature of registered professional: ppDTFIrl m 10,
..� J� Fs �'iS p • /7
Subscribed and sworn before me this g day of f'`4 �•►s�0 �� � /
G e►s♦
my commission expires on
otary Public
116catrldoc
Springfield District Office, 165 Liberty Street,Springfield,l4IA 01103
Phone: (413)736-3628 Fax: (413)733-5849
(508) 520-4700 LIC. NO.000793
FAX(508) 520-4712 E-MAIL: ipfpsinc@comcast.net
INDEPENDENT PIPING
FIRE PROTECTION SERVICES, INC.
SPRINKLER INSTALLATION • REPAIRS&MAINTENANCE
INSPECTIONS• 24 HOUR SERVICE
837 UNION ST. UNIT C-17
PHILIP KELLY FRANKLIN, MA 02038-2583
NORTIy
Town of over
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odover, Mass., 2 -�-� '"
0 LAKE
A- CO C N 1 CHE"ICN
�J�A°RATED P? C7
S ` BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT// G
...... ..... ..�............................................................................... .... ................................... Foundation
has permission to erect........................................ buildings on .......................... Rough
to be occupied as.................... f �,.5 /... '�'V..l....11 ..>� ./'r.� �l.!�� '........ s!1...............
Chimney
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provided that the person accepting this permit shall in every res ect conform to the terms Ltee�applklaiion 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
/ i PERMIT EXPIRES IN 6 MONTHS
/ ELECTRICAL INSPECTOR
t UNLESS CONSTRUCTIO ART Rough
.... . ..... . ... .........
.................... Service
BUILDING INS ECTOR
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.