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Home My WebLink AboutBuilding Permit #109 - 158 OLYMPIC LANE 8/14/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION O t Permit NO: Date Received o > +' Date Issued: O SSACNU`.+�� IMPORTANT: Applicant must complete all items on this page LOCATION 57�- �\ Zan J Afhb,r,-,(- 0 Pri t,�,� PROPERTY OWNER �0 (Y1 t` } ACX a, 1 Y1R�C�1✓ Print MAP NO.: PARCEL: 'Q-5' ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WO TO BEP FORMED a1i1 PUN)(Ar& t Ct�*�AS Identif ion Please Type or Print Clearly) OWNER: Name: �r Phone: �aic-1.—'1 (039 Address: �- CONTRACTOR Name: G�� r,� fin' t ! NGS hone: &)3 3 G �U Address: 90 Caz � f. PANG bT�1� Supervisor's Construction License: Exp. Date: Home Improvement License: d Exp. Date: r ARCHITECT/ENGINEER �k Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 6,00, o(7 FEE:$ aZ)p, — Check No.: Receipt No.: f Page 1 of 4 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ ❑ ❑ Tobacco Sales Well ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting th unregistered contractors do not have access to the gu ranty Signature of Agent/Owne Signature of contractor Plans Submitted ❑ lans Waived ❑ Certified Plot Plan ❑ Stampe Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ CQMMENTS NI 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 Temp Dumpster on site yes_no Fire Department signature/date 1 Building Setback (ft.) Front Yard Side Yard Required Provided Required Provides Re uRed Yard 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) i M W, 0 (�1 r why N d i i i I Page 3 of 4 Doc:INSPECTIONAL SERVICES Dr,EPARTMENT:BPFORMOS Created IMC.Jan.2006 - r- 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the I that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. Board of Appeals pp One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 `� Pane 4 of 4 i TOWN OF NORTH ANDOVER NORT11 APPLICATION FOR PLAN EXAMINATION o��t�eo "tio O L FO � �� K I Permit NO: � � Date Received v +' � � 41 Date Issued: • C� " d SgTED cl+us��y IMPORTANT: Applicant must complete all items on this page LOCATION 5? l �\ -� � Pri t -- n PROPERTY OWNER �� (Yl �` .Q as l� Y1R�C�I✓ Print MAP NO.: W14 O.PARCEL: J'A'S ZONING DISTRICT: I TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family ❑ Addition ElTwo or more family ❑ Industrial ❑ Alteration No. of units: Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition , ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WO TO BE P FORMED mw& I CAQ R� Identif ion Please Type or Print Clearly) OWNER: Name: L6CU_a_ �_M Phone: Address: i Ln VV, �J 0A ya tj CONTRACTOR Name: C&� C.0 � - �N t t^�Gr c Phone: &)3"3 p Address: 90 C�tz—s I'/Vo 7, , PANV C-!4 C-STS r/ay(o I Supervisor's Construction License: Exp. Date: Home Improvement License: q qS C Exp. Date: ARCHITECT/ENGINEER n (YQ _ Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ WOO, On FEE:$ 3D — Check No.: ,JReceipt No.: Page I of 4 Location I -C No. 169 r Date �aRTh TOWN OF NORTH ANDOVER f 9 + i ; : Certificate of Occupancy $ z �' b''•'°''<� Building/Frame Permit Fee $ ,`f sA�NUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 9349 � Building Inspector t4ORTH 0VM Of 4 over 0 No. 101 % A E dover, Mass., COC MICMEWICK 7�AoRATEO Cl `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System WBUILDING INSPECTOR THIS CERTIFIES THAT....... ...........��.............�!�!l ... ...t ........ .. .�.l0�..�1. Foundation has permission to erect........................................ buildings.on IT&O....0........ AMjp�.A� . Rough C to be occupied as.��/�1�Y�/ ..."../ .11! .... .d�1"�. �l ..... ........p� � .. him ney provided that the person accepting this permit shall in every respecTconform 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTISTC4RTS Rough .......... ........ .... .............. Service .. . .. . . ..... . ..... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved Py the Building Inspector. Burner Street No. SEE REVERSE S 1 D E Smoke Det. NpRTH TOWN OF NORTH ANDOVER � qy „tfl °" OFFICE OF p BUILDING DEPARTMENT l =t: 4 1600 Osgood Street Building 20, Suite 2-64 •9pOgAiEO tpP,`,5 North Andover, Massachusetts 01845 9SSACauSgi Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: `-i JOB LOCATION: Number S reet Address Map/Lot HOMEOWNER)�'M'1 d l Q� 1 V l /� ��—qi S 3o Name Home Phone Work Phone PRESENT MAILING ADDRESS � � � �j(_ Lo-il) ,Q 0MN-ale-tAl- A� / l C4S� 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 req, 'rements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICI Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 6889530 HEALTH 688-9540 PLANNING 688- 9535 The Cummun►vealth of,Massachusetts II i Department of Industrial.tceittents Office of Investigations 600 Washington Street •� Boston, AM 02111 �a , , ►v►v►v.ntass.govidia Workers' Compensation Insurance .Affidavit: BuilderslContractorsiElect ricians/Plumbers Applicant Information Please Print Legibly V,ame IT/4t /1 - 14 1 6- I r C ,Aciclress:- too C' 05 lj� - c City State� 1-� Zip: Pf`�6UCSI_IIL\ Nhone .4: �j�3 -C Ave you an employer?Check the appropriate box: Type of project(required): I.❑ I am a employer with 4. ❑ 1 am a general contractor and 1 6. Q ^Jew construction cmployces(Full andr'or part-time).* hate hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed un the'attached:.heet. ' Remodeling ship and have no employees These sub-contractors have 3. Q Demolition workingFor rite in an capacity. \.corkers' comp. insurance. q YQ Building addition [No workers' comp. insursance5 We are a corporation :and its required.] officers ha,,e exercised their 10-El Electrical repairs oradditions 3.❑ 1 .stn a homeowner doing all work right of exemption per MGL 1 1.Q Plumbing repairs or additions myself. [No workers' comp. C. 152, §1(J;),;and we'have no 12.Q Roof repairs insurance required.]t employees. [No workers' 13.Q Other comp. insurance r;:ctuired"] --__ �ny ippticant that dicck;box,I I nntat al:,o fill.:ut the:,cchuo below:,howing their workers'compen_atien policy intbrm;dion. I I,:mecwncrs who mhnnt Ihis anidavit mdicatink they are doing all work mid then hire outside a:ntractars must submit a new affidavit indicating itch. I , ntractcr•,that.heck this hot must auachcd:m Adifirnal.beet showing the name :f the .uh-contractors and their'.Ncrkers'comp.policy m(cmiauon. I um nn employer that is providing)vurkem'cvunpensation insurance fur my employees. Below is the policy and job site inlormution. In°:urancc Company Vame: Expiration Date:---- --- _--- --. !vb Site address: City State.Lip:. ----- - — - --- Attach atopy of the workers' compensation policy declaration page(showing the policy number and expiration(late). i ailuro to .ccure coverage as required under Section '5.\ of%lGL c. 152 can icad to the imposition of criminal penalties ot.t rine up to 51.5011.00 and,or une-�.-:ar imprisonment, as well as civil penalties in the turm ufa STOP� ORK ORDER .tnd a tine 1)t up to y2:0.00 a -lay against the�iulator. E3e advi:.ed that a copy ut this tatcment may be forwarded to the Office of Into.options(:f the DIA for insurance cuccr:.t;e 4erification. 1 10 herehy cei tih,un, r s and penalties of perjury that.,he htfimmution provided;shove i.'trite find correct. /06 Ia�r Biu , 1-�--Kc- -c� d l 7: a' •<v ! .:ha�+tw I.:ar;:te-tt)e): --- --- �._ __ - —'-----_— II ). +`:11'l in g ;?')I':',li,'d _. '•i f. , a 1 ,� .. ^ ;f 'Al --- - ------------- I i Note: This dr<c mg is an artistic202W"' Desi, ned: 10/20/200-5 Intf;I"prCtatlon OL the general appearance Of TECHNOLOGIES� Painted: 10/22/2005 the design. It is not meant to be an exact — - - — — — rendition. i tlu-oop, rebecea throop, rebecca and tone-conceptual construction Drawing h`_ 1 Existing wall to be Existing wall to remov j poor trim rema (B) �(A) - -- -- - ----rema-in.------�- ,. ., removed, smooth 1 1 _ Details: I2 -4 � - — 5 finish to opening. Remove 5' 2 ,2" x 3' 6 '2 of non-bearing wall in 1 kitchen to create an \\. opening. (A) Return end of watt at 2' \ {C) 4 %" from rear facing wall as shown. (B). Build counter to 40 %" --- — -- — rough to receive I countertop extending 3, into opposite room to create a 'bar'. (C) Throop, Rebecca & Tom, 157 Olympic Ln., North Andover - 938-258-5309 Scale: 1' = 1/4" � � � �� _ � ' � � j � ; ` � � � � i � I , I + I � } I f � � +' � � 111 l I !.__.� ( � 1 �"'�s�� i , _a � _� 1 —�.�— -'�...i U_, _ =�`� .._____ ______.. i i I i 1 1 DesLerlcd: lU 2tti2UU- Note This dray ln`is an artistic LTJ t ,� Iplinted. 10/22i2UU.5 interpretationOf the oetleral appearance OF TECHNOLOGIES'ii the desion. It is not nlealnt to be ark exact rendition. tLiroop, robe cca throop,rebecca and tom-collceptllal constriction - _