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Home My WebLink AboutBuilding Permit #213 - 164 HILLSIDE ROAD 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION /r - ll Permit NO: Date tWeived Date Issued: IMPORTANT:Applicant must complete Tl ijems o;Nhis page LOCATION 16 14 J'/IS!de R,pA4 Print PROPERTY OWNER % ;g S,4!'A)? Wei )/Cpc k Print MAP.NO: PARCEL: o ZONING DISTRICT: R3 Historic District yes Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New BuildingOne family Additions Two or more family Industrial Alterations No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District r DESCRIPTION OF WORK TO BE PERFORMED: A/e-w basky,*2d Identification Please Type or Print Clearly) OWNER: Name: Lc/CIfor Phone•1 7YP Address: CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: - Home Improvement License: 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. Total Project Cost: $ � �/� FEE: $_ Q Check No.: Receipt No.: 2;z ey Z NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Si nature of A entlOwner -/i u - _.___ g_ g Signature of contractor - — Plans Submitted Plans Waived Certified Plot Plan Stamped Plans 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 ❑ 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: Doc.Building Permit Revised 2008 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 21 A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) C19 ffeW ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/MassageBody Art Swimming Pools Well Tobacco Sales ,. Food Packaging/Sales Private(septic tank,etc. Permanent Du�pster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on A?h) Si nature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes M 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 Location No. a/ Date Na^T� TOWN OF NORTH ANDOVER Certificate of Occupancy $ • orb+,�_. c' • CNus Building/Frame Permit Fee $ �a Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22 Building Inspector NORTH Town of : 4Andover 0 No. i= A K E dover, Mass., COC.'C."'.CK y1. 7,p ADRATED p �4 `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System �f/ ''` �Ce 40 I E//� l( BUILDING INSPECTOR THISCERTIFIES THAT............ ........... ............................................................. ........ ......................... .................................. Foundation �I has permission to erect................................... buildings on .A6 y. ... <� ....�......�....... Rough h to be occupied as Chimney �� . ....../.. x...1. ............................................................... .. . . . . . . .. .. . . . provided that the person accepting this rmlt shall in every respect conform 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 CONSTRUCTION STARTS 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. ��y,,o�' I CERTIFY THAT THE STRUCTURES I.P. SHOWN WERE LOCATED BY AN FND INSTRUMENT SURVEY AND EXIST I ON THE GROUND AS SHOWN. ZONNING DISTRICT : R3ING INFORMATION: ZO MIN. BLDG. SETBACKS: FRONT 30 FEET SIDE 20 FEET REAR 30 FEET ASSESSOR INFORMATION: MAP 98C PARCEL 22 DEED REFERENCE: BOOK: 3857 PAGE: 180 J' OWNER INFORMATION: lJ � t, cp !; WILLIAM & SARA WELLOCK v'o 164 HILLSIDE ROAD ''LOT AREA o o, n .,. 1397 W Lu 33,4 76 S.F. NORTH ANDOVER, MA 01845 ' f �z t„¢ IS�f tiR� ��rt'{v � W C) S EXISTING SEWER LINE CONTINUES I TO #81 WESLEY STREET OWNER c PROP. ADD177ON I✓ OF #81 WESLEY STREET HAS EASEMENT W RIGHTS TO MAINTAIN SEWER LINE THROUGH PROP. PRECAS #164 HILLSIDE ROAD (DEED: 3857/180) I� BULKIHP 9�G - 1oQ 6 S 47.5' 1.P. - -I 23.0 17.0\' J� g �. FND 35.3' ~' 0 2J.6'- EX. 3.6'.EX. 2 ST. 1 ST. WD. FR. EXISTING SEWER LINE STRUCTURE GAR. - - - 37.1 I � 1.35' SECOND co FLOOR OVERHANG I o o PLOT PLAN OF LAND 73.1' 75.2' I z #164 HILLSIDE ROAD NORTH ANDOVER, MASS. s I PREPARED BY: t. N24°30'08"E JOHN D. SULLIVAN III, P.E. I.P. 149.74' (MEASURED) 'LP. 22 MOUNT VERNON ROAD FND 150' (DEED) I FND BOXFORD, MA 01921 HILLSIDE ROAD (978) 352-7871 SCALE: I "=40' DATE: 11 /5/07 -UNLESS OTHERWISE SPECIFIED- COMPANYi ALL DIMENTIONS ARE IN INCHES 164 HILLSIDE ROAD AMR-ES +_S' PARALELL B IN 5 FEET .x+—.,as .roc+—.Da NORTH ANDOVER, MA. frocuone +— one eight TITLE, PLAN VIEW DECK JOB NO. : SCALE, DATE, 9/1/09 FILE NAME: DESIGNED BY, REV NO, BACK DECK W. W. DRAWING NO, HILLSIDE DRAWN BYr PAGE, 1 W. W. 18,0 15.0 2,5 T_ 3�3 4, D- T 7.0 7 .0- 817 8,7 16.0 1, 8.0 ----------------------------------------- L--------------- ---------------------- :NG ---------------------------------------,L--------------- XISTING FND -UNLESS DTHERVISE SPECIFIED- COWANY' ALL DIMENTIDNS ARE IN INCFES s r w�a� 164 HILLSIDE ROAD acs•� ai vs IN X+—.125 M+—.as NORTH ANDOVER,MA. TITLE'ELEVATION NW SIDE JOB N0. : SCALES DATE] 9/1/09 FILE NAME I DESIGNED DYE BACK DE DRAVING N01 DRAWN BYi PAW HILLSIDE W. W. 2 EXISTING HOUSE 2'X8' PT LEDGER 5/4"X6" DECKING 2"X8" #2 PT J❑IST 28- < GROUND PLATFORM POST ANCHOR (2) 2X10 #2 PT BEAM 4"X4" POST 8" CONCRETE #2 PT F❑❑TING -UNLESS OTHERWISE SPECIFIED- COMPANY' ALL DIH6NTI0lIS ARE IN INCHES 164 HILLSIDE ROAD vacs+_x r�u�.vs m s icor x+-•+n -=+-m NORTH ANDOVER,MA. TITLE ELEVATION SE SIDE JOB NO. : SCALE DATE 9/1/09 FILE NAM DESIGNED BY, V ND BACK DECK W W DRAWING ND DRAWN DYE PAGEi HIT T GIDE, 3 W. W. 5/4" X 6" DECKING LEDGER 2' X8' #2 PT 2e• III 4"X4" POST POST ANCHOR (2) 2" X 10" Q GROUND PLATFORM #2PT BEAMS A: a.0 8" CONCRETE .: F❑❑TING ur"vm vmvm- A" ""VDIDffum"E IN RCM N s rar 164 HILLSIDE ROAD waa.p rirai» NOMW ANDOVER,NA. GROUND nTm PLAN VIM 2 PLATF❑RMMTD 9/1/09 iIWAVM mm HII13IDB R. A. 4 1 ' 0 5/4'X 6' DECKING 1 2'X8' HEADER 2'X8' JOISTS NO / / (2) 2'X10' #2PT 8' CONCRETE FOOTING 8 . 0 4 . 7 . 0 7 . 0 EXISTING 16.0 BULKHEAD 1 5 'X6 DEC ING 8 . 0 EXISTING FND I I I L------------------------------------------------- t t tre Lo►nrnoezweala of Mtrssachusetts f t DeF°�ent Qf•fndustrial Acciderr�s Vice of Investig adores 600 Jrashirzgton Street Boston MA 02111 Workers, Campeesation Insitrsntee �W trzQssgrry/din • A 'cant information. A- d�vi &udders/Coatractars/Eiecfriciarts/PiQmbers Please Print Leeibi Nan a(Business/Otgeaizaiionnndividual); �t a Address.- Ci : Are you au em m p yert Cheek.the appropriate-bo I:❑ I am a employer with 4. ❑ I a Q Type of Project(t egait ; employees(full and/or—* general contractor and T part-time). have hired the sub-cortttactors 6• [],New cosistruction 2•D r am.a.sole propriZ or Pier• iistad on the attached sheet 3 7. ship and have no I D Remodeling working far me ar �Y�s The subcontractors have [No workers' co ny�P '• warkom' comp.ins g' D nalition mp•iasraastce . S. 9• BW'Icii required) ❑ We are a corporation and its D ng addition �XTYBOIC I ain a homeowner do' ° h8ve exercised their I O.Q E1ev^tricalrepairs or additions mg ail wont rigizt of exemoan PM IyyGL 1 I.[No waric ❑Plumbing repairs or additions insuratrce. �, §I(4),.and,we have no regnurd.] .=PIcr [No workrm' 12.[]Roof repairs tY BPPticarrt treat t# COMrrcks bo>!t l mmt also Fitt out thep izZsurance required.] I 3.❑.pmt section below showing theirworka t botomcatioa Pohoy infonnetion• o mC0 n;ti who submit this aftidavh indicating they ars doing an work.er►d 16�hes outside con �Caatracton tical check this box n ust•atmohd=addWo=j sheetsho tractors must submit a.neiv x'r t3te name of the sub- Affidavit indiodiag suck' coanacfors and rho' t ar.:.arr et�sioper ti:cr is prtvuiaurtg:toor� '�r,�serzsater�a tr work=' in£aumiton. infar�inz. � •trisarasrefor my empinveet; �edaw.g•tF.e pa a-job sr`& Instaanee Company Name: Policy#or Serf-ins.Lic. #: - Expirstion Late; Job Site Ad&ms: Attach a copy of the workers' co Crty/StatelZrP• mpeusatios Policy d�eeFarafiao oe showioa Failure to sectre coverage as required under Section 25A of . Pah ( b the policy number and e MGL c. I52 can Iead to the i osition of xpira6ou dale} fine up to S1,500.00 and/or one-year imprisonment;as well tis civil � criminal pena}ties of a Of uP to$250.00 a day against fir=vicalatar. Be advised pees in the farm of a MP WOiu{ORDERMd a fine Investigations of the DIA for insurance cov v s copy of thist be forwarded to the . enige erin�on. Otfi�of I do hereby ceWfy under the pains and penalties ofp=lury tYrat the i►tformationry Si p vu<ed above true and corm-a Phone#: Date: 3 v Oficial use Duty Do not write is this arra,&be contptetmff!ry ahY or town ofkial City or Town: Issuiao/� Permit/License# d athor•ify(circle one): L Board of Heattb Z Building Department 3.City/Town Clerk 4 Electrical Inspector S. Plnatbi 6.Other ng Inspector Contact Person- Phone#: Information '. nd Instructions Massachusetts General Laws chapter 152 requires all emp 3oyers to provide workers' =npensafion for their employees. Pursuant to this statute,an wr*yee is defined as"..:every person in the service of another under any contract ofhirc, express or implied,oral or wrhf .n." 15. An emptnyer is defined as"an individual partnership,association, corporation or other lege] entity,ar any two c r more of the'famping engaged in a joint enterprise,and includi"g-the legal rcpresentafives of a dcc cased employer,orthe receiver orttistee•of an individual,partnership,associatia1n or other legal entity,employing employees.'Howcwthe owner•of a dwelling house having not more than three apartmerrts and who resides therein, or the occupant of the dwelling house of another who employs persons to do rrraintenarrce,construction or ' worse on such dwellinghouse or on the grounds or building appurtznaat thereto shall not bezzuse of such muplayment be dwmed to be an employer." MGL chapter 152,525C(6)also states that"every state as-beat nednsiug agency shall withhold the inwanceor renewal of a licause or permit to operate a business or too construct buitd'mtgs in the commonwealth for aay apPlicamrvho has not produced aeceptabk avideacm of compl'saace with tiia nwrance coverage required." Additionaliy, WGL chapter 152, g25C(7)statos"Neither tic commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public worse until—acceptable,evidence of compliance with the in mat regrrir=cnts.of this dsapter have been presented to the cotritrazimg authority." Applicants Please fill out the workers'compensation•affidavit complertely,by checking the boxes that apply to your situation and,if necessary, supply sub�toi(s)rrame:(s),address(es):a.•nd phone number(s)along with their ceatificate(s)of insu m= Limited Liability Companies(1,LC)or Limited Liability.Partnerships(LLP)with no employees otherthan the members or partners,are not rzquvrd1to carry work=s C(.-.*rnp=mdinn insra a= Van LLC or'LLP does have empioym s,a policy is required. Be advised that this af[da-m-it may be submitted to the Department of Industrial Aeeide:rts for confmnation of insurance coverage. Also.131'e sure to sign and date the iff iduVt The affidavit should be retuned to the city or town that the application for the p�jt or license is being requested,notthr Department of Industrial Accidents Should you have any questions,regaz-ding the law or if you are required to obtain a woticers` oompensation polioy,please-c .R the Department at the nurmber,listed below, Solf-iasurzd companie s sh=uld ansa their self insumuco'lieansc hung on the"aopmpfieta unr. City or Town Officials Please be sure that the affidavit is complete and printed 6Wbiy. The Department has provided a space at the botiam of the affidavit far yoir to fill out in the-event the Office of lnvestipations has to contact you regarding$re applicant Please be surew fill in the pmrmit/liccnse numberwhia will be used w a reference number. In addition,ase appHc:znt that must submit multiplt parmit/iiccnso applicatiarrs in any given year,need only submit one affidavit indicating. U11011 policy information(if necessary)and under"Job Site Address"the applicant should write:"all locations in (city or town)"A copy of-the affidavit that has been,officially stamped or marked by the city or town may be provided to the applicant as proof that a'valid affidavit is on rile for fitare permits or licenses. Anew affidavit must be frBed out each year. When a home owner or citizen is obtainirtga licenses 'or p=it not related to any business or commercial ventam (i.e. a dog license or permit to bum leaves otr.)said person is NOT.roquimd to_complcts this affidavit. The Ofrrce of Investigations would Iter to thank you in advance for your cooperation and should your bane any questions, please do not,hoshate to give us a call The Depart mont's address,telephone and fax number. The Commonro$1th of Wkwachusetts Depmtment of Fazdustrial A=de3313 Office of Lnvestig2fions 600 Washington Sti=t Ragtm, MA 02111 Te1. #617-727-4900 i=406 or 1-5.77-h ASSAF$ Fax#617-727-7744 Revised 5-26—(15 WWW.mam-govidia A North Andover MIMAP 164 Hillside Road September 8, 2009 025,0-0048 098.0-0020 098.C.-0095 O 025.0-0047 098.C:-0021 098.0-0094 025.0-0046 r _r 098.('-0022 098.0-0025 V 0-0045 098.0-0024 N 098.0-0023 Z �r •fey Ct/ S 098.0-00.52 098.0-0028 098.0-0048 098.0-0113 —Rall Une Interstates Interstate Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Major Roads Meters Data Sources:The data for this map was produced by Merrimack Roads NORT1y Valley Planning Commission(MVPC)using data provided by the Town of pf"'Go �h, North Andover.Additional data provided by the Executive Office of r;Easements ? •e 0, Environmental ANalrs/MessGIS.The Information depicted on this map Is - Trails 3' for planning purposes only.It may not be adequate for legal boundary Streams f "`• ,. n definition or regulatory Interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING 0 MVPC Boundary ! ♦ THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY + t .^, Y OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Municipal Boundary ! sol+ �• ! ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF ❑Percale .]� oe,r,o "�j THIS INFORMATION Hydrographic Features 1SSACMuS�t 'S Wetlands Exempt Lands 1"=68 ft "�` NORTH TOWN OF NORTH ANDOVER °� OFFICE OF n BUILDING DEPARTMENT o f 1600 Osgood Street Building 20, Suite 2-36 9y+o�wrip��``,� North Andover,Massachusetts 01845 ,SSwCHus�t Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: � °1 JOB LOCATION: 79 C ,2 a Number Street Address Map/Lot HOMEOWNER WeI�,� 92 g/�a Name Home Phone Work Phone PRESENT MAILING ADDRESS Vls-1,�-le j2 ons Gj �1/c✓ /1��i Cf:: 1 P 5/S 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 requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE �� APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 R Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL =PublicSewer 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 TE REJECTED DATE APPROVED CONSERVATIO �� 26y COMMENTS 'l i irc�r�S (,l)A (a) 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 ocated at 384 Osgood Street F1RE DEPARTMENT Tempumpster on site yes r�o { Located at 1241iita�n Street ri �+ }f .7 r Fire Department signs#ure�date i ' rt ' , "` 1' G01�1�71E'NTS � fY �: 4 ,40RTH Town of . _ . Andover 0 .- - VO No. L A K o' dover, Mass., I� cocHICMEWICK yA. 7,95 RATED BOARD OF KEALTH Food/Kitchen PE ,RMIT . T D Septic System BUILDING.INSPECTOR THIS CERTIFIES THAT........ E.��t..'`'"1........Wf. e .................. ................................:................ Foundation has permission to erect........................................ buildings on. ..?.....f'/.4.��N./. 6.........`�................................. . Rough ........................................... }� r !t s ! l< ��-�/1c- jf— �!t Chimney to be occupied as.............(�. . .1..�t...`'`9.....:.. ................. ..............:..., ................................................... . �'/........ y provided that the person accepting this permit shall in every rbspect conform 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 Ins pe ion, Alte " d Construction of Buildings in the Town of North Andover. r� /A/ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S Rough ..................... _ .............................. service BUILDING INSPE Final Occupancy Permit Required to Ocmpy 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.