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HomeMy WebLinkAboutBuilding Permit #029-2017 - 2 UNION STREET 7/7/2016 (3) BUILDING PERMIT ONORTH - F�tt.eo ie�'y� TOWN OF NORTH ANDOVER 10 APPLICATION FOR PLAN EXAMINATION y Permit No#: l%�1' " Date Received SSACHUS� Date Issued: ') I ORTANT: Applicant must complete all items on this page LOCATION k (/,k ' ki S t Print PROPERTY OWNER Bm d'a,-v '¢'VC1z� .1_/Lf Print 100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ErA'Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ® Se IN'/ ® amSe_�wer DESCRIPTION OF WORK O BE PERFORMED: �i� W r, D e; e �r �� '1 Identi}fication- Please ype or Print Clearly OWNER: Name: 160_07= WIV atPhone: Address: ae4 �` ON Jr/ /Ua lz-KA WivWo vee Contractor Name: By '���� r 'hone: -3.j 9 ZIq 0 7a 3 Email: 61c),"V 2e fah;` eo Address: �2 6' r ,-`C J'-z� AlO Ve1�4 11 H Q VE'� Supervisor's Construction License: 62S - �D�'°2 57� Exp. Date: 0 /a .-IR Home Improvement License: `'2'� Exp. Date: ©z.2 e, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE;BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ V,0,6), c--O FEE: $ - l44 Check No.: l Receipt No.: NOTE: Persons contracting with unregistered ontractors do not have access to the guaranty fund ( '¢m A r;i�wt�eti K � t�b,;c-. icf Li _ I r NORTH.� - w: 1 : ¢ : :. .c . : ve' . No. Z� 2 '� : bah , ver, Mass, o COC MIC NllAM!WICN TED S u BOARD OF HEALTH Food/Kitchen PER D Septic System • THIS CERTIFIES THAT BUILDING INSPECTOR ......... b 'Idin s on Foundation has permission to erect .. .............. g .............. .........�.�11h1.1... .. ... . Rough Der to be occupied as ........... .. .. ... ......... 1 .YY..� .�:...... .... ........ chimney Provided that the person accepting this permit shall in every respect conform to he terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to thenspection,Alt i Mz tion and Construction of Buildings in the Town of North Andover. z&Vj� Pp �,a PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST 10 Rough Service .. ... . . ...... . Final BUILDING ECTO. GAS INSPECTOR Occupancy Permit Required to Occupy 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. TOWN OF NORTH ANDOVER j OFFICE OF y BUILDING DEPARTMENT }_ * 1600 Osgood Street,Building 20, Suite 2035 North Andover, Massachusetts 01845 Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION RU[DtNG PERMIT APPLFCATION Please print DATE: JOB LOCATION: Number Street Address Map/Lot HOMEOWNER 8 O AN ��v�jZe !��`G' 3 3 -9 Name Home Phone Work Phone PRESENT MAILING ADDRESS 6eee rIVN 3 LZ Ile 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,provided 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 com ly said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 8.2015 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 i The Commonwealth of Massachusetts Department of IntlustrialAccidents d 1 Congress Sheet,Suite 100 Boston,MA 02114-2017 www mass.gov/dia ,�. Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE]FILED WITH THE PERMITTING AUTHORITY. Applicant Information . Please Please Print LeObly Name(Business/Organization/Individual): rt� Address: 02 �ti•` oti f l� -4 of/✓Qw"'o Ve/z- City/State/Zip: eq -(If 4T Phone#: 9 <<G,/0 Are you an employer?Checktlie appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, Remo dang any capacity.[No workers'comp.insurance required] 3.F1I -homeowner doing all work myself.[No workers'comp-insurance required.]t 9. El Demolition 10[]Building addition 4. `am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11. Electrical repairs or.additions proprietors with no employees. 12:❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ ' 1 13.[]Roofxepairs These sub-contractors have einployees and have workers'comp"insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL C. 14.❑Other 152,§1(4),and we have no,employees.[No workers'comp.insurance required.] -. ;Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who sirliriuf#his affidavit indicating they are doing all work and then hire outside contractors must sgbmit a new affidavit indicating such. tContractors that check this box must•aitached an additional sheet showing the name of sub-contractors and state whether or not those entities have employees. If the sub-c' ottors have employees,they must provide their workers'comp.policy number.• X am an employer that is piovidhig workers'compensation insurance for my employees'Below is the policy and,/ob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby certify un er tliepains andpenaldes ofperyury that the information provided above is 6rue and correct. sign re: Date: Phone#: d Official use only. Do not write in this area to be completed b city or town official. .ff� Y .F Y tJ' .ff City or Town: Permit/License# Issuing Authority(circle one): ; 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 7/4/2016 •, IKFA Home Planner Printout a -- � All measurement in inches EO Project name 4 union st kitchen rev black ,/ I Project number 0000-9375-2320 t � 1 1 E t t t I I I { 1 � r z tMt Included in the total price Lighting $348.91 Total Price: $3,018.7 Username(Email address or IKEA FAMILY number) http://Kjtchenplanner.ikea.com/US/LJI/Ila.-cs/VPUI.htm 1/19 7/4/2016 IKEA Home Planner Printout 4 union st kitchen rev black - Plan View All measurement in inches 0000-9375-2320 47 113 2112 36 50 20 51112 47 24 5/16 587116 30 1 47 I 27 I 379116 118 7?16151 47 1141XI6 98 3116 I 47 I 24 1 743116 14131161 _ J a w �n A m m I w v ^3 v m I `m I ; i 160 http://kitchenplanner.ikea.com/US/UI/Pages/VPtll.htm 2/19 7/4/2016 IKEA Home Planner Printout 4 union st kitchen rev black - North/West Wall All measurement in inches 0000-9375-2320 1415,16 36 12 26118 1 261116 N � m 0 cn Q' D tl ' N Q tD pap Q 2415!16 36 38118 I http://kitchenplanner.ikca-com/US/UI/Pages/V I'l Jl.htm 3/19 7/4/2016_ IKEA Home Planner Printout 4 union st kitchen rev black - North/East Wall All measurement in inches 0000-9375-2320 261118 1 2611161011%1b 24 26118 261.+16 w w I � v a i i i { � v I m i 0 I Q M a 4 V 38 J8 � 2e 24 013,116 28 1,'8 � E1 let 1 20 511,12 I http://kitcheiiplan.rier.ikea.com/LJS/Ul/Pa.aes/VPUI.htm 4/l9 7/4/2016 IKEA Home Planner Printout 4 union st kitchen rev black - East Wall All measurement in inches 0 CZ LIS C�i 0000-9375-2320 261116 21 30 30 12215,'16 26 1116 261116 24 7i8 30 122 15+16 i : M P i v � M 0 318 47 J16 I 72,18 311 80 ll8 hitp://kitchenplanner.ikea.com/tJS/UI/Pages/VPUI.htm 5/19 7/4/2016 IKEA Home Planner Printout v 4 union st kitchen rev black - Island View 1 All measurement in inches hU Ca OZ3� 0000-9375-2320 130 I 34 _ http://kitchenplanner.ikea.com/LJS/Ul/Pages/VPtJ]_htm 6/19 7/4/2016 IKEA Home Planner Printout 4 union st kitchen rev black - Island View 2 All measurement in inches o ca -�� 0000-9375-2320 i 140.15,-'16 15 74 lilfi I http://kitchenpIanner.ikca.com/[JS/(JI/Pages/VPtJ1.htm 7119 7/4/2016 IKEA Home Planner Printout 4 union st kitchen rev black - Island View 3 All measurement in inches 0 Ca_OCI 0000-9375-2320 30 I 18 112 I http://kitchenplantier.ikea.com/US/LJI/Ilages/VPtJl-htm 8/19 7/4/2016 IKEA Home Planner Printout Project name Included in the total price 4 union st kitchen rev black Lighting $348.91 Project number 0000-9375-2320 Total Price: $3,018.79 Price Quantity Total Price 1 90265500 SEKTION base corner cabinet frame $79.00 1 $79.00 wood effect brown 38x38x30 " 70266845 TINGSRYD 2-p door/corner base cabinet set $34.00 1 $34.00 wood effect black 13x30 " -60 60215291 UTRUSTA corner base cabinet carousel $99.00 1 $99.00 34 1/2 " 40 - ° 00204648 UTRUSTA hinge $15.00 1 $15.00 153 ° U http://kitchenplanner.ikea.com/IJS/tJI/Pages/VPUI.htm 9/19