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Home My WebLink AboutBuilding Permit #277-2017 - 2 UNION STREET 9/14/2016 Y' BUILDING PERMIT TOWN OF NORTH ANDOVER ° p APPLICATION FOR PLAN EXAMINA UON Permit NO: Date Received-02 '` °*.,.. �- •, " ��ssac►w Date Issued: I� I PORTANT: Ap licant must complete all items on this page LOCATION ( at 4`d ''a/ Pri t PROPERTY OWNER " f Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ 0 e family F]Addition ��'fwo or more fa mi ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg C Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑Wetlands -1 Watershed District 9 Water/Sewer A,,e wBc2,P �i`�•`o.�� ,`� ��e met w-e h �If�� rclu�e �p�itrrlo� u �lri�Y ,�/Zecl, �a,cro4(/2di V4411 ly �eOO tl_f a-iv�f �LI,�Oo4-te V4iL Identificati n ase Type or Print Clearly) OWNER: Name: 8 eye( Avov xe f Phone: b3!9 qqO -7Z 3/ Address: CONTI�A'CUR ,Marne: Phone: ;address: .; H fA '4Supervisor's Construction.License ,.Y 4 Exp. Date. Home Improuement..License: Exp. Date: 7 . 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: $ J P Q-OU FEE: $ Check No.: 1 Z04 Receipt No.: NOTE: Persons contra t' with unregistered contractors do not have access to the guaranty fund Signature of Age _Owl r Signature of contractor a NORTO 9 BUILDING PERMIT - ° TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION y yy � oRA Date Received TED Permit No#: gcI405 Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT:— istoricDistrict yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ New Building ❑ One family ❑Addition El Two or more family ❑ Industrial El Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition - ❑ Other -- - " ❑FI''Jami U 1Neflandsz 1Natershed Distract: L7`Sept�� ❑1Nell O'1NateTlSewer ____, ___ _ ' DESCRIPTION_ __,_ __ -___.___. ---___v_.r_____ RIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone. Email. Address: Supervisor's Construction License: - Exp. Date: Home Improvement License: Exp. Date:— ARCH ITECT/ENGI NEER ate:ARCHITECT/ENGINEER Phone: Address- Reg. No. FEE SCHEDULE:BOLDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have,acces_; to the guaranty fund s ---------- ----- - ----------------- f _- —=- -- -- --- _J Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑� Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swill g pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Pennanent Dmnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature r COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafter & Sewer Connection/Signature& Date Drivewav Permit i DPW Town Engineer: Signature: Located 384 Osgood Street FIRE IDEPARTMENT'- Temp,Dumpster onsite yesIL , Located of 124.Main Street FireDepartment signs±i�rei late ��.. t F_,5 COMMENTS 4�'C , C 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) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 J 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 4- Building Permit Application .46 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 OTE: 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/Cross Section/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 OTE: 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 2012 I ECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 Location C� a r-, kV-Y-. z-'-=4 No.0 1-7Date 1 • - TOWN OF NORTH ANDOVER; '� .._., . Certificate of Occupancy $ Building/Frame Permit Fee $. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# i? + / :� Building Inspector' r 1 - NORTH q W" ' c . )ve" ,* O " �A A. No. 11 � C% h ver, Mass, C0C"1CH2WKK y1. ()'OATEO S u BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT i3.05CU4. ..................... V BUILDING INSPECTOR .... Foundation 1k.11111hifthas permission to erect .......................... b ' ings on .............. ....... .......... Rough to be occupied as .1( . .. ... .. . .....��.. .. !.....4s�.,�,,, ...... Chimney provided that the person acceping this permit shall in evey respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and -Laws relatin to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building.Regulations Voids this Permit. tow%H j,el Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TIO Usb Rough +, Service .. ....... A Final BUILDI INSPTOR 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 i Street No. Smoke Det. I I a � aw r Q O V NO 6 n}' 5T r ee.-f- 50r) Alp .�d1�w w�t( r u ic�t 3 to - 9- etv✓ otA Pef r cr4IN Gorr►��e�� /4 -S v Flans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanu ng/MassageBody Art ❑ Swi mYng Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Permanent Dmnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ I COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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: Signatu)re: Located 384 Osgood Street FIRE;DEPARI'NIENTmp,Oumpster on ;yes,. . .. nb._ . t Located at 124 MainStreet ,.� r . Fire;Departments�gnrate 'Z7kj'° COMMENTS c C A203 2 EXISTING STAIR EXISTING STAIR 1:3 y ATH { f COMMON - / 2 A202 -6J- RAGE 8` FAMILY ROOM /"" TI AREA UNIT 1 0 3 }, NEW x PARTITION; TYP. NEWSMOKE AND CARBON MONOXIDE t DETECTORS;TYP.IN ALL UNITS. EXISTING STAIR 1 32 w X o2 0 h 40vv A2oz NEW PARTITION o EXISTING PARTITION AREA NOT IN SCOPE SMOKE DETECTOR CARBON MONOXIDE DETECTOR 1 PROPOSED BASEMENT RENOVATIONS Z 1/8"=1'-0" BOGDAN ANDREYKIV No. Description Date CL CONCISE DESIGN GROUP 1 PROJECT RENOVATION SET 08.26.2016 PROPOSED BASEMENT PLAN a 7 KENT STREET#4 2 UNION STREET,N.ANDOVER,MA �_----�-"I BROOKLINE,MA 02445 _ Project number 16.001.02 0 CJ/) 617.285.0872 Project Tide Date 160808 Al 00 oCJ PROJECT RENOVATION SET Drawn by Author N Checked by Checker Scale 1/8"=1'-0" N f NORTH TOWN OF NORTH ANDOVER 0= 0 OFFICE OF BUILDING DEPARTMENT 111 Rol 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 °UnD *s CHUSe Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 9,02 0/% JOB LOCATION: / ffat Number Street Address Map/Lot HOMEOWNER ,60VA6Z t/ I�•�V�/�e�lk"`U 9-919.4Iwo 7231 Name Home Pho e Work Phone PRESENT MAILING ADDRESS of 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 OFFICIA Qa�z� Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Scute 100 Boston,MA 02114-2017 kywww.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERAfffTING AUTHORITY. Ai)plicant Information N Please Print Leelbly Name(Busincss/Organiznhonlladividuao: Tp�,� aAl Address: C2 P 2� City/State/Zip: //-®/L-l(4VA9 MeR,At Phone#; ?S 4 Are you an employer?Check the appropriate box: Type of project(required): 1.❑1 am a employer with employees(full and/or part-time).* 7. ❑New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling l 7 am capacity.[No workers'comp.insurance required.] 9. DDemolition3. t a homeowner doing all work myself.[No workers'comp.insurance required.]t ❑ 10❑Building addition 4.©I am a homenwricr 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 11.0 Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance t 6. We aa corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 0ro 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that chocks box#1 must also fill out the section below showing their worimrs'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additiorml sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an emplayer drat is providing workers'contpensation 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: e2— 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. I do hereby cergy de thepains rd p, allies ofperjury that the information provided above is true and correct. Signature: Phone#' Jd9 7 oO 17 J� 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 Z.Building Department 3.CitylTown Clerk 4.Electrical inspector S.Plumbing inspector 6.Other Contact Person: Phone M