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Home My WebLink AboutBuilding Permit #141 - 20 BRIDGES LANE 8/31/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATIO ^ nAi = a PROPERTYOWNE :Print WAP,-NO PARCEL ZONING DISTRICT'--;4.- Historic District: yes.. 7' t _ �.�.Pe.. L _ x , :Machine Shop"Village _yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One famii Addition Two or more family . Industrial Alteration No. of units: Commercial Repair, replacem Assessory Bldg Others: Demolition Other Septic ;Well i Faoadplan „ Wetlands t WatershedDistnct ' K w ,Water/Sewer_ f x - _ r �c DESCRIPTION Of. WORK TO E PERFORMED: t �. Id tification Ple4se Type or Print Clearly) OWNER: Name: 119M Phone:9 T--,A Ll — Address: ` — Address: _ �... CON,TRACTORName1''�`C: PhoneE'�g: Address` a�r"E Supervisor'sConstr-uction License�5 HomeXlmprovement 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: Xo';o FEE: $ c�l Check No.: '� l f Receipt No.: �--3 y NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund _�. Signature of Agent/ n /iA� 7�' Signature of contact Plans Submitted Plans Waived Certified Plot Plan Stamped Plans Location No. ! Date 0 V4,. TOWN OF NORTH ANDOVER f 1ti ' Certificate of Occupancy $ ssBuilding/Frame Permit Fee $ AC11U5 Foundation Permit Fee $ Other Permit Fee $ ` TOTAL $ Check # Jiclj 22 Bwidingr�!nspector 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 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature � J COMMENTS HEALTH Reviewed on Si natur �ll 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: Signature: - - �,:. Located 384 Osgood Street FLRE DEI?ARTMENT ='Temp Durnpster on site yes==� noY` Fire=Depa-rtmen't#signature/datea _. 3 s CQ(VIMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, rust or service drops requires approval of (Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 - ,�r Certified Surveyed Plot Plan ❑ Workers Comp Affidavit 'C�/N �1—r� ` ❑ Photo Copy of H.I.C. And.C.S.L. Licenses D Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑,, s 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 I e tomrn nwealtk of Massachusetts . ► De�artmerzt of Industrial Accidents Q0 ce of Ixnestigatioas. ' 600 N,"=jz ngtan Street Bosun , MA 62111 Workers' Compensation LQsurance - s.�gnv/din . A 'cant I�or�ation Affidavit Eut'Iders/Contractors/Elea friciaas/Piumbers Please Print LeQibl NBIne(1a=n`WDrgsaizafionA di idciai�; Address: citylsta&Zig (� Phan . . j Are you sa employer?Check.the appropriate.hoz: I.Q I am a employer with 4 Type of ro ect ' I am a�enerai contractor and I p 1 (required): iioYem(fu and/or pm t-time).* have}gyred the sub- 6. [C Now construction . 2 .asole.prr primo.ar p�,T, Iiste:c( on the attached 7. ship and have no employees Thome sheet �:R. adeling working for me in sub-contractors have 8. (]I?�alition �3'�P�Y• workers' comp.insurance. [N°wed=,comp.izmrance 5. [3 We are a Corp oration end its 9' ❑Bw1ding addition required.] 3•❑ 1 am a homeowner tin' ofiicers have exercised their 10•[]--lectrical repairs or additions self all wont right of eotemption'par MCX I LEI pluntbi myself�T�io'work='camp, c, ng repaimoradditiom insur�ce. §I(4),aad'we have no regnaed.]'t employes cs (No workers' 12•Q Roof repairs `t+ny eppticam ther comp. insurance required.] 13.I].Offs r cn-bMi thi, f must akso lite outthe section iciow showing thoirvmrkms'bampenoatimi policy rofotmatioa r Komeovmdt¢who attbtnit this s rf&davit indicating they,are �j 3C a=bt t m that nh=k this bm must dnmg www Land than ham outside eonoaetots enure ' an additiaasl aheCat�owatrm etre rusnc drd,-sub.eontraetors Submit a new tt r davit isdiceti4 such.' I m:r.11 employer th&isPnot ktg;teor��'eor; a ctrppt f+ workaa car,-"r :i s i fmr®rion. infarmQfiot: �rmire�nrmy.pmpjmes; ��w.�"Ie:,l_ Instnance Com r amdjul s*r Company Name: Poficy 9 or self-ins.Lic.4: Expiration Date: Job Site Address: Attach a copy of the workers''co t✓rtylSt�rp, mpeesation Po�Y d�Farafion page(showing the policy cumber and e FmIum in secure coverage as requited under SCCfiDn 25A of xpitstioa date fine up to$1,500,00 andlar one-year imprw� MGL c. 152 can lead to the imposition of Miminal of up to 5250.00 a as wail es civil P=dfies in the form of a penalties a a �3'agatnstthe violator. 13e advised that a c of this S'1�7P WORK ORA£R and a fine investigations of the DIA for insurance coverage verincat9On, statement Y forwarded to the ptfiM of I do hs cert& P pereatei�`of pe .fv der the 5i �u'7'rfiat the infnnnwoa Pmt+ided is a an11 coneet Date: Phone#: Qfflcim!use a,* Do not write in this are¢,In bt cn+xpjet�� or town of cw City or Town: Lwuiao A PeMAILWelose# b «tltorify(circle one): 1. Sohrd of Frith i Soiiriiiteg fi.Other Deparfineut I Cityrrowa Cleric 4.Electrical Inspector S.Piambirte las r pdo Contact Person: Phone#: Information a- end. Instructions Massachusetts General Laws chapter 1 S2 requires all emp;oyars to provide workers'compensation for thoir employees. Pursuant to this statute,an enipinyee is defined as"..:every person in the service of another under any cont-ad ofhirc, r- . =q rass or implied,oral or writt.-n." An emptayer is defined as"an individual,partnership,msrxiiation,corporifim or other legal entity,or any two OT MOM of the'famping engaged in a joint enterprise,and includis-rg the legal representatives of a dcccasad employer,or the receiver ortrvstc-of an individual,partatnhip,associatic i,r or other legal maty,employing employee.'However the own6r•of a dwelling house having not more that three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do rrnaiinazuce,construction ori work onsncb dweilir�ghouhse or on the grounds or building appurtenant thereto shall not because of sucb muploymo t be deemed to be an employer." MGL chapter 15z 925C(6)also states that"everg*state a;-local licensing agenacy shall withhold the kmanmor renewal of license or permit to operate a business or *v construct buiidiap in the cammonwealth for any applicant who has riot produced acceptable"euce.of compliance with the iasurauc a coversae required" Additionally,MGG chapter 152,§25C(7)states"Neither the cotmnanweatth nor arty of its political subdivisions shall enter isrto any mmrat#far the perfornaumce of public worle rarh'l accepts£ile evidence of co npliencx with the insnranco fzquirzmefas.of this chapter have been prasartsd to the co nu acth g authority." ApPiicants .. Please fill out fife workers'cornpmsation-a5ldavit compiately,by checking the boxes that apply to your situation and,if necessary,m ply sub-cofrhactnr(s)rmme(s),addimKcs);eLnd phone nnan*s)along with fiheir canificate(s)of insurance. Limited'Liabik Companies(LLC)or Limited Liability.Partnerships(LLP)with no employees othetthan the member;or partners,are not rmquirsdlto carry work='cc>rnpensafion h suu m= Van LLC or LLP does have =ploy=,a policy is required Bt advised that this affidiavft may be submitted to the Department of Industrial Accidents for coniamatian of mmn==coverage. Also ibe sure to sign and date the affidavit The affidavit should be returned to the city or town that the appfioaiion far.the perraft.or license is being requested,uot1he Dq=matt of Industrial Accidents Should you have any questions.regal-ding the taw or if you are enquired to obtain a worl=' oompenzation poligy,pleawcali the Depic-ti next atthe-nurrtber.listed below. Self-insured companies should entatheir ( ;. Self UW1mxi1ec licehsc Bum=our tiro appro rulte ime. City or Town Officials Please be sure tient the affidavit is oomplete and printed hgubiy. The Department hes provided it space at the bottom of the affidavit for you to fill out in the event the.Office of Investigations has to contact you regarding die applicant Please be sure to fill in the permit/licame;mrnber which w-M be used as a r cf ranee number. In addition,an applicant that must submit multiple pmmit/liapplications in any given year,need only submit one affidavit indica*-eurrent policy;information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or to m),"A orgy of-the affidavit that has been.officisiiy staff. ped or marked by the city or town may be provided to the applicant as proof thata valid affidavtt is on file for nuts permits or licanses. A new affidavif mos`be Med out tach year.Wh=i a home owner or citizen k obtaining a or permit not related to any business or commercial ventre (i.e.a dog license or permit too bum leaves ate:.)said person is NOT required to complem this affidavit. The OFnce of invesOK860ns would idea to thank you in advance for your cooperation and should you have arty questions, pleas✓do not hesitate to give us a call. 7Pc Department's address,telephoneand fax mmrber.. The Commonwemlth of Massachusetts Department of 1xidustiial Accidents 4f'ice of Lav�sfiesEions .. . 600 Wxd: gran Ste=t Boston, MA 0.2111 TeL#617-727-4900 6=406 or 1-877-"SAFE Revised 5-2645 Fax 9 617-727-774Q www.mass.govidia NORTH ONNM Of _ over 0 . No. /G T C%0 i" L A E dover, Mass.., 'y? COCMICMEWICK ADRA_TED S BOARD OF HEALTH Food/Kitchen PE R ..M Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......).o.�l...,d�l.LGh- � w Foundation . has permission to erect........................................ ..................... buildings on p� ...... `n ... . -.—......................... Rough to be occupied as.... / / Chimney spm'n aprovided that the pe ll 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 ,31 PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCI•IO/ S ELECTRICAL INSPECTOR 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 Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. MORTGAGE INSPECTION PLAN BOSTON SURVEY, INC. 99-07346 P.O. Box 220 Charlestown, MA 02129 (617)242-1313 MAIN (617)242-1616 FAX APPLICANT: BIANCHI LOCATION: 20 BRIDGES LANE DEED/CERT: 988 -163 CITY,STATE: NORTH ANDOVER,MA PLAN REF: 9513 LOT iAA 44,365+1-S,F. M1 S ( t\ V r, � DECK V PORCH DK s a' 's 2 STORY 11tP o ►11� N BRIDGES LANE yeas fC)&Ston,Survey S,,%-ore PREPARED: 08-09-1999 CERTIFIED TO: DIGITAL EMPLOYEES FEDERAL CREDIT UNION SCALE:1 inch=50 feet OF e �Cfl The permanent structures are approximately located on the yskp' +� Aecording to Federal Emergency Management Agency ground as shown.They either conformed to rhe setback d' JOHN requirements of she local zoning ordinances in effect at J. m maps,the major improvements on this property fall in an the time of construction,or are exempt from violation en. o gUSSELL y area designated as Zon /r�p ,e( Sercemenl anion under M.G.L.Title V)l,Cbapicr 40 A. 387 C uni nrity Panel No: ,l1cs S Ilion 7,and that there are no encroachments of major �w 1 Q•�'�� improvements either way across property lines except asEffective Dare; ZZ shown earl noted hereon. �qNO Sulk N E:Zone C is areas of minimal 0oodin5o shading).This designation is not based on an elevation certificate. NOTE:This is not a boundary or title insurance survey.This pian was prepared in accordance to procedural and technical standards lot Mortgage Loan Inspections as adopted by the Massachusetts Board of Registratlon of professional engineers and land surveyors.250 CMR 6.05.and use for any other purpose is prohibited.This plan is not 10 be used Int recording,preparinn deed desrrintinns.or rnnsrmriinn BRUCE NcELMMH CONTRACTOR 316 LAKE DRIVE SO HAMILTON, MA 01982 468-3853 or 5313831 CS 017457 Co o/1el TYPE OF WORK 4/�W)V �4A.�&A(A d14L Pyl)VA-14 0 1'�d ��/Z'/ L`" A f - r� x� I�A 1 F J�- - P� CLEAN-UP Y GUARANTEE COST MAT.&LABOR f t ,A 0 TERMSVL OWNER y Q .� CONT t` \ Soard of Building Regulations an Stsudar& HOME IMPROVEMENT CONTRACTOR. :registration: 106280 ` r Expiration: 7/22/2010 Tr-3 .270443•• Typa: Individual BRUCE MCELWAIN Bruce McElwain 316 Lake Drive S.Hamillori,MA 01932 y Admiiiish'aror• Board of Building Regulatiorfs and Standards Construction Supervisor License License: CS 17457 i Expiration:, 311/2010 Tr# 14864 ` Restriction: 00 i BRUCE E MCELWAIN 316 LAKE DR S HAMILTON,MA 01983 -Commissioner L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION{continued) Properly Address: Or. I.,A-1 wne Date of Inspection SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply come; into housel J I I I uovS� I r�� 1'�.0 N VCC IU ei"� 3 5cr mrn •e \ nik �7t 5 i y (r.vi•.d O(/1S/p7J (r 10 _ _j -t f Qs oil �--r mr, it AA i + � I I + i I S I I I 1 i 1 I I I (�pMidCj 0,4 4 _ C"gc_d o� t f i t i f ADO �r�7_!•_��2..l9,7`'/t__7�"�Lr'V/< �� o s{ t �I tt 1 y { i i p t 5 t .