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HomeMy WebLinkAboutBuilding Permit #238 - 200 CHICKERING ROAD 10/30/2002 Location�Cry No. c t Date J ' f 40RTN TOWN OF NORTH ANDOVER f w 4L 1 Certificate of Occupancy $ cNuBuilding/Frame Permit Fee $ ' s� se Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 1�f1 Check # f 43 15966 uilding Inspece TOWN OF NORTH ANDOVER BUILDING DEPARTMENT C APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, R DEMOLISH ANY UILDING OTHER THAN A ONE OR TWO FAMILY DWELLING n� 7Gv 4 x3 'Th>ts Section for Official Use BUILDING PERMIT NUMBER: DATE ISSUED: O SIGNATURE: Bulldln Commissloner/Ior of Buildin Da A` 1.1 Property Address: 1.2 Assessors Map and Parcel Number. ZLt� of 1 t � = I06 Map Number Parcel Number 1.3 Zoning Wormation: 1.4 Property Dimensions: v VA �Z4 46 .��7 � Zoning Distritt Proposed Use Lot Area A Fronta ft m 1.6 BUILDING SETBACKS(ft) . Front Yard Side Yard Rear Yard Required I Provide Required Provided Required I hl Provided A J�J Q 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public X Private ❑ Zone Outside Flood Zone Y% Municipal A On Site Disposal System ❑ 2.1 Owner of Record me(Print) c Address for Service: M Signs Telephone X 2.2 Authorized Agent OF1=C H IZE 60"STZi U67P 0)4 C O Zt i l CD;ZPOJ ATE t121 VE, �J' OAJrr I O ZZl.� D Name Print Address for Service: Z 66S- 7_90910 O Z gnature Telephone m Nt 3.1 Licensed Construction Supervisor Not Applicable ❑ I�l� `t'© C 079544— Address 7$ ZZ E�TZ Y 1�. 5 O Address License Number 17 kn L Ax> sr , (._DI`C.f�12D: 1�f1-1 �?�l�l n Licensed Construction Supervisor_: /0 " Z7— o4 Expiration Date 603 - ZZ4 93Sf1 r Signature Telephone .� 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name,, Registration Number m r Address r Expiration Date ' ZZ/� + G) Signature Telephone I I sEc�rvx a4> 0 Qls� t®x +� Workers Compensation Insurance affidavit must fbe completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Si ned affidavit Attached Yea...... No.......❑ SECTFOAI 5 :PRdF�U1�At.)�lE�IGAI� l$�tiTC"Jf`I�N�R�C�S tF4$$1�7J�A]�t�SS AT�b S�tU�t'I`[31L+�S�Et'�`.�'#3 CON51�11JC"�'Y©�i C4�1' Q)lE PL1RA�'�C� iR������ITA ��0 ��ID�3:4 �.F��J►F� 51���'A 5.1 Registered Architect: I Name: Address Signature Telephone S.2 Registered raf�s.,i Area of Responsibility Name: Address: Registration Number Expiration Date Signature Total Not applicable ❑ Name: r Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number ' Signature ) Telephone Expiration Date Company Name: Not Applicable ❑ Responsible in Charge of Construction e � New Construction ❑ Existing Building >( Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition_ Other ❑ Specify ' Brief Description of Proposed Work: pFrmo coviZE�rx•'AI.. O;r 30 x40 2 :SmizY AL�tJj!� mac/, i STOr y 5 ZSX70 &1ma&A-bL6e SMatL St+aFD r-0t*J1>o-r70QS j 60X-,,C� 'R:,Oir. r USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ IA ❑ A4 ❑ A-5 ❑ 1B ❑ B Business ❑ 2A ❑ C Educational ❑. 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: I, Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA b EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft In ndent Structura eerie aural P Review Required Yes ❑ No SEC l0a w er Aa horization- TO COMPLE WHEN ERS GET NTRACTO P S FOR ]WILDING PERMIT 9� I Owner of the subject property . Here S iZtJ LS�1Z Tltl to act on half, i rs five two rized by thi building t application r 7 t Signa of Owner ' Date —f uM?, h�t'Ft `y ll n i cc<c c i I, ,as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name 041 OZ- Signature of Owner/Agent Date Item Estimated Cost(Dollars)to be Wi � G Completed by leTmiPP t applicant 1. Building ---- (a),_Building Permit Fee ( 61660. Multiplier 2 Electrical (b) Estimated Total Cost of Construction from(6) 3 Plumbing Building Permit fee (,)X(b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number � .._� �l^ �,- t y y4y. n, r}t kGa i .? _tir., LS r,txy}ar ro.<,,,,r r,Y.:h`` f{'z-✓'...4 u..•t 1-a x'. „ +: fk NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS Sr12ND 3RD .' SPAN DEMENSIONS OF SILLS j DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE .... ,._�. :; ...... Y..v...=..,."..a4.,-., �> w £..yd�.a,-fit' 34 k"h'r $rpsth\z.-S �:�.,�`rye•t"+a4�'S?-4Y� .. .. S'�r1 d�4 rs r.:. 4� 'x?.. TownO �r a5� 1 J ..I . , f' Andover No. z - dower, Mass., O o COC L CX �p ADRATED BOARD OF HEALTH d/Kitchen Se 'c System ER' .- T THIS CERTIFIES THAT p 1C.o�os`i'. LDING INSPECTO A.. fi. . .o... `. ....i?.Rea �1 Found on has permission � on ... Rough to 81lI►�O� . �?�:�!t�rart...�.......... 1. . .Il�tasr�s�R'ef.s�!�4ez1L,�.Q,�W�SM�c L Chimney provided that the person accepting this pe it shall in every res ect conform to the terms of the application on ffle 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. PLUMB G71N _ECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRIC SPECTOR Rough ........... U1t1R ............... ........... Service : BUILDING INSPECTOR Final S INSPECT Display in a Conspicuous Place on the Premises — Do Not Remove /er DEPARTMENT -SEE REVERSE SIDE • North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number 2.323 is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. b The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant 2-- Date I r NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector aTown of North Andover NORTH Building Department 0�.� ID �6 tip 27 Charles Street .�'� a North Andover MA 01845 0 Tel: 978-688-9545 Fax: 978-688-9542 T �� T O lAK! � T SQA COC"ICHIWICK`y1' DEMOLITION OF BUILDING AFFIDAVIT Zj 01#Arso PPP �g ACHUS DATE OWNER'S NAME &AD DRESS �oV . k00-j LOCATION OF PROPERTY TO DEMOLISH h4r 46 , Lerma 3546 d/C6 -cgiceet4 004,c> DESCRIPTION 26-mytY flw,Flu�x, l Slt�TtSr 8c�nusa �� Cc+�,�,�sE yr{E�s rpt_ CONTRACTOR'S NAME &ADDRESS CBEQ42W l /ST TIAU GD i?sC7lc�V DEPART T SIGN-OFF 09 � DEPT. OF PUBLIC WORKS -WATER: 6/e SEWER: GAS01 V ELECTRIC TELEPHONE,,`? /Z) CABLE TAXES y POLICE FIRE EXTERMINATOR DUMPSTER ON/ FF _ REET v DIG SAFE NUMBER ZOOZ, 350 4635- DATE REC'D BLDG. INSPECTOR 00C30, L FROM : ESSEX NEWBURY NORTH FAX NO. 978 372 6754 Oct. 29 2002 04:18PM P2 ?22 )01 TUR iA!58 FAX 7819326211 ATC ASSOCIn'fES INC, evATc X1002 800 west Cumrnln P ak V!oburr�, Massachusetts 01801.68500 I www.ata-enviro.cem 781.932.9400 A390CIATE :, INo . Fax 781.932,6211 I �- Octobw 29,2002 Mr. $ill Boss Essex NOwbtiuy North 25 Kmza Avmue Haverhill,Messachuwm 01$30 ' I I RrL: Former Beanie's Florist 200 Chickering Road North Andover,Massachusetts ATC Project Humber: 60. 8 5.0024 I Dcar Mr. Boss. On 4etober 26, 200?, ATC pis tes, inc, (ATC) of Woburn, Massachusetts perfornod projeet mentoring semees in support of =Oval of asbestos-colataining materials from the above refamoild address. Project monitoring service r eluded a visual inspddicn m1d the coUmion of final air e10&='Go samples. All air samples wtte d via Phase Caatsast Microscopy (PCM) for the Presetwe of ers 4irborne fib . Air &AMPling was p�rfomwd and an by ATC �preseiltative and Massachusetts satuple collected; lieeased Project Mctnit4r Sam San a The following table i1h.LqMtes 1he locadon and result of each air ,, �'�3i.1>�' f'L'ir :;aga^• �':�y ,�,. + ,:+ +.t;.. .Z'•.h: nA>: �;1• �Y � ''! .`' •' :!1 1 i'7;:L ♦O.]Vf., r•:i$i i... M M ni TA:�..S Sl1C� ISE. .. .0��1:�1< >�+ 1tN' 1 1; S•I 5.... ..'� '�S• 3�'� }..:. ey '., •i1: 0126/02 I 1 Blanc N 0/1041 ' �Z Bt it elan]: 0/100 �3 Base of House Final 0.003 '�4 Base Of House Final O.Od I Air sample results can be found as zn attachm To This lever. All air smnptes eolleated during clean-up activities were Less than 0.01 fiber or enbic centimuter, �vcll bolow aot�tabl, lesrels established by regulations. All air ==les were <n yZe4 Utilizes � Phase Contrast Microsc (PC meth flCCOIdaI1Ce aI1H1 �CRt r °PY (PCNP method In yu p ocedures a hsd by the N[0SM 7'4tJ0 method. ATC is licensed by tht State of Massachus=s for analvsis of PCM air mpk;s. Should you require any addsttanai ' anon,pleme C013taat Ime at(781) 932-9400,ext.202_ Resp � � A A dates c- I i Cbilstopher LaP ' Operations Manager I Building Sciences Division Attachments I I II I�