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HomeMy WebLinkAboutBuilding Permit #586 - 214 OSGOOD STREET 5/5/2009 BUILDING PERMIT of N PD 16 qti TOWN OF NORTH ANDOVER 02 batt �6,, o°, APPLICATION FOR PLAN EXAMINATION. '' I Permit NO: J o Date ReceivedV ,04qo 7 RA7lD I.P`y.(�J �SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION ') /` 0 S 6 0�d L) S C--LZ- -' N6iq 771 AAf d 0 Iii 1� M A Print PROPERTY OWNER ++.Me6lfnaLM 13C-`A,/A#11j 4 Print MAP NO: 3 PARCEL: / 5- ZONING DISTRICT; Historic District yes Machine Shop Village yes a TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition V11, Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: . 2 5r Ay A1)L) Ti 0,V 2 17� t:-r- X 4,c- Ali C4)AIS1.5 riAJ G 0 v Al ua/r{ l L'l)/10 0 M © VL;5 /T Identification Please Type or Print Clearly) OWNER: Name:T^y G/94 /fl M 13 L=-A,//l M M ! Phone: (�78) 738 Address: vO.,U 5 �i IV0111?-1Y A IJP oVI 1V r CONTRACTOR Name: Q w d+JCIS Phone: Address: Supervisor's Construction Licenser Exp. Date: Home Improvement License: Exp, Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PE IT: 12.00 ER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. " Total Project Cost: $ FEE: Check No.: Receipt No.: NOTE: Persons contracting gistered contractors do not have access to the guaranty fund Signature of AgenVNO Tier Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans 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 -5 Si nature r COMMENTS MA L,�CL J/LEA LAJ 4 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Conservation Decision: Comments Water $ Sewer Connection/Signature& Date Driveway Permit DPW TownEit.ngineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 Qri� `iQl� f Iv 0 Notified for pickup - Date Doc.Building Permit Revised 2008 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:Building Permit Application Revised 2.2008 Location, No. Date NORTh TOWN OF NORTH ANDOVER F?O•,,,•• •• •BOO' 49 ' Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ///9 2 1 Jr ) Building Inspector v t e� _, cco PnT P/VIA16 Llt) S s FArA��yS� oZy 'fid ND � a off GRAD� /door^ z�� 0 I� r-f-o 1 T ckisf / co s�u3s •r V, SIX ya i OPT tv �?tY t3�U�aoM 2,00'• GLU �XlsT 1 \ I Al S 1r a /3AND i ti - L;L CVlt 770N EXIsr -� cp r- �I LLI �I��,...r r-ter- ✓Timm R�4/? �t.�n�*►-r.�,w lillfl111 � 111 � I --------------- iG �L 2No )=G.13 C <r n(G 2K/a Q 6� /Y/P /3,A KE 4 �0 ZNb�LdO� i N b � d l FL00) AXs�" l o s' C13n-14. SPACE o(i pyaeA r S G� /c I .LL��SHFC>�itCCft WALLS CIE IL�N(r HaR,ze�✓��t c i��y �'�L3f�oolS - :(•(rL;•O✓E,Q w�Tf/ WeaD -an 77<c- 61T 7ct6/Q ZX8 ' '" i j Or C r ANIR_ g Off! � O,Q. f"/sE'AL..".._._.._�j-'�_....co/JC. .s�/�� • �L�cRrtANA fM+�J1�" s•-W AT PARTN`S Aa j 1 '0'1 2yj CC.tKr FTG, tS Scc.T�aiY GL/yL�R.gL �voT��a►tS� C�.AAI�/CATtt�i✓S • COA)C. Lo o 7-1 NGl y 'OC-r-P - Mv,44 9-1771 (7a s[ EXl rf.CR4P6- /91c S "-tkT�/vy 4XIS71/4; - BA c qn/c.E •� Dos�.n/ t,d.G• w.�� scSFPC-mss RAs /►+�i✓f i 3 GjC.3 - ffoR1Gc i9/Id-A - q-o sauo7qeCP/45 �A4Y �/YlAcc � s.4Gc-� mPT<m/(A,L o,�rj cNAL T .s' s/Nc�-C�y:2X•�.-' /;+ Trt S/� c�.TN'-�►c✓�a?.:r, 9_'a.c. fv , ALL b�tOo�? ii✓CaNT/1irN .di�,l'/�:.�sw4E j�'E/f��D Bi f*qA'f23A)A�-3/�S�A)D3CAfjrJO OA( r i�• /°ti-Y�?o0� �1t���16 i�1� �f�A�rm,�,-f�4L cs�►c�s SpEc•F�.tp m fYE'4'"/SC EX rtWb C2) s7Z mm a R/vCw ttM TAs I,CA-r a c.E o/; Fi�✓ts,�r .l�/►GC f�a� y'Vll�a M�°�cfE R ly- oPTi.NA4 /o ��X `1�$" 'ZNsi'vA�/ E'XTcic►sloN ov�R �x�s,�uG Nedr/�y�inJf IG fILL�OG►1,e1�C,E. ,.� ��,K,,w w�nll�ow.S D4E ?� P/f�►'�i�'-Y Go�/S/DE��°Ns Of Tiyl� SueTFCjOwE.u.in/C p oaf sC0 C DL-k c.0 ,fCW j.-bK,A'- i5x 3xG � f3 �� 3x2 ' ASN/NG 41' W AI 30X 3�/O (o/°f WAL G''x 8 0 / REVS �s�►tA t h �� 2 X Z,-/O �• �r - SttAtl�fG 3o Xao s/ '4Ge�� oPTio�✓AL 0 7� r� 4 ESS sAsN GF FLS/0, 07 SEA Building Sketch (Page - 1) Borrowerr'UtM Benammi Propel),Address 214 Os ood Street Cite North Andover Coun Essex State MA Zi Cade 01845 Lender Wells Faro Bank N.A.CD-P53 �DDtf oN '�Op�7)ol�/ AAM 4 M AE /30o/►� a 26.0' 26.0' r � Kitchen 44P o pGH/ o 6� Z�p Bedroom O N � N Dining Room Living Room 26.0' 11.0' b b g.0' ; a 6.0' �:- /s' 1 SMd KE Tb -✓ f 13 G d Zy a SMOff� C� Lo W. `A14LL)4Y, r. C-0Noor")s e ro..,,� /�gSEr+Ex►l S M o ACL O K 4 t_ GP�E/✓ \J �� �B1�,AStc�N1�cN t Comments: . p/3j/ew�Al_— �'A Al glN�rB�✓sl�/KE/Q,e, t�/� rs -- 3 s•k s K-9Oyu /3�D W.V f AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN Code Description Net Size NetTotais Breakdown "Otsts GLAl First Floor 648.0 648.0 First Floor GLA2 Second Floor 468.0 468.0 24,0 x 26.0 624.0 Second Floor 18.0 x 26.0 468.0 Net LIVABLE Area (Rounded) 1116 3 Items (Rounded) 1116 form wsldSkl—WmTOTAV appraisal software by a la mode,inc.—1-800•ALAMODE f 0ORT11 TOWN OF NORTH ANDOVER 3r •��+_ : °0 OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover Massachusetts 01845 CNust� Gerald A Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please mint DATE: JOB LOCATION:2/ k3 Number Street Address Maptw /''A/?CC/- AMY HOMEOWNER c:iyr� 7 3 y 2 3 61 _ S , Name Home Phone Work#hone PRESENT MAILING ADDRESS 2 lis 6 6 v0 ST" 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 lick,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 DWt went minimum inspection procedures and requirements and that he/she will amply th said procedures and requirements. HOMEOWNERS SIGNATURE t / APPROVAL OF BUILDING OFFICIAL xe'viwd 10.2005 Fmm Homwwom Emw i°n 110ARDOF \PPE:\I_S63R'9541 CONSERVATION6R8-9530 IiE.\l:l'I{689-9540 PLANNI\G6Rx--9535 PLAN r:;x4AA C o MR -grA/S"44AWCE A r-FI PAV17- IM A66'-d ION CA J�X ALr-,44P7—Ion4 2 sirs pl-AIVS PAGg-s eL-CV}T ONS 1' G�vSS SEGTl4N w j j1)aw sG1trou LC G. 84414-DIMG -44 z�-q d, Ayq,-,Il a,4ro S^olfc � C-o et�� � -ir ID1Irq4A.J1Ajjq _ The Commonwealth ofHirssachusetts 1Department of Industrial Accidents. 4 r-i7 1/di H .`,' ! Office of j"nvestigations ;1L!d ' """ ' 600 W Nh ing,tonEr Street Bostoiz, M,4 0111 C '- WNtFV.�SS.bOi��di:a Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers An hcant Information �7 Please Print Leaibfv :Name (Business/Organization/Individual): Address: 2/i/ ©s G o,o hS r3 E G City/State/Zip: de,a-n4 / d n o✓ .j3 fill 4 Phone#: � `Z3S - e23 � Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4. ❑ I am a aA Type of project(required): ..neral contractor and I employees(fill] and/or part-time).* have hired the sub-contractors 6. ❑New constriction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 1 7• ❑ Remodeiing ship and have no employees These sub-contractors have working for me in any capacity. workers' comp. insurance. 8. Demolition [No workers' comp. insurance 5. ❑ We are a corporation and its 9' wilding addition 3.W regtrired] officers have exercised.dmir 10 ❑ Electrical repairs or additions I am a home,..owner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4) and we have no insurance required.] t employees. [No.workers' 1240 Roof repairs comp, insurance required.] 13•❑ Other *Anv appli.=t.that checks box#1.must aiso fill out the section below showing their workers'compensation policy information. t- rionirmuers wire subinii.this aiidevit ilydicatiug tiiei'ett i uiu•Ei'tva�,a= Conmetors that eheck this box must attached an additional sheet showi , tncn hi outside contracturs rnum subrmit a new arndavit indimty s ch. ng the[lame of the sub-cor�ctors and their workers'comp.polis infonastion. I am an.employer that is providing workers'compensation insurance for 'employees. Below is the o informationp fi:y and job site Insurance Company Name: Policy#or Selfins. Lic.#: Expiration Date: ------------ .lob Site Address: _ City/State/Zip: Attach a copy of the workers' compensation policy declaration pace(showinig the policy number and expiration date). .Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one-year imprisonment,as well as civil en of up to 5250.00 a day against the violator. Be advised that a co p a]nes in the form of a STOP WORK ORDER and a fine Investigations of.the DIA for insurance coverage verification.copy of this statement may be forwarded to the Office of I do hereby cert,under the pains and penalties of pe urx than the in rnalion provided above is true and correct Sia-riature: t Qat • 3— fj Phone#: Official use nnip. Do not write in this area, to be completed bj;city or town ofcial City or Town: Permit/License 4 Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town 6.Other Clerk 4. Electrical Inspector S. Plumbing Inspector Contact Person: Phone Information C. .nd Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined.as "..every person in the service of another under any contract of h ire, express or implied,oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dweiling house or on the grounds or building appurtenant thereto shall net because of such em -employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state o r local licensing agency shall withhold the issuance or renewal of a license or permit,to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence o►f compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states"Neither *he commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit comps-etely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. ff an LLC or LLP does have . employees, a policy is required_ Be advised that this af5da.vit maybe submitted to.the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Theaffidavitshouid be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have.any questions regi rciing the iau, or if you are required to obtain a workers' compensation tioiicy,please call the Department at the ntzmcnber;listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the�afridavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of-Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In additiion,an applicant that must submit multiple permittheense applications in any given year,need only submit one affidavit indicating current 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 starnped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Mrhere. a home owner or citizen is obtaining a Iicens� or permit not related to any business or commercial venture (i.e. a dog license or permit to burnleaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you.in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax numbs: The Commonwealth of Massachusetts Department of lxidustrial Accidents Office of Investigations 600 WashLington Street Boston; MA G21 I I Tel. # 617-727-4900 e= 406 or 1-877-MASSAFE Revised 5-26=05 Fax#617-727-7749 wvm'.Mass.Dov/dia ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 1� 780 CMR Appendix J Applicant Dame: Z'!�-M M I Site Address: �1_ P own: i1/ka A 1l� b 0✓� Use Group: Date of Application: Applicant Phone: Z t— 7 IL=- Q,2 9 Applicant Signature: Compliance Path (check one): ❑ Prescriptive Package(Limited to 1-or 2-family wood frame buildings heated with fossil fuels only) Package(A through KK from Table J5.2.1 b): Heating Degree Days (HDD65)from Table J5.2.I a: (For items d.through i., fill in all values that apply from Table J5.2.Ib:) a. Gross Wall Area .S� c sq.ft f. Wall R-value R- b. Glazing Area] y1r sq.ft. g. Floor R-value R- c., Glazing%(100 x b_a) �9, % h. Basement wall R- d. Glazing U-value U- i. Stab Perimeter R- e. Ceiling R-value R- J. Heating AFUE ❑ Component Performance: "Manual Trade-Off' (Limited to wood or metal framed buildings only) ID CIimate Zone(from Figure)6.2.2) ❑ Zone 12 ❑ Zone 13 ❑ Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC Trade-Off Worksheet, if applicable) ❑ AfAScheck Software Attach Compliance Report and Inspection Checklist printouts ❑ Home Energy Rating System Evaluation Attach Home Energy Rating Certificate(HERS rating score must be 83 or higher) ' ❑ Systems Analysis OR ❑ Renewable Energy Sources Attach Mass Registered Architect or Engineer Anal sis AT TERNATWE FORA DITfONS ONLY: "DrTION a. ross n +ail Ceiling Area L,?�0 sq.ft. b. Glazing Area] r-r sq.ft. c. Glazing% (100 x b=a) _/o with Glazing % (c.) up to 40% may use 780 CMR Table J1.1.2.3.1 below: MA3:IMUM Ii-value MINIMUM R-Values i Fenestration2 I ceilinL3 I Wall Floor Basement Wall I lab Perimeter.Denth 0.39-'• R-37 R-I3 R-19 R-l0 R-10.4 ft I Glazing Area may be either Rough Opening or Unit dimensions. 2 Based on NFRC Iisting. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full 11-value over the entire ceiling area (i.e.-not compressed ober exterior walls, and including any acceSS openings.) ❑ "SUJN'ROOM"addition (greater than 40% blazing-to-wall and ceiling Bross area) Attach "Consumer Information Form"from 780 CMR Appendix B. Official's Name: Official's Signature: WORTH OoT Andover .NM f No. Qf 8 dover, Mass., LAKE 6 oT1 co C..0 ...0 IT O"?ATE D BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR /&"'-I 15C—Ala *f,-)'40f/ THIS CERTIFIES THAT .............................................................................................. Foundation .. has permission to erect........................................ buildings on .&��./. ..& ............................. Rough tobe occupied as........... ....................................................................... Chimney provided that the person accepting thi�s�j Kerm....ft-tihalil/1n Wevery respect conform to the terms of the application on file 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 TS 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.