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Home My WebLink AboutBuilding Permit #299-11 - 25 Maple Street 10/13/2010 i BUILDING PERMIT O FORTH TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION 'yy" Y -h Date Received Permit IdO: A R TED R5 �SSRCHL15�� Date Issued: ®� IMPORTANT:Applicant must complete all items on this page LOCATION 1 NICi��s6 Ave ' Print PROP ERTY.OWlVER >Dav, - Print .. . MAP 210 _PARC ZONING'DISTRICT . Histonc,District,"-'. yes. no . Machine Sho .Villa e es no p 9.. yes OF IMPROVEMENT PROPOSED USE E Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other f Septic p Well 0 Floodplain O Wetlands b Watershed District. Water%Sewer. f DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: S Address: CONTRACTOR Nam Phone: Address:: t, OW --e.,. .. Supervisor s_Construction License: Exp: SDate Home..ImproVement License: Exp.. Date:` ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT;$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ d2�� FEE: $ ko �— Check No.: J5 OL Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art E] Swimming Pools El 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 COMMENTS HEALTH Reviewed on Siqnature COi(IMENTS 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'gown Engineer: Signature: Located 384 Osgood Street [FIRE DEPARTi�ERIT - Temp Dumpster on site yes no' cated at 124 Main Street ire Department signature/date OMMENTS. 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 - Date Doc.Building Permit Revised 2010/October 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Ih 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 rnust be submitted with the building application Doc:Building Permit Revised 2008 p R'�'ty o mm 0 Afidover o No. O dover, Mass. ,�� td LAKE �• • 'A COCHIC HE WICK A 7�AagATED S BOARD OF HEALTH Food/Kitchen PERMIT T . D Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT........ •.......�. :.�r .allr. ..A!'�'................................................................ Foundation has permission to ere ........ buildings on..,�: .... rA.,�. ........ ... .......... Rough to be occupied 8s.... ............�. . ........ � ..... . .... l�r.R'1i.. ......... .......... ........... ...... Chimney 411 �. permit hall in eve respect conform to the terms of thea lication on file in provided that the person accepting this pe its every p pp 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 b MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR C TARTS Rough . ".�.' . .......... Service BUILDING INSPECTOR inalE2k ` ^ Occupancy Permit Required to OccuPy Building GAS INSPECTOR Rom Display in a conspicuous Place on the Pre — Do Not Remove Final No Lathing or Dry Wall, To Be Done FIRE DEPARTMENT Until inspected and Approved by the Building Inspector. Burnet Street No. SEE REVERSE SIDE Smoke Det. GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO lift MOW 11 •, ',,. • " POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..dr no inspections . INSPECTIONS:(Minimum) Excavation.Footing, Foundation,Frame,Insulation,Final. FOOTINGS: Continuous Ftdl 2x4 Keyway Continuous strip footings for interior columns ,, , '- ' • '` FOUNDATION: Rebar as required s ' I Angor bolts or straps �• °+ .. Damproofing a ` Foundation drain-pipelstone/febric filter/cover and outlet connection. FRAME:Fireblock-over girts/plates between floor joist Penetrations for plumbing, heat,elec,etc. Walls at stair stringers. Windbrace comers and center bearing partitions. Size ridge to provide full bearing at rafter cuts. ti Hip and Valley rafters-watch bearing at wails. Ridge&Hip-Provide proper connections. ' Cathedral roof rafters provide proper connections and use°Hufficane Gips"ti t0 Stair stringers-watch cuts and treat support. Joist hangers-fully nailed w/hanger nails. 0 Sill plates 2-2X6(1 PT)w/sill seal. I Girts-solid brick or steel plate bearing at foundations 'r4"air space at sides.in foundation pockets. Lateral bracing at ends. ; Certified calculations. required for Beams/LVL's Trusses. , Solid bearing support for Hs/Beams etc. / Check headroom dearances_L stairways,under beams Attic Access. min.2240 w/3'headroom above). {{c y{ Crawl space access. (min. 18x24): Bath exhaust fans to have metal duct to exterior(rat in soffit). Firecode S/R wood frame of'O'clearance fireplaces&stover ' Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. 'r4 of required glazing shall be openable. M M +4 Bedrooms required min. 20x24 egress window or door. Vent attic spaces- proper vent",soffit and required ridge vents. ' Firecode under stairs if used for storage ; FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber-Finish i Smooth parging,dean joints,8'solid @ combust. DECKS: Lag to house,provide flashing. Rails min. 36"high, Baluster max space 5"on center. Over 8'above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48 Conc. pad at stair base. b . FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. „ Temporary Stairs required for inspection. r Re-inspection fee- $30.00(Be Ready). j r Certificate of occupancy required prior to occupyina structure. _ � i �;-� z_ � l 4 �, � T '�'� TE if ��. � ..aAe �I �� Y 4�r- �• yz V _ � p. r, `"try: -�� .y —». , (.� ��{ gk 3 �' � -- � f r� . �?y _ � "' � � 1 i' _ -- ',: ham' � � t � ''�.., � �rn-� � .� w. c r F. r- ,. E �,. � ,.. � -!. _ _ .r ,,� ,� t Y � .� .- _x - � �e F Y u:-, � � � '. a 1 �. ;; � ....... ., �,pm � _ �� A �,,,,�� >'�Q'.,.�. _sir � � � �� "y :.«¢-�.. #S � � w z , � w"z��fl�l5�"�� " �i i ,� ~ � _ ...,_ . �„, ... <,,:; 3 ._ - .�`.yc i� .. 4 - I T' aY f �_.5 q F� e µ �`f /I1p� VFX• _ �G � 1 ,� li■.A( T �.. Y k c� � s � fi �X _ -,.•. �'. w4 .� 01/04/2011 10:12PM 7812750764 PAGE 01101 r Department of Public Health-Childhood Lead Poisoning Prevention Program Deleading Notification Please complete all sections of this form clearly.Incomplete or illegible forms will be returned. Lead faint Inspector A 11 tart E. -Cusc pct. License# 3 i L l Inspection Date Properly Owner Do-v i A T. Dana%k Property Owner's Address '3o A4t 1kein 1A1ar Red- 4 MA Zip Code b L7 3 6 Authorized person performing work:_ D g v j eL T. . D on ny cz rn- Licit/,A;uth.# 1331 :4-- Address of authorized person 3o 11lei liean Wee aedfDFd MY4 Zip Code Q 1310 Telephone Number 0 17 2'7 6' [?' L,it Address where the work will be done: Building Name(if any) Floor Street Address olSr M�,wj e v Apt 1`l0. City_ ISI, l4rl d ay e-r Zip Code_019 14 Sr The property is a,,,&multi-family single family. Rre-ini e_s arc uriaCC- 1-Q {. Deleadiang Metbod(S): b ❑ Making paint intact(high risk) Making paint intact(moderate Q Applying vinyl siding on exterior ❑ Demolition risk) K Component removal(low risk a Scraping o Liquid encapsulant components) a Component removal/replacement 2k Covering ❑ Other: X Dipping ❑ Capping baseboards The work will'begin.on Y/ff/Lland will finish by cS/�MThe work will be done in the X am ern or_weekends. In Case of Emergency Contact D&vtA T `Ia a,�o san Daytime Phone U1 1 27 s' 67 L Evening Phone '7f 1 �k 7S' J>7&LI The Property Owner must complete and sign the following information: I certify that only authorized persons who have complied with the training requirements of the Massachusetts Lead Poisoning Prevention and Control Regulations, 105 CMR 460.000,will conduct deleading work.I further certify that the authorized person(s)will not exceed the scope of his/her authority and will be performing only those activities indicated above. All of the information contained in this document is true and correct to the best of my knowledge and belief. Date # 't Lg! 11. SignedAMA The following people/ageucies most be notified tent days before beginning work: 1. Occupants of the dwelling unit 2. All other occupants of the residential premises, if any work will be done in the common areas 3. Childhood Lead Poisoning Prevention Program,DPH Fax(781)774-6700 MWRHO 5 Randolph Street,Canton,MA 02021 4. Asbestos and Lead Program,DLS 19 Staniford St, 1"Floor,Boston,MA 02114 Fax(617)6266965 5" Local Board of Health/Code Enforcement Agency *If the home is on the State Register of Historic Places,call the MA Historical Cormmission at(617)727-8470. 01/04/2011 10:10PM 7812750764 PAGE 01/01 .+ 'Department of Public Health- Childhood Lead Poisoning Prevention Program Deleading Notification Please Complete all sections of this form clearly.Incomplete or illegible forms will be returned. Lead Paint Inspector A11t-n E. Cvscao_ License#_3Inspection Date 2-1/4-1 Propeity Owner D o-v l a T. D-n o v li Property Owner's Address 3o Wo,Y R Q d,(*,rd M4 Zip Code 6036 Authorized person performing work: D a v j j- T. D on o v et rlLic#/Auth.4 13 3-7 A--0 Address of authorized person 30 Al ei l t e W r,, [i e0o ra M4 Zip Code Q I`1 Telephone Number(fY .17,5' U'Z L q Address where the work wil I be done: Building Name(if any) Floor Street Address a ST Maple- Ore Apt No. City N. An d of e-r Zip Code DI g 4 s The property is a_&multi-family single family. Pr Aeleading Method(s): e-�t e_S a S se, u Aa e • y 0 ❑ Making paint intact(high risk) 0 Making paint intact(moderate ❑ Applying vinyl siding on exterior ❑ Demolition risk) Component removal(low risk A Scraping ❑ Liquid encapsulant components) X Component removal/replacement ok Covering a Other: X Dipping ❑ Capping baseboards The work will begin on y/C//Zand will Brush by 6/ I'LThe work will be done in theZam x pm or_weekends. In Case of Emergency Contact Da.vId "1'. D on a van Daytime phone 1 S 1 p dr b7 L y Evening Phone -11 7 S' 076�1 The Property Owner must complete and sign the following informatioa: I certify that only authorized persons who have complied with the training requirements of the Massachusetts Lead Poisoning Prevention and Control Regulations, 105 CMR 460.000,will conduct deleading work.I further certify that the authorized person(s)will not exceed the scope of his/her authority and will be performing only those activities indicated above. All.of the information contained in this document is true and correct to the best of my knowledge and belief. Date -0J 1 it 1 Signed The following people/agencies most be notified ten days before beginning work: l. Occupants of the dwelling unit 2. All other occupants of the residential premises, if any work will be done in the common areas 3. Childhood Lead Poisoning Prevention Program,DPH Fax(781)774-6700 MWRHO 5 Randolph Street, Canton, MA 02021 4. Asbestos and Lead Program,DLS 19 Stani£ord St, l"Floor,Boston,MA 02114 F~m(617)626-6965 5.• Local Board of Health/Code Enforcement Agency *If the home is on the State Register of Historic Places,call the MA Historical Commission at(617)727-8470. A NOTIC Date l d Zr� d Article , Section of the Zoning Ordinance WHEREAS, violations oft rticle , Section of the Building Code have been found on rticle , Section of the Code these premises, IT IS HEREBY ORDERED in accordance with the above Code that all persons cease, desist From, and STOP WORK at once pertaining to constructs n, alterations or repairs on these premises known as / All persons acting contrary to this order or removing or mutilating this notice are liable to arrest unless such action is authorized by the Department. BUILDING OFFICIAL ORTH Tovm of yo =`- o " dower, 1Vlass., K COC MIC WICK 7�S0 ATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR D.�... 'Q.�.,�.THIS CERTIFIES THAT....... .. f/.......... d...../�..lr ................ ...............................................: Foundation has permission to ere .................. buildings on .QC..... 4%. ........ ................ Rough to be occupied as.... 0..4 1 . ........... ..... ...... . ►.Iw.! '!! ................................... Chimney provided that the person accepting this permit shall 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC TARTS 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. µoRTH TOWN OF NORTH ANDOVER ,03? b...�_ oA OFFICE OF BUILDING DEPARTMENT b 1600 Osgood Street _ g eet Building 20, Suite 2 36 North Andover,Massachusetts 01845 SACHUS� Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: c4 13 Zo rD JOB LOCATION: 5' nnnn /"LkhL �ye Number Street Address Map/Lot HOMEOWNER Davl4 I 79D 27$' Name Home Phone Work Phone PRESENT MAILING ADDRESSWV 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 es 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 OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 685-9535 The Commonwealth of Hassachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/JElectriciansfPluanbers Applicant Information Please Print Leffibly Name(Business/Orgaaization/Individual): !/ v Doney a J — Address: o Alel Ilrcr LII G City/State/Zip: Sod Ld pA4 D 1?3 n Phone#: 7 F1 a-7S' d 7l, Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. []New construction employees(full and/or part-time).* have hired the sub-contractors Remodeling . 2.El am a sole proprietor or partner- listed on the attached sheet.# E] ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their 3. 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c.152,§1(4),and we have no 12.❑Roof repairs insurance required.]i employees.[No workers' 13,0 Other comp.insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new'affrdavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation insurancefor my employees. Below is the policy andjob 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Signature .9" 'T Date: 1 b 1131 t D Phone#: ?9-/ ' a 7S D7 to Y 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 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Location S No. Date I b ` 1174 V NORTM TOWN OF NORTH ANDOVER 0 F w A i Certificate of Occupancy $ MUst� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # a �00 74- 23543 Building Inspector