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Home My WebLink AboutBuilding Permit #Exception - 254 GREENE STREET 5/1/2018 11 i, NORTH BUILDING PERMIT `�.� 'd o� t,�o ,°qa TOWN OF NORTH ANDOVER 32 °` ". . *° oL APPLICATION FOR PLAN EXAMINATION Permit NO: Date ReceivedU ��SSACHUS Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATIONAL y� PROPERTY OWNER I r `-� K �Print t t� E6 /V Print MAP NO: PARCEL:. ZONING DISTRICT: ', Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE 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 Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: LK ck Le 'TVwA c),Av A i- /0, 106 -5, I; Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: ^bAt "7 ! the A Phone: Cf Address: 'i 1. v� fiJovey MA alto Supervisor's Construction License: Exp. Date: Home Improvement 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner 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 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: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 1 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 3 ❑ Notified for pickup - Date Doe.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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 ��ffa ��p. �� r�� Date.lee-' HOttTN Of of O� TOWN OF NORTH ANDOVER f � P • - PERMIT FOR GAS INSTALLATION ACHU`'Et This certifies that �.1�?�� /. �l-:<: :. . . . �'/5 . . . . . . . . . . . . . has permission for gas installation . . . `� . . . . . . . . . . . . . . . . . . . f in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . .�. .. . . .f:. . . . .7. . . . . . . . . .. North Andover, Mass. Fee. ?.? .. . . . Lic. No..: .�. . .. . . . . . . . . . .. . . . . ..�. ?A . . . . . GAS INSPECTOR Check# / is 4. 77 � o MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING Type orprint) Date 161 /a/ NORTH ANDOVER, MASSACHUSETTS ~� `'�' Building Locations 1 q 6REE V <- / AL / Permit# ZY' Amount S �J— Owner's Name A TUB New❑ Renovation ❑ Replacement �--- Plans Submitted ❑ x Cn U N F C C cn In 21 C C w C C w r i L U . G SUB-BASEM ENT B A S E M E NT IST. FLOOR 2N D . FLOG R 3RD . FLOOR 4TH . FLOGR 5'r H . F L O O R 6T It . F L O O R 7T 11 FLOOR 8 T H . F L O O R (Print or type) 1 / / Check one: Certificate Installing Company Name �/ f-f /�! /1� 1�'� / r( El--eurp. Address 'L ❑ Partner. U Business Telephone '�� ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter �,e CALLA INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑' No❑ if you have checked ves,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ i hereby certify that all of the details and information I have submitted(or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit [ssued for this application will be in compliance with all pertinent provisions of the Massachus s Stat Gas de and Cha I oft e Gene 1 Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber 7 6 City/Town r--f—Cas Fitter (cense umber ❑rIvCaster APPROVED(OFFICE USE ONLY) ❑ Journeyman Location No. Date L NORT1y TOWN OF NORTH ANDOVER O Certificate of Occupancy $ sACNUs t� Building/Frame Permit Fee $ o _ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /U 3s'I 22 � � U Building Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: 142 LL O IMPORTANT: Applicant must complete all items on this page LOCATIONS�j S--r PROPERTY OWNER C, C Print MAP NO: PARCEL:_;] ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Ad ' 'on Two or more family Industrial Iteration No. of.units: 1 Commercial (�-epai replacement Assessory Bldg ;/l/CD Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO PE PERFORMED: 1 M O Q L; J stye lei Identification Please Type or Print Clearly) 11 OWNER: Name: C'��cc� it.� Phone: Q7 �� /� Address---Q - C) C� G c�GQe( CONTRACTOR Name: .�Pt`? iv C., Phone: 7 Address: 2. Q 1 Y10 �0�-- &AQue� AA Supervisor's Construction License: 31 rN Exp. Date: la, 1 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER AJ4 Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMI :$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.:/b �� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce tgn Signature ofAentOwner g Plans Submitted Plans Waived Certified Plot Plan m d 4;s TYPE OF SEWERAGE DISPOSAL ublic Sewe Tanning/Ma ageB Art Swi Xng ols Well Tobacco SalesFood Ping/Sales Private(septic tank,etc. Perfnanent D pst 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 Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes (kf Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: r, : ' ` Located 384 Osgood Street FIRE DEPARTMENT - ternjD-ternbumpster 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.$10041000 fine NOTES and DATA— (For department use) ❑ 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 L3 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: Doc.Building Permit Revised 2008 F NORT1y Town of Andover No. E dower, Mass., .�— COCHICHEWICK y�. 7�p A�RAT E D P' �� `S BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......S . . ................................ ............................................................ ............ Foundation has permission to erect................................. buildings on ..........� ►. .......... ...................... ...w... Rough s to be occupied asa..... ................ ..�..........� 11�.�...�. ....... Chimney .... ....................... ..... provided that the person accepting this permit shall in every resp conform to the terms of the plication 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 UNLESS CONSTRUCTION STARTS 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i Massachusetts_ Board of g DEPartmen wldinrtot'Public, Construction S ,ulations;In S itEh Lice uperviso `inStandards. License- 0 31830 r License Restricted to: 00 PO BOX 802 O802 AHERN ANDOVER, NDOVER MA 01810AL ('unuuissiune—� Expiration: 9121/2011 Tr#: 3328 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): C10 Address: G,-- City/State/Zip: - AA-AG 00V Phone#: Are you an employer?Check the appropriate bog: 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 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. emolition workingforme in an capacity. workers' comp. insurance. pm�D,y p �'� p 9. Building addition 5.` We g o workers comp. insurance are a corporation and its � P IP 10. Electrical repairs or additions required.] We have ❑ P q � exercised their 3.❑ I 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.] t employees. [No workers' 13.❑ Other comp:insurance required.] may ayyi5�.au�ww�n a.checksbox*r♦must--,so..11 but the section be.oW showing their workers'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. :Contractors 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 is providing workers'compensation insurance for my employee& Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 010 Job Site Address: �`I >`Vreti-P S � 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 pa s and penalties of perjury that the information provided above is true and correct Signature: Date: a Phone#: if�3 9_ Official use only. Don 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 Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and 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 hire, 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 dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or 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 of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the 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 completely,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. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should 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 regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number 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 affidavit 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 addition,an applicant that must submit multiple permittlicense 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 stamped 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. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves 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 number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston, MA 02111 Tel.#617-7274900 ext 4.06 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-05 www.mass.gov/dia F7 Town of North Andover NoRTti BuildingDepartment °��ct`-ED �6 �ti p ? ,......, 46 0 1600 Osgood Street North Andover MA 01845 11- R Tel: 978-688-9545 Fax: 978-688-9542 T 0 L � K"I A CO[NMEwKw`y DEMOLITION OF BUILDING AFFIDAVIT SgCHUSE DATE 11do q OWNER'S NAME &ADDRESS �� f LOCATION OF PROPERTY TO DEMOLISH C�,Vcelvc DESCRIPTION GaYA C q✓LJ I�/tt HUVs(l) * `ot �Z CONTRACTOR'S NAME & ADDRESS HY16Y 14V fHUA) ftlft VCA- DEP N-OFFS Z�� O DEPT. OF PUBLIC WORKS -WATER: SEWER- DEPT OF CONSERVATION /I A HEALTH DEPT: Septic s � 9` �� .�r�. HISTORIC COMMISSION C �^ GAS � v r n�� ` P 1 U3 ELECTRIC6Ad 7 q 7.1 clG TELEPHONE CABLE _ LTAXES Plm� Q.-�r FY Zul D itk U3 D� FOLIC �- / /L L+ I"PJ��I _ •OJ FIRE72. 'EXTERMINATOR" v1 L 1 DUMPSTER- ON/OF REE 1 W �� YS `J bY�� I'1'� u t,.OG c1 wmt DIG SAFE NUMBERyO "DATE REC'D BLDG. INSPECTOR Doc.form demolition of building affidavit Location 6� ..S No. Date NOR,h TOWN OF NORTH ANDOVER f � F41 9 Certificate of Occupancy $ cHu9 <� Buildin /Frame Permit Fee $ s� sE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #LO 2250- 1 Building Inspector NORTH BUILDING PERMIT ,,J-60x.96 TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION41 o,P coc..cc...c. Permit N0: Com, Date Received 4�RATOD �SSACHUS�� Date Issued: "f ImpbiiTANTe Applicant must complete all items on this page �J A, LOCATION ( 0 z3rJ Print PROPERTY OWNER 3 'ZeQ G Print MAP NO: 2 - PARCEL: ZONING DISTRICT: Historic District yes no-- Machine o-Machine Shop Village yes lKo ; I i TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial 'on No. of units: Commercial Repair epIacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District ater/Sewe DESCRIPTION OF WORK TO BE PREFORMED: w Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: DAs 1,f0ee Phone; Address: 11. oL`f y &U, - &&tn �4 01 I � Supervisor's Construction License: Exp. Date; Home Improvement License: Exp. Date: ARCHITECT/ENGINEER J ✓VN V � Phone: Address: LC t Reg. No. FEE SCHEDULE:BULDING PERMIT:$1,x.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ UU.C o FEE: $ e �� Check No.: Receipt No.: NOTE: Person co tracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owne Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/MassageBody 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 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: Signature: ' Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 MainStreet 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 i ❑ 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 o 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 9 9 9 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 l NORTH T 1, , '. " ® of 19Andover , 0 No. <3 o a 4L C, ---- -L A K 6 0 - - over, Mass. COCHICHE".C. ORATED 77 BOARD OF HEALTH Food/Kitchen PERMIT T _D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ..................................................................... Foundation has permission to erect........................................ buildings on .p_7x. .... xew�.- 7..:: ............................ Rough ---------- z e 1; - Chimney ........./ to be occupied as. . .....................j.......1117.e4ie.................................................................... provided that th";e�rOfaccepting 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 CONSTRU qARTS_ Rough Service BUILDING INSPECTOR Final Occupancj Permit Required to Ocmpy 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. Massachusetts- Department of Public Safeti Board of Building Regulations and Standard,,,- Construction tandardsConstruction Supervisor License License: CS 31830 Restricted to: 00 DOUGLAS J AHERN PO BOX 802 ANDOVER, MA 01810 Expiration: 9/21/2011 ('ommisiuner Tr#: 3328 Zoning Bylaw Review Form ,10RT1, `�' Town Of North Andover p Building Department 1600 Osgood Street, Building 20, Suite 2-36 o ," 41 AT:o�•�`1y North Andover, MA. 01.845 �SS�cHUS Phone 978-688-9545 Fax 978-688-9542 Street: 254 Greene Street Map/Lot: 22/51 Applicant: Charles &Rosalie Eaton Request: (A) Raze&re-build 254 Greene addition; (B) raze shed on proposed Lot C1. C Construct new duplex on proposed Lot C2: Date: September 22, 2008 Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning District: R-4 Item Notes Item Notes A I Lot Area F Frontage 1 Lot area Insufficient X(C) 1 Frontage Insufficient 2 Lot Area Preexisting 2 Frontage Complies X(A),X(C 3 Lot Area Complies X(A) 3 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed X(A),X(B) G Contiguous Building Area 2 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required X C) 3 Preexisting CBA 5 Insufficient Information 4 Insufficient Information X(C C Setback H Building Height 1 All setbacks comply X(A),X(C) 1 Height Exceeds Maximum 2 Front Insufficient 2 Complies 3 Left Side Insufficient 3 Preexisting Height X A 4 Right Side Insufficient 4 Insufficient Information X C 5 Rear Insufficient I Building Coverage NA 6 Preexisting setback(s) 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D Watershed 3 Coverage Preexisting 1 Not in Watershed X 4 Insufficient Information 2 In Watershed j Sign NA 3 j Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required I 1 More Parking Required X C 2 Not in district X 2 Parking Complies X A 3 Insufficient Information Remedyfor the above is checked below. Item# Special Permits Planning Board Item# Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit K-1 Parking Variance C Frontage Exception Lot Special Permit A-1 Lot Area Variance C Common Driveway Special Permit H-4? Height Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board Independent Elderly Housing Special Permit Special Permit Non-Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Special Special Permit Use not Listed but Similar Permit NU Planned Residential Special Permit B-4 Special Permit for 2 Unit R-6 Density Special Permit Special Permit for 3d-5 units Watershed Special Permit G-4, H- I Supply Additional Information 4, K-1 The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative'shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the abov ou must file a new building permit application form and begin the permitting proce S. 44 A4 A Building Department Official Signature Application Received A icatio Denied Denial Sent: If Faxed Phone Number/Date: