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HomeMy WebLinkAboutBuilding Permit #252 - 27 CHURCH STREET 10/2/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o� NORTh 6 tt�.o .6 a o o A Permit NO: v Date Received __2&1-� -,1),6 Date Issued/0—,9— �9SSAC HU`����y IMPORTANT: Applicant must complete all items on this page LOCATION —17 (_ik(A.`(CAA S Print 11 PROPERTY OWNER� er l� f k Vh — I Print MAP NO.: PARCEL: ZONING DISTRICT: 01 TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) >C05ther ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE j REFORMED I a— CA30&d STO Yd 1 mou h� in qh i �h m mr -�re Iden//tificat� n Pleas//e T pe or Print Clearly) / OWNER: Name: �!✓1 is k 4eP_ z4lAnPhone: Address: a7 (Ji U1'C,4 ..St /UOrA 4) C) CONTRACTOR Name: .S4_0a;J-� Phone: 663' S 3 7—OSS.- Address: P5_ _ i alia4 lf6c k 61 (,622�hkjn A/ G X 67 Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDINGT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ P MIFEE:$ C. Check No.: J��O Receipt No.: Page 1 of 4 Locations%' No. Date MaRT� TOWN OF NORTH ANDOVER f w a ` Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ J�CMust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # lf' Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools Ll Art ❑ g Public Sewer Well F1Tobacco Sales ❑ Food Packaging/Sales [I Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting nregist d 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 ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 Building Setback (ft.) Front Yard Side Yard Rear Yard Require-da: Provided Required Provides Required Provided -4 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC Jan.2006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 C Ga T m rd a- 1 C AW-c Sf,, 4rff.4 QUYr, /111,4 O I l S Q 7? li r --Y 9- ._.. OOD STOVE INSTALLA HON CHECKLIST Permit A building permit is required for the instalfation of any solid fuel burning appliance. The building permit and installation inspection are limited to the stave installation and not to the stove construction. :.� Stove .1' A. New✓ Used r_ . S. Typelradlant l OO& Circulating C. Manufacturer _Zg h�l fab.No. Z v-�ilcktk TQSJk�,a' ArN S I /(AU 7 k/1rNSt/ISL l4 Name/Model No. Collar size G " DimensionslHeight ' - �S t' Length !}q" Width 0•2- Yq r� Chimney A. New Existing G. Size(flue area) 15" X 24" C. Other appliances attached to flue(Number arid flue size) AoV\e- D. Prefab(Manufacturer—name and type) E. Masonry/Lined ✓ Flue liner 14 Unlined Iva@•manus.aur.rr F. Height(refer to diagrams) cap OVER, Icr ' J ST µ zI tut z %.I J! ox HE4RTH CHIMNEY HEIGHT Hearth(non-combustible) A. Materials b r;c,k G. Sub-floor construction _by-:(AK C. Minimum dimensions(refer to diagram) ''11 11 11 Clearances and Wall Protection(see stcve in-,allat,cn c!earances chart) See 6.T" ` A. Type of wall protection provided (ne&' -A\Sdik &501,\r B. Clearances(refer to diagrams) (� I r i FIREPLACE "-CORNER WALLCENTER. V40R Town of Andover 0 No., 4L 0 dover, Mass../d•2 • 040 LAKE COC H I C HEC 0RATED P" BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.............Z..40.100.1......... ......7' ......................................................... Foundation has permission to erect........................................ buildings on"?.+........eAmm,!.0A......... .................. Rough to be occupied as..... ........J.)i-j-k%we An.... ...................................................... 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 ?6%00- PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR o' UNLESS CONSTRU SITS S Rough ...... .... .. .. ...... Service .. .... TOR 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. °Hrri TOWN OF NORTH ANDOVER % OFFICE OF �`w x BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 ,^�CHUEt�y� North Andover, i� 01845 `-� Massachusetts Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (97,S)6,Q8-954? HOMEOWNER LICENSE EXEMPTION Please print DATE: 7SC-/ 0 JOB LOCATION: I___" til / 2 Number Street address — Ma /Lot HOMEOWNER_ CSN•�S;�,PH(--� L��/�t�,/ �l�y� 6y 2-/2 F( � 1 Name �� / ?�•/ �-��� Home Phone Work Phone PRESENT MAILING ADDRESS J— 0/� City Town y 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 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 R wised i020(u5 Prrm 1+)InLwmCI:9 Exonplion 0.d,A)C:F,JP;-i;l,':r;;:;_,i;.: USA/Canada Jotul F 3 Clearances Stove Clearances Unprotected Surfaces Protected Surfaces Top vent/vertical per NFPA 211 or CAN/CSA-6365-M Side Rear Corner Side Rear Corner. Rear heatshield with 24" 25" 18" 10" 14" 10" Single wall pipe 61omm 635mm 46omm 255mm 355mm 2S5mm Rear heatshield with 18" 1011 14" 6" 6" 6" Double wall pipe or shields 46omm 255mm 355mm 150mm 150mm 15omm Stove Clearances Unprotected Surfaces Protected Surfaces Rear Vent/Horizontal per NFPA 211 or CANKSA-13365-M Side Rear Corner Side Rear Corner Rear heatshield with 24" 25" 20" 10" 25" 18" Single wall pipe 61omm 635mm 510mm 255mm 635mm 46omm Rear heatshield with 18" 14" 17" 6" 6" 6" Double wall pipe or shields 46omm 355mm 430mm 150mm 150mm 150mm Connector Unprotected Surface Protected Surface Clearances per NFPA 211 or CAN/CSA-B365-M Singlewall pipe-vertical installations 18"(46omm) 6"(lsomm) Double wall pipe-vertical installations pipe mfgr.listing pipe mfgr.listing Single wall pipe-horizontal installations 18"(46omm) g" (230mm) Double wall pipe-horizontal installations pipe mfgr.listing pipe mfgr.listing Very important: Top_vent/v_ertical- assumes the connector pipe is exiting off the top of the stove and traveling vertically If top vented A to any horizontal runs —the stove's position is dictated by the connector pipe clearances. Rear vent/horizonta.l- assumes the connector pipe is 0 existing out the rear of the stove and is traveling horizontally to the chimney. If rear vented to vertical run— C the stove position is dictated by the connector pipe clearances. Dimensions in Inches represent U.S.requirements. A:Top to Mantel 34 860 mm 2� Dimensions in Millimeters represent Canadian << r' B:Top to Top Trim Zo" 510 mm requirements. ---1 C:Side to Side trim 13" 330 mm Wall protection is discussed in further detail on page Y D:Side to Side Wall 24" 610 mm 10 of this manual.