HomeMy WebLinkAboutBuilding Permit #777-14 - 273 BERRY STREET 4/29/20141 1 1 OORTH q
BUILDING PERMIT 3?���t``D °•6�`
TOWN OF NORTH ANDOVER °
APPLICATION FOR PLAN EXAMINATLONJ�o �y
Permit NO: Date Received
Date Issued: S CH
IMPORTANT: Applicant must complete all items on this vaize
LOCATION 273 Berry Street, North Andover, NIA 01845
Print
PROPERTY OWNER Heather and Joshua Seidel
Print
MAP NO: 108C PARCEL: 49 ZONING DISTRICT: Historic District yes no
Machine Shop Village ves (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
We are proposing a 6' x 10' shed to be built on the property for the purpose of storing outdoor
equipment .
OWNER: Name
A
Identification Please Type or Print Clearly)
Heather and Joshua Seidel Phone: 978-500-2067
idress'. 213 Berry Street, North Andover MA 01845
CONTRACTOR Name: Phone:
Address:
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: $ 2500 FEE: $ 30
Check No.:-—
� Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
Signature of Agent/Owner ' Signature of contractor '
Permit NO:
Date Issued
_'TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
IMPORTANT:
Date Received
must complete all items on this page
LOCATION
Print.
PROPERTY OWNER
Print 100 Year Old Structure yes no
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
11 Addition
El Two or more family
El Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
El Water/Sewer
DESCRIPTIUN UI- VVUMM 1 U or- rr-mrm r -u.
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
/1UU1 CJJ.
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License:
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
S_ig_nature of Agent/Owner Sidnatureof contractor
Plans Submitted LJ Plans Waived ❑ Certified Plot Plan ❑
Stamped Plans ❑
L
Location 2 1
No.
Check
Date 2�
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $30—
Foundation
yFoundation Permit Fee $ ;
Other Permit Fee $
TOTAL $
Building Inspector
- L:
Plans Submitted ❑
Plans Waived '❑_ -.:Certified Plot Plan ❑ Stamped Plans ❑
= :TYEE OF EWERAGE.DiSP_OSAL"
Public Sewer ❑
Tanning/MassageBodyArt ❑ ..
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private tic :se tank etc._
(septic � ❑ -�� = -.
=Permanent Dknpster on Site ❑
THE.:FO.LLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
�ANNING & DEVELOPMENT
COM ENTS
-DATE REJECTED
❑
DATE APPROVED
CONSERVATION Reviewed onNSi nature d .
COMMENTS �4, a ;
.N
ALTH
COMMEN
U
r -
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition N
Planning Board Decision:
Comments
P
Conservation Decision: :Comments
Zoning Decision/receipt submitted yes
Water & Sewer Connection/Signature Date Driveway Permit
DPW Tow;z Engineer: Signature:
Located 384 Osgood Street
FIRE DEPMWENT. =.Temp Dump:ster on site yes., no
Located -at 124Mair Street
Fire be—pai! diNts."— to date
COMMENTS `
-Dimi-ension
Number of Stories:_
.Total land -area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
ELECTRICAL: Movement.of Meter. location, rriast or service drop requires approval of
"Electrical Inspector Yes No
DANGER.Z®NE LITERATURE: Yes No
MGL -Chap ter-166.Section 21&. F and G min.$100-$1000:fine
IVU I is anti UA 1 A — (i -or department use
D Notified for pickup - Date
Doc.Building Permit Revised 2010
Building Department
,The fohowing is'a=list of the *uired.forms to be filled out for.: the appropriate -permit to .be obtained.
Roofing, Siding, Interior Rehabilitation Permits
L Building Permit Application
o Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C:S:L Licenses
u Copy of Contract
Li Floor Plan Or Proposed Interior Work
Li Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off. from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
Li Building Permit Application
o Certified Surveyed Plot Plan
o Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
o 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)
o Building Permit Application
o Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
o Mass check Energy Compliance Report
L, 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 apw'�al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be subm.tted with the building application
Doc: Doc.Building Permit Revised 2012
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ROOF RUNOFF .
CHAMBERS A7
\(TYP.)
LIMIT OF 25'
NO-DISTURB ZONE
75' NO BUILD \
EPHEMERAL POOL
HABITAT BUFFER ZONE ` `' , ., so•
r A.C.
UNITS 50,3'
50.1'
lop WEI
AIT OF 100'----'
.AND BUFFER�ti
ZONEPATIO
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IX
` ji CONCRETE
EXISTING A .
HOUSEID
`\i '`� ��' TOP FND. /
132.31
ti`s �`}OWNSPOUT �.
CAPE �, y r� „% / (TYP.)
CONCRETE 5o FIELDSTON
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SEA �\ ` •'� , � �� �� "ell/ LIMN
ISTUR�-
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. JND �:..::.,,�� 130 / g 53.0'/
= ��` `' `mss``•`'"♦'GP' /
55.1' J
21.6 A17
ROOF RUNOFF
SEWAGE f CHAMBER A18
EJECTOR o
goo. oo'
EXISTING
" HOUSE #245
VINYL FENCE N/F
GREGG FRATTO
MAP 108D LOT 50
04/08/2014 02:54 19786884244 EASTERN SHED COMPANY PAGE 01/02
Phone: 978-688-4222
Fax : 978-688-4244
www.easternshed.com
Email: easternshed@verizott.net
Fax Transmittal Form
Date: L
To: Je
From:
Phone:
Fax
Number of pages including cover page: C;
Message:
04/08/2014 02:54 19786884244 EASTERN SHED COMPANY PAGE 02/02
The Commonwealth of Massachusetts pint Form
Department ofIndustrial Accidents
Office of Investigations
kv 1 Congress Street, Suite 100
Boston, MA 02114-2017
www.massg'ov/dia
Workers' Compensation Insurance Affidavit: ]Builders/ContractorsCElectlricians/Plumbelrs
Applicant Information 1 ase Print Lezi�
NaTne (Business/Organization/Individual)
Address: aoOl
-U. E4 Ll
City/State/Zip: 03EY-1(-- Phone 4: 9-)13-&60ML/
Are you an employer? Check, the appropriate bozo:
I. I am a employer with b 4. Q I am a general contractor and I
�� of
con (r
employees (full and/or part-time).*
have hired the sub -contractors
New construction
t' ❑New construction
2. Q I am a sole proprietor or partner-
listed on the attached sheet.
7, ❑ Remodeling
ship and have no employees
These sub -contractors have
g, ❑ Demolition
working for me in any capacity.
employees and have workers'
9, ❑ $>�11d1p9 a dltloP
[No workers' comp. insurance
rNuiredj
comp. insurance.t
5. ❑ We are a corporation and its
10.❑ Electrical repairs or additions
3. ❑ I am a homeowner doing all work
officers have exercised their
11. ❑ Plumbing repairs or additions
myself: [No workers' comp.
right v)f finewtiorl pt<r MCL
12. Roof repairs
insurance required.] l
C. 152, § 1(4), and we have no
employees. [No workers'
l 3
comp. insurance reauired.l
`.Any applicant that checks box #1 must also till out the section below showing their workers' compensation policy information,
t Homeownen who submit this affidavit indicating they arc doing all work said thcn hire outside contractors must submit a new affidavit indicating such.
lContractors that check this box must attached ao additional sheet showing the name of the sub -contractors and state whether or not those entities have
employees. If the sub -contractors have employees, they trust provide their workers' comp, policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Namc;
Policy # or Self -iris. Lie. # CA Is 91 Co Expiration Date: LI -10 —C')OIq
Job Site Address; Qn3 &r,T 6 . . , - _ Cily/State/Zip: �d - �j/�ct�, % -0,16A6
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 25.A, of MGI, 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 ceritfjytnder thepfijlis andpenaldes ofperjury that the inlormafioa provided above is true and correct
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 Clerk 4. Electrical Inspector S. Plumbing .Inspector
6. Other
Contact Peraon:
Phone #:
Gerald A. Brown
Inspector of Buildings
Please print
DATE:4/8/2014
JOB LOCATION: 273
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
North Andover, Massachusetts 01845
Telephone (978) 688-9545
Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Berry Street Map 108C/ Lot49
Number Street Address
HOMEOWNERJoshua Seidel 978-500-2067
Name Home Phone
PRESENT MAILING ADDRESS 273 Berry Street
N.Andover MA
City Town
State
Map/Lot
781-278-5817
Work Phone
01845
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 at he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING
Revised 10.2005
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
North Andover MIMAP
April 8, 2014
106 D-0036
106.D-0055
203 BERRY,ST 89,
t..••, 210 BERRY ST
." 166-M-0054
213 BERRY ST
9
106.D-0053 9•
•.. flu '`.`::::" .,_.. • : •`.. �� 106.D-0052
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i,... ."':::" �xlu : ••.:;•.. ':.`::: flu :.s� .. _..•: •.:: •.. 6..227 BERRY ST
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273 BERRY ST
`.1!OBC-0049
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108.0-0023
.It ::•lti .: c..:
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a..'108.C-0063
1'08. 0`0 = =::. -._.
? 303 BERRY ST
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108.0-0013
!<. V'='..,yi' ..... •'°:::' qtr :..;,
h 296 BERRY ST
:. 'flu '_ 108.0-0064
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108.0-0021
- 315 BERBY'ST
A&' 325 BERRY ST
108.0-0052
= i08.0-0068 _.
310 BERRY ST
atJcr
' .'== u' •'== - 108.0-0065
108.C-0014
.
— Rail Line Wetlands Zoning
Interstates :.: Exempt Lands Busine
_ I O Busine
s 1 Distt
s 2 Dis rld
Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83,
— SR m Busine
■ Busine
s 3 District
s 4 District NORT1t
Meters Data Sources: The data for this map was produced by Merrimack
Valley Planning Commission (MVPC) using data provided by the Town of
Roads 0 Genera
r Easements O Plannei
Business District Ot ac q�
Commercial Dev ' •�6 00
North Andover. Additional data provided by the Executive Office of
Environmental Affairs/MassGIS. The information depicted on this map is
MVPC Boundary t . Corrido
ry
'����
Development Dist 3 _ L
for planning purposes only. It may not be adequate for legal boundary
E3 Corrido
0 Municipal Boundary O Corrido
Development Dist O --• — /P
Development Dist �' 9
definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER
MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING
Zoning Overlay Industri
t.r Industri
O Adult Entertainment
11 District M :{
12 District K i .^, .1r
THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY
OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT
O Industri
Downtown Overlay District
1 3 District M
'�
ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
E3 Historic District 93 Industri
Water Protection Reside
Reside
'ISDistrict •eo "'•"•^
ce 2 District '=J,' +�r�o 'fit
2 District SSACHUS�
THIS INFORMATION
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Hydrographic Features A dsii
1" = 132 ft •i }•dece5
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District
Streams YYY de
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�a a
esidential District
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