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Home My WebLink AboutBuilding Permit #Exception - 30 CARTY CIRCLE 5/1/2018 F NORTH '9 BUILDING PERMIT O �4�Fo 164�O 6 TOWN OF NORTH ANDOVER 0 A APPLICATION FOR PLAN EXAMINATION ��f Permit No#: Date Received 7 q0 Areo gSSACHl1`��'( Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP 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 ElFloodpiain El Wetlands El Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: i 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 r 3 • -...f N�RT►i ✓ oOSt�.lD r BUILDINTPERMIT o� '(U� TOWN OF NORTH ANDOVER o / APPLICATION FOR PLAN EXAMINATI N Permit NO: din.— — �` Date Received � II • ,/ Arco Date Issued:® t U�� 9SS�CHU IMPORTANT:Applicant must complete all items on this page LOCATION 36 CGrIv Cirelr Wotlk Andover MA n1g'4s Print PROPERTYOWNER David E Tahns•Iny, -"r. Print MAP NO: PARCEL:(b7- ZONING DISTRICT: Historic District yes no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building X One family ❑Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial M Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District x Water/Sewer 1Zennave enxistinc Cabinet's and Cnar&erinp In +he kitchen. iyistall ne .2 Crebine+s, CounferFno and cen-Fer Island . Identification Please Type or Print Clearly) OWNER: Name: David E. J'nhns+wg Tr. Phone: 978 c8S-SISy Address: I CONTRACTOR Name: Phone: i 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: $ 9.So n . - FEE: $ Check No.: 1Lf- / Receipt No.: :to-4604- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of A ent/Owner . Signature of contractor 9 _ 9 9 rr`i.,rA�lix r.. R. Location s 0,0,27` 6,09- No.ez? ,09-No.(z? � Date tea/ • - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ a Check# if T r rQ' Buildingj Inspector Y v Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL i Public Sewer ❑ Tanning/Massage/Body Art ❑ Swunming Pools ❑ i w Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. Permanent Dumpster on Site❑ Elt 1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM { 1! PLANNING & DEVELOPMENT Reviewed On Signature_ i CO MENTS I CO SERVATION Reviewed on Signature COMMENTS V 11" i 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 n DPW Town Engineer: Signature: Located 384 Osgood Street F�I.REDEPAR�TMENT Temp�D��-_s-ter,4onsite° yes Locatedta - ► t''F124IVIainSfreet - -— •a Y I FireDepartmentsignature/date _ w _. .. - Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Deter 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 Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4. 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/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit i 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 2012 IECC Energy code Engineering Affidavits for Engineeredproducts Department prior to issuance of Bldg. Permit OTE: All dumpster permits require sign off from F p p 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 m ust be submitted with the building application Doc:Building Permit Revised 2014 7 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 99500.00 m $ - $ 114.00 Plumbing Fee $ 14.25 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 14.25 Total fees collected $ 242.50 30 Carty Circle 033-2017 on 7/11/2016 Kitchen Remodel NORTH own of 2 _. t E ndover O - ti 0 IL �—Za1 * _ t "- - No. 3 � h ver Mass IO I Iw�a f 1. A- tocHicHewIcw � '7,eS RgTEO PPa,��y U BOARD OF HEALTH Food/Kitchen PER T T LD Septic System THIS CERTIFIES THAT ......... me ..........�..�.....IJ. ......... ............ ,..,,, , ...... ......... BUILDING INSPECTOR 20 has permission to erect . . ........ buildings on . .... .. .............. Foundation ............... 9 Rough to be occupied as ........... ..... ........ .. .................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 CONST TION S Rough Service . .. .... . . .. ..... ..... . Final BUILDING INSP TO GAS INSPECTOR Occupancy Permit Reguiked to Occupy Building 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. Smoke Det. 7/11/2016 Dave and Linda Final Plan.jpg »a T 60i" _ i SCHF'OCK ICABINETRY: i ' < W2733 153F ELSTONDOOR T . ._�.COCONLiT FINISH r. t.......... .. ..._.y.... - W341524 r+. ;ALL PLYWOOD CONSTRUCTION ' 48CPOL 4D818 24.DISHV T t�+r 8 2 I SPC,ORAWER FR_ONTS ' .. r I rc1 i c i � .. _ _ ... I.L - j NOTES FOR INSTALL i O tJSPLEGS "-USING EXISTING FRIDGE SO CABINET ABOVE. €UNIT1 IET} _ .i=CABINANDPANTRYWILLrBE PULLED.--. . • =rv' V ! rn FORWARD TO LINE UP WITH PANEL TO GIVE p'. FfdIDGEABUILT..IN LOOK... 7 t6 tCJi !-BLIND CORBER WILL BE PULLED OFF WALL M JSf APPROX 1-314- iGS--1 - � � -- - fi_7SL?NDFILLER"PIECES TO SUPPOERT OVERHANG'i --{-" WILLIMEASURE 10-WIDE ON SMALLER ONES roNLA t c " li ; ... _. +......_C: O NE 6AN : XI (DMEO[U EALL IM1KD-TO BE ONSRE CAN'BETA WRAPPED H.E BASE BOARDMOLE 3 , AND BASE CABINETS ON ISLANDG COMSOUTG 9wrrHTTO _. yWALL CABINET SALLIGNING AT 87,-FLOORCE ___` JEECROWN MOLDING DETAIL ;€ _... FOR ASSEMBLY 4225 i 47 i 1 1 .. _--- I a 225a 7234 , https:Hmail.google.com/_/scs/mail-static%�s/k=gmail.main.en.HUp9gP19A7w.0/m=m_i,t/am=nhGPBDD 7 3BulZRQFb6SoV57z3fLSk YoGH_-9M-Eit8vjt7P... 1/1 i f N°RTM 1 TOWN OF NORTH ANDOVER 3r°-',•`gyp�` 0 OFFICE OF 0- p BUILDING DEPARTMENT ` ` 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 SSwCHU Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 1L JOB LOCATION: 30 Ca e+v C i re I e Number Street Address Map/Lot HOMEOWNER David E .Inhns+0n S1- 97g C`65-814y 18160_g-1936 Name Home Phone Work Phone PRESENT MAILING ADDRESS_ 3o La r1-y (i rc t e Norf-h Andover NIA q.5, 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 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 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I The Commonwealth of Massachusetts Department of IndustrialAccidents b I Congress Street,Suite 100 < Boston,MA 02114-2017 ` www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Ayylicant Information Please Print Leeibly Name(Business/Organization/Individual): David E So h ri s to n Tr. Address: 30 Crx4y Ci rel e City/State/Zip: Mar+h Andover M A 018 4 S Phone#: 979 L 2 S-x l 9 y Are you an employer?Check the appropriate box: Type of project(required): 1.E]I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required] 3.4 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or am sole 1 LQ Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.= 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] I i *Any applicant that checks box#1 must also fill out the section below 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 subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I I am an employer that isproviding ivorkers'compensation insurance for my employees. Belmv is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: I 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 MGL c. 152,§25A is a criminal violation punishable by 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 j day against the violator.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 and penalties of perjury that the information provided above is true and correct. Sianature: 2)/ajin( ir QU"dj&21, d4. Date: 7 - 9-/6 Phone#: 781 61 $-1936 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: