HomeMy WebLinkAboutBuilding Permit #357 - 30 MIFFLIN DRIVE 10/24/2011 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: S�- Date Received
Date Issued: U �O 4 — ( (
IMPORTANT:Applicant must complete all items on this page
LOCATION _3�0 I7 r EFI/,N Dr.
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PROPERTY OWNER Q'WAYI I t Unit#
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MAP NO: PARCELDC,,1�10NING DISTRICT: Historic District yCno
Machine Shop Village y100 year-old structure y
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
TRepair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
Ij Septic 0 Well 11 Floodplain 0 Wetlands 0 Watershed District
0 Water/Sewer
DESCRIPT ON OF WO TO BE PERFORMED:
9
ri 1t� �- Xew�otl�e Re I►4 ce R v d woo
(Identification Please Type or Print Clearly)
OWNER: Name:
LLAA O cU'k N t u Phone:
Address: ,30 rv)IFFliq br.
CONTRACTOR Name: Ke=u lq Yom d,,,)L Phone: 4?$- 4/76--V(15O
Address: '? pnyVv ih s l'L Me 4k.,,eh Ylgot Orb U(/
Supervisor's Construction License: Q V 7 Exp. Date:
Home Improvement License: /60 a7 a Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.•$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ �SU- ° C) FEE: $
3--D
Check No.: �)4 Receipt No.: aq�3—
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature_of Agent/Owner _ Signature of contractor
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: Doc.Building Permit Revised 2008mi
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools 0
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
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 de artment use
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2011 June/mi
Location X36
No. Date O r ■
MORTM TOWN OF NORTH ANDOVER
10. �
9
i s
Certificate of Occupancy $
Cw t� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
2 r Building Inspector
PROPOSAL
K & C Contracting
DATE Proposal#
7 Marvin St.
Methuen Ma 01844 10/24/2011 2405
978-476-4450
Dan O'Connell 9 -)'� -66-77d 7
30 Mifflin Dr
No Andover Ma 01845
DESCRIPTION AMOUNT
Remove rotted top plate and replace with new 2x4
Install new 2x12 header for fireplace and frame opening with 2x4
450.00
l
Y
Dan O'Connell
Kevin Kondrat � 1c '
TOTAL $450.00
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4 Board of8i�il�ltn�i ., en .
$upe�`►aQr. 1.1cs"e
CC' �;Ct,on I
;.Icr.nt z: C S 99457
200
F- ._
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KEVIN KONDRAT
19 RACHEL RD
METHUEN, MA 01844 I
expiration 412712012
-T 99457 ;
• - -- ` f�!e �o�rri7ui�uunallli a��/�/L'aaaac�iva�tta
Office of Consumer Affairs&B siness Regulation
VHOME IMPROVEMENT CONTRACTOR
Registration: 160272 Type:
Expiration: 7/72012 Private Corporatior
KS, acting Inc.
Kevin Kondrat
64 Chadwick Street 4 � �
Bradford, MA 01835 Undersecretary '
NORTIy
® of over
.. .,
O c��+ L A K E o , dower, Mass.,COCHI C HEWICK
ADRgTED PPPER
a,��C�
`S U BOARD OF HEALTH
Food/Kitchen T T
Septic System
BUILDING INSPECTOR
Alod
THIS CERTIFIES THAT40:�!M ............. <. .w�
...................................
.................................. Foundation
has permission to erect.............. ........................ buildings on ...#3�............ ..... . .................................... Rough
to be occupied aS.................... ... ...�.... .. .�......!*........ � . ...... .............................................. Chimney
provided that the person accepting this permit shall in every respect conform tot a 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
3� • PERMIT EXPIRES IN 6 MO ELECTRICAL INSPECTOR
UNLESS C®NSTRUCTI® Rough
............................ ...... .................................................................. Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy .wilding GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
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.