HomeMy WebLinkAboutBuilding Permit #642-16 - 31 FRANCIS STREET 11/23/2015zs = is`
BUILDING PERMIT 0 L.EU ;6��
TOWN OF NORTH ANDOVER
02 '` c'
APPLICATION FOR PLAN EXAMINATION
Permit No#: !U I Date ReceivedA�`F
Date Issued:
'ANT: Applicant must complete all items on this
LOCATION 5ii��vC`/S Sf �f%G�• �j•L�yz��— %'�1 rJ�F�(_
PROPERTY OWNE
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Print 14
MAP CD_PARCEL:W�l ZONING DISTRICT
100 Year Structure yes 62
Historic District yes
Machine Shop Village yes Fho
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
Vo One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
V Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed Distract
❑ Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
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Identification - Please Type or Print Clearly
OWNER: Name: ��t�hex, Phone: F lo -FA 3 oZ
Address: WP ,P�.✓voeA- AiA 0/ T- 1<—
Contractor Name:_ Td wes C 4,*1,'12Y-- Phone:
Email .i Cr4..,/ZA; p ,vcgfti
Address:
Supervisor's Construction License: e S - /O fe 02 Exp. Date: // -; 0 - A0/ V'
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT: $12. 0 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting\ �it1 unregst�ed contractors do not have access tthe guaranty fund
Location
Datell )3
(,V I I f f-�"
Check
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee 4$-. *r
Other Permit Fee $-
TOTAL $ 1
Building Inspector
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Swimmin
Tanning(Massage/Body Art ❑ g 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
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed On Signature
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/signature � pate
Driveway Permit
DPW Town Engineer: Signature:
FLocated 384 Osgood Street
IRE DEPARTMENT Temp)Dumpster,on,site ,yes:..... nrj
Locat- '- 124tiMain�St�eef -
Fi._re0:epart0!ent,,aignature/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
MGL Chapter 166 section 21A —F and G min.wo-$1000 fine �®
►�A4Pw
Doc.Building Permit 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
a. 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
TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
IOTE:
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 .
All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
Building Permit Application
4, Certified Proposed Plot Plan
Photo of H.I.C. And C.S.L. Licenses
Workers Comp Affidavit
4, 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 Engineered products
TOTE: 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: Building Permit Revised 2014
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M E RICAN
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Broadway
Methuen, MA o1844
978-687-6825
436
Bill To:
North Andover Housing Authority
i&8orcokiMeadows
North Andover, MA o1045
970-682-3932
PROPOSAL -P Francis ~.��
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DESCRIPTION*\ �&�{JlJy�y
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Allison Knobs
Allison Pulls #53o13 -EB
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Total
Please sign and date below tpconfirm shown above and return asigned copy 10American Cabinet to
place your order. A 5oO/( depc)tit is required at time of order. The remaining balance is due upon
delivery. Please undqr��nd/hat, by signing this proposal, you will not be allowed to cancel or
return all or partAf Itlis oror. Price is subject to change once a field measurement has been taken.
Thank you for your business!
All dimensions -size designations
given are subject to verification on
job site and adjustment to fit jobAO�O
conditions.
1
This is an original design and must
not be released or copied unless
applicable fee has been paid or job
order placed.
Designed: 10/1/2015
Printed: 10/1/2015
Designl All Drawing M 1 I No Scale.
10/02/2015 16:55 9786876837 AMERICAN CABINET PAGE 08/08
31 :FRA4J C- c-.,
Note: T11is drawing is an artigtic
lnterPrOtntionofthegeneral
appearance oftheanse. It is
not meant to aext
Fin exact rendition.
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20 0
Boxignad: 10111201.5
Printed_ 10/1/2015
Design _ �_ All Drawing//: 71
North Andover MIMAP November 23, 2015
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40 PATRIOT ST 31 PATRIOT ST
013.0-0023 75 WAVERLY R
013.0-0033 018.0-0061
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19 PATRIOT ST
013.0-0039 \018.0-0064 018.0-0062
08.0-0040 28 PATRIOT ST 83 WAVERLY R
67'BALDWIN ST 013.0-0042
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22 GILBERT ST
-0013 G��b 5 FRANCIS ST 019.07 PATRIOT ST
27 FRANCIS ST 014.0-00031\
34 BALDWIN-ST 27 FRANCIS ST 11 FRANCIS ST et
013.0-004729 FRANCIS ST 014.0-0006 S'
29 BALDWIN ST 25 FRANCIS ST �<aX\
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08.0-0 27 BALDWIN ST31 FRANCIS ST23 FRANCIS ST
014
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33 FRANCIS ST
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25 BALDWIN ST33 FRANCIS ST
10 FRANCIS ST
14.0-0020 014.0-0023 106 WAVERLY R
009.0-0074 014.0-0020\2,1
21 BALDWIN ST 014.0-0018
DWIN ST 24 FRANCIS ST t---
21 BALDWIN
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32 FRANCIS ST !J
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46 FRANCIS ST 121 WAVERLY RD11 AVERLY R
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6 BALDWIN ST
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5 UNION ST
37 UNION ST 23 UNION ST 13 UNION ST 107 SECOND S
61 UNION ST 74 1 / I I
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114 SECOND S
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10 ANNIS ST 147 WAVERLY RD 019.0-005
014.0-0036
014.0-0046 144 WAVERLY RD
009.0-0009 014.0-0045
34 UNION ST 014.0-0048
14 ANNIS ST� 014.0-0015
13 ANNIS ST 014.0-0049
151 WAVERLY RD
9.0-0021 014.0-0044 148 WAVERLY RD
13 MVPC Bo
Q Municipal Boundary
Horizontal Datum: MA Slaleplane Coordinate System, Datum NAD83,
- Rail Line
Meters Data Sources: The data for this map was produced by Merrimack
Interstates
-I
NORTH
Valley Planning Commission (MVPC) using data provided by the Town of
North Andover. Additional data by the Executive Office of
- SR
Of ao �
? ���� ���� 00
provided
Environmental Affairs/MassGIS. The information depicted on this map is
for
- Roads
t Easements
F9
planning purposes only. It may not be adequate for legal boundary
definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER
MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING
❑ Parcels
4L ><
f s ^
THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY
OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT
- Trails
tF o r •
ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
7 Hydrographic Features
THIS INFORMATION
�1'+o��tu ��``�aj
�SSACNUs�t
Streams
Wetlands
:: Exempt Lands 1" = i28 ft „�,
11/23/2015 11:13AM FAX 4135925218 DPM CMS FAIA
MAS,%4_ETTSf)
M HRO
INSURANCE
GROUP
MASSACHUSETTS WORKERS' CMPENSATION AND EMPLOYER'S LIABILITY
INSURANCE CERT-FICATE INFORMt TION PAGE
ITEM I.
PARTICIPANT NAME AND MAILING ADDRESS:
North Andover HA
Box 373
North Andover, MA 01845
ITEM 2.
CERTIFICATE EFFECTIVE FROM: 06/01115 TO: 06/01116
Effective 12:01 A.M. Eastern Standard Time at the articipant's mail
TE No: WCMN0112
NTITY:
address.
00002/0002
042427248
Non-profit, public employer
ITEM 3.
COVERAGE;
A. Workers' Compensation Insurance: Part One of this certificate applies to the Workers' Compensation Law
of the Commonwealth of Massachusetts.
B. Employers' Liability Insurance: Part Two of this ' ertificate applies to work in the Commonwealth of
Massachusetts. The limits of liability under Part Two are:
Bodily Injury by Accident: $1,000,000 each accident
Bodily Injury by Disease: $1,000,000 certificate limit
Bodily Injury by Disease: $12000,000 each a iployee
C. Other States Insurance: Massachusetts Limited Other States Insurance
D. This certificate includes these endorsements an'd schedules:
WCNG0000 Insurance Certificate
WCNGTERR Terrorism Risk Insurance Act Endorsement
ITEM 4. i
Theremium for this certificate will be determined
p your Manuals of Rules, Classifications, Rates and Rating
Plans. All information required below is subject to erification and ch9nge by audit.
SEE EXTENSION OF INFORMATION PAGE
V
This certificate is hereby countersigned by o 1 on 4129/2015
Authorized Signatur4 I Date
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