HomeMy WebLinkAboutBuilding Permit #166 - 344 MAIN STREET 8/29/2008 BUILDING PERMIT o* "°RTh q
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TOWN OF NORTH ANDOVER c� �, ` ` °�,
APPLICATION FOR PLAN EXAMINATION 'A
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Permit N0: A& Datelceived VVV 'js9°�aTeo►P°�4`�
SSACHUS�
Date Issued: �d®
IMPORTANT: Applicant must comp all itgen this page
LOCATION �. S
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PROPERTY OWNER ti 'v h itPrint
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MAP NO: PARCEL: ZONING DISTRICT: Lf 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 Floodplain Wetlands Watershed District
i
Water/Sewer
DESCRIPTION OF=RK TO BE PREFORMED:
1 4 1 W�Iu;q%ul I,'#, U
ntification Please or rent Clearly)
OWNER: Name: yr K CA- J , 5 Phone:
Address: `f el
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: $ C�� FEE: $ 3 ED)
Check No.: � Receipt No.: �' 1
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owne� Signature of contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming 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
DATE REJECTED DATE APPROVED
I
PLANNING & DEVELOPMENT
�f
COMMENTS
CONSERVATION Reviewed on Siqnature,� Wlt�
COMMENTS -
` ODD
HEALTH Reviewed on
Signature
COMMENTS
f
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 signaturef ate
COMMENTS
i
i
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 department use
❑ Notified forick
u Date
p P -
............ .._......................__..._..............._......._...._.—_...............
Doc.Building Permit Revised 2008
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
o 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
o 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)
o 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)
Li Building Permit Application
Li Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
Location
No. Date
M°RTM TOWN OF NORTH ANDOVER
e 3? • ' °c
� A
t Certificate of Occupancy $
Building/Frame Permit Fee $ �'7�..J
Foundation Permit Fee $ ,
Other Permit Fee $
TOTAL $
Check #
2 i 4 7 4 Building Inspector
pORrp TOWN OF NORTH ANDOVER
O `"s D '`•"° OFFICE OF
p BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
�►''°�,.:e:�' * North Andover Massachusetts 01845
1SSACHU`�tt
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please p int
DATE: —
JOB LOCATION:
Nunibir Street Address 11?ap/l:,at
HOMEOWNER �wY 4-
Name Home Phone Work Phone
PRESENT MAILING ADDRESS
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 SIGNA '
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Fom Homwwam E=nvdon
TIOARD OF 1PPEAJ.S 6X8')541 CONSERVNFION 683-9530 HEAL'Ilf 688-9540 PLANNING 688-9535
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information 14 Please Print Legibly
Name(Business/Organization/individual): ��— SYS
Address:
City/State/Zip: Phone #:
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7• ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their I0.❑ Electrical repairs or additions
3. 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs
insurance required.] t employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
Homeowners who submit.this a„idavii indicating they arc duiiig ail wink arid 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 sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-.ins. Lie.#: Expiration Date:
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 Section 25A of MGL 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 herebyc ify un r the pains
�and penalties of perjury that the information provided above is true and correct
Si--nature: J 1� G Date: �(7 00,E
Phone
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#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to cavy workers' compensation insurance. If an LLC.or LLP does have
employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-7274900 ext 406 or 1-877-MASSAFE
Revised 5-26-05 Fax#617-727-7749
www.mass.gov/dia
FORTH
TO" Of
Andover-
No.,//O
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�`��- LA o dover, Mass., ® � •
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COC MIC HE WICK V
A�'QATE D
BOARD OF HEALTH
PERMIT D
Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT........ ..! � �.............. ... �..
................... ............................................. Foundation
;0�
has permission to erect........................................ buildings on . W... .............�A......4- ........................... Rough
. / ..... • Chimney
to be occupied as y
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
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONS UCT'I T !;: Rough
. ...... ..... Service
BUILDING INSPECY�It
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.
1
Uri
218 .r
3
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MAIN ST.
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ThismmV9 inspection plan is for mortgage a e A reuiew of the Flood Insurance Rate Map,
��
purposes only, it is not an instrument survey Mortgage. CommunityPartel Number
Hence it is not to be used to establish propen 2 5 Oc'D (2%D<-' g
lines,fences,driveways,hedges,etc.,or to be used Inspection
for any pitr7xme other than its original intent dated sTuN(. 15 3 a been conducted
Plan and to the beat of our interpretation this property
is T located within the flood sone.
(hereby certify �y1%Of k(p Location MAIr V �.
hat the principal building on this plan is appmximatel X
y � COSMO
bcated on the ground as shoum, and it conforms to the OAMIANO MA
timensional setback requireme�its o the x i " CAPOHIANCO H Scale: I in. (' ft. Date 2-2 3—f 9q 3
I A, ng and build"i" g Q
a7US Of lite ctly/tolun ��t ,j »>a Plan Reference r Y JL'leif Cohen Wnstructed�to the restrirti�i on record � 9,y'fcsTER OQ
signature y� 0
� SUAV�y MORTGAGE INSPECTIONS INC.
lQ SUITE 311.265 MEDFORD ST..SOMERVILLE,MASS.
18. Any accessory use customarily incident to any of the above permitted uses, provided that such
accessory shall not be injurious, noxious, or offensive to the neighborhood.
19. Accessory buildings no longer than sixty-four (64) square feet shall have a minimum five (5) foot--
setback from side and rear lot lines and shall be located no nearer the street than the building lie-
of the dwelling.
20. Day Care Center by Special Permit. (1985/23).
21. Congregate Housing for Elders—Special Permit
a. In the R-4 zone the Planning Board may grant a Special Permit for congregate housing
consistent with Special Permit criteria and procedures set forth in Section 10.3 of this Bylaw.
regate housing shall be 0.30 in the R-4 District seven
b. The maximum allowable FAR for cong
(7)units.
c. In no instance shall any new or pre-existing building used for congregate elderly housing, have
no more than fourteen(14) dwelling units.
d. All dimensional criteria established in Section 7, Table 2 Summary of Dimensional
Regulations shall apply to all structures used for congregate housing purposes.
14. a. One-Family Dwelling
! 4.123 Village Residential District (1987/11)
1. Single-family residential structures.
2. Two-family residential structures.
3. Multi-family residential structures,not exceeding five (5)dwelling units per structure.
.4. Place of worship.
5. Renting rooms for dwelling purposes or furnishing table board to not more than four(4)persons
not
6. For the use of a dwelling in any residential district or multi-family district for a home occupation,
the following conditions apply:
a. Not more than a total of three (3) people may be employed in the home occupation, one of
whom shall be the owner of the home occupation and residing in said dwelling
b. The use is carried on strictly within the principal building.
c. There shall be no exterior alterations, accessory building or display which is not consistent
with residential buildings.
d. Not more than twenty- five percent(25%) of the existing gross floor area of the dwelling unit
so used, not to exceed one thousand(1000) square feet, is devoted to such use. In connection
with such use,there is to be kept no stock in trade, commodities, or products which occupy
space beyond these limits.
e. There will be no goods or wares visible form the street.
f. The building or premises occupied shall not be rendered objectionable or detrimental to the
residential character of the neighborhood due to exterior appearance, emissions of odor, gas
smoke, dust, noise, disturbances, or on any way become objectionable or detrimental to the
residential use within the neighborhood.
g. Any such building shall include no feature of design not customary in building for residential
use.
Real estate signs not to exceed twenty four(24) inches by thirty six(36) inches in size which shall
a. Farming of field crops and row crops,truck gardens, orchards, plant nurseries, and
greenhouses.
b. On any lot of at least three (3) acres,the keeping of a total of not more than three (3) of any
kind or assortment of animals or birds in addition to the household pets of a family living on
30
Zoning Bylaw Footnotes and Graphics
C. Any road providing access to more than 18 apartment dwelling units
or more than 24 parking spaces shall conform to appropriate
provisions of the Subdivision Control Regulations as if it were a minor
residential street. Before issuing a building permit in such cases, the
Building Inspector shall obtain a report from the Planning Board on
the extent of such conformity.
d. Maximum height (apartment building): 40 feet.
e. Maximum stories of living quarters (apartment building): 3.
f. Maximum units per structure(apartment building): 18.
8. In Residence 4 Districts only, front setback may be the average of all front setbacks
of dwelling units within 250 feet on either side of lot. Buildings on corner lots shall
have the required front setback from both streets except in the Residence 4 Districts,
there setback from the side street shall be a minimum of 20 feet.
9. Nursing and convalescent homes shall have at least 600 square feet of lot area per
bed. Minimum lot size for such homes in Rl, R2, and R3 shall be 2 acres.
10. Where a public sanitary disposal site is the primary use, the setback area shall be used
to provide a screening, natural or artificial, from adjacent residential use of public,
roadway.
tl. Where a public sanitary disposal site is the primary use, an increase up to 100% of the
lot coverage shall apply, not including the setback areas.
12. If multi-family structures are selected to attain the maximum density allowed, the
proposed project shall be subject to the minimum open space requirements found in
Section 8.5 (Planned Residential Development), and to the site plan review
requirements of Section 8.3.
In the instance where no public sewer service is provided and there is no private
sewer system acceptable to the Town, the allowed density in the Village Residential
Zone shall be one dwelling unit per acre and said dwelling and associated lot shall
conform to all the regulations consistent with development in the R-2 Zone. Further,
under no circumstances shall multi-family development be allowed in the Village
Residential Zone, regardless of density, without the provisions of public sewer or a
town approved and accepted private sewer system.
13 In instances where a lot fronts on Route 114, for purposes of public safety, the
required lot frontage shall be 250 feet.
Footnote Page 2 of 2