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Building Permit #262 - 349 WAVERLY ROAD 4/27/2010
BUILDING-PERMIT of po RT TOWN OF NORTH ANDOVER �� ry°`1" '6�0 APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received A°^�="�•-�•,.°• � r, wraD III (9 Date Issued. �lV �SSACHUS�� IMPORTANT:Applicant must complete all items on this page :.f.a.,F .. .; .f--. e35'}rYF:jii'.F�.-c- ='i�s:.e..- -..^.'3.;1•. -''='s:�•7- -3:: _ -rt%cr..:y;r._ :a,,. ^•law . - ":=ar.. .F:i�•r _ - - -.'.� a-Kt•' ....r_� ylk; -.7,'.�_.',/_ ^�,(-5_ - :,�a`n' -�:tl_ .!"'� -�}VC`'+1-..� --' - �•i e`.' i!tis•..' .,.z,d.,..7.... -r:r_r. <.x.r-s+,�7.i`�j... ,�.:I.•;.i��r'� ^"y,:.}G.y -..lz ._�r,•aea _ ¢:��'C��i'ixr3:;;zc:n..; .1' J�:t" itJ-^ ;' .7.J. '-:Hi'13 5•Tilr'S:�"-r ,(+r.� "�f-. =�.i .;I.�..I'�:=:Y`":•'svl:•;. x�;�:$ - �/. �f-� �^�::i_ _ 7011. - •.•�• ,., e„_ 7�! "=1=ii,-.-t;.> - - C+'`:" 1'n:.i: ''•mac-�.. .,.C',;r i, r-�� _ �,.;,:.:,aF-',•.-.. 10 ��IN. I•!�- ..r-,�.3�.._"'._rt_ .r.; Siir�•- - - .`_1'.i::: c::T'I=a'_. P_. tea•='ir�.'r: n Y•� _ _ - . 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"ez:"- ;'C=Sa-:.. - -a�-r_ _ ^,*. ..zn•.^,i'.-_ ';,�,.�.,''..''.;Fi}a���.�._,;,%-:���:p.r,;:a•r:�. _ _ .a"'unn73s["j, .!�-eT.i,�t/'=i. �y=K`•';` �. .S;r-:�ntr�i.��� ..x'��"�r'�7;^..z+: ,gin..�.-..wyp w•. -.c.�,3'y�.r�.c:aF�ac. .t� -- ,y[�a .?�;��;.., _[ S - - - - .rflll1{,'� ''-`4i-'•'t�'�_=`�:e�a�, ,n:�„f.z`�.;�bLe!cz`�h)u:asccMs,��' .•n +�. :da- ,:'�-'�.c,..:;„!f`$``E '1] ,�S .1,...:�".C.i•- 5- �.....:Z 1.:•r+r�.�yy_�_"54;1.:.>.:-4_ .7�L.- �Y.i rt��..� v G �< � _�r 4 n.l 1._ y:1 as.y3.1ar � � f.Ja1.. L.$��-�i.•- r4 � �_. ---."d"-.'.vl:'4:':Z-.. h y •a`i. :a'"€" ..f���r' -/3r.. ..F^T +,`,�, _ �..v..w;:N.1G.:�r.+-s�'.:aic �L�,c;r1�k,,.-G.:,a',. Y �fir_ dr a 5.- 1-� .,� ��I��`, � h'Tc ,+a.,. f�5` q, f. r. �a�r�'�t,--i,5�.,:1�-.:'!�r�_,�.�."��.^-r'r*�i'-.+��•1`s1=F.cY � '�• _ y',ri•. � �� ,��'.. F�: .-' ?-�� �:..�.� _ �:�s�r ��Y�'f ,;�IST�:CTS����� :�' [� :,:,fir.�F=Teri-�:��:,.,•x,�:�?.,,,�;�.`�`� _ � St� ,a.:., ,fir.._ _r�`=qty,..a�zaw r-.:rto�'`•,.(.. `ar�F��..r ,p.. a';•a�:F�-'.a��r�;:i:.--.a...:_„'�,�; r,-��, �_ � X,a��5'.r�;,�1��r ? r, r t'-"i,'�x, L _� :�.� ..rsm�rc y.-...:yaGf�3wzr .s .4J-,.,- 31--_•r'•'..1nT•,rr�,:_,'3 a t..�,r� oma.,�.r.�-or,-�irma'1:"!t3ii8 v.._ - -- s��'.r r.�: :r{,`.^Pm.l�s:a:-�y; -wry...�, ::S:;x::-sinol.`y^.*i'Y ;=='.�,,...v-arn'�T,''�3;t v.,1:S_..�:9'•,_. ':u, x .x�v.•-i�.F:�t-�3� .k '...."t"-..•"-i`=:.fit.�4:._ t�:_ ..2. -r�'�:..t. - _ ,..as...tiic}1r�•a�r.�:.r:�:i;.;��z_-:!K�-nl�s:_.rc';�m :i�;_ .:;':i-.�.r:,.F...-,t���'• r.�.:u ...:�' _ .c7 - Y;.-` q�r•.i; .:'4_i�-f7'•i..rtn. --"r`r"�i "'_._ _-_ - :.n=,:.�, --,wr,.. ��{..<.�-':_ ��t�.:isi��'n`9. ��;�711��'�n�`:�7����;�BL�s!v��' ;i;�`}-STI .�a�• TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building q family Additioh or more.family Industrial Ateration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other s ."� �-r_�"+�•u'�"i'-"c Fr{..r tt �',y5;t r•` irn�.. -�-'-r4.o-+E:� e-r-��.,c_� m� _rte•--�-`x• ��'�.,`!',.,.. +y �r' ,. 'x `,.;`.cam aJ��i ..Et•?�^ t� 1. s•s x a'�h.Gr¢a" "':4":"'„ Y: k:�;"_..,$!a` - �F.. ,�".-tl-ar,_„ ���- �^_ '��-r•�� �-'^_2S�s ,.,a!�. �, s �'t��•r�Cl.� s*"�•�'< � ti-: s.�--"5z.,,. . ;•..r �� t f ct= I X. ,'�„-)'G4:G..- 'tea--: ���ii 1� !� � �h,. •shy � ,,� >a -y.� F=v,.. z ,•rr..,rg,- K :'. I;�Y�F,e s+.r.>�'.'''x��Ys(5�%{"z i Yr � "� c..�°1-`+,�.-PI• ..t.;5!'s' =�'k5"Ar,.Z`,P"' 3a„-�'°.r.k' .9 '� r�.�, ;'�':' L �:Y?e..a.; 'c,��+„_.^......,...!,....'�_•.aF-+;�:.:R>:_ara���.T�'+•^^Fe-,y�.'!F �l'i�:,e - _ ttM �+','' GF�r'xe�r' ,� .��,9';^- �l 9•.-� r h� on� � a.x�fi N OF WORK TO BE PREFORMED:- f�..., •vim���... ' Identification PIease Type or Print CI.earIy) OWNER: Name: �,,.;`��� ;��� Address: _ �'ei�_ .:.Ain'.4 - -_ r• ry ':Pr•.. - •,r+__; r,3fi�:G�'-kms`="'�- ___ "Y R�U�����w: '^c��Z5'� � a;c 5'S,�r'�4��1 .�! r `w'�•�^s�'� �: -,sc'csr..��.,T,�i.,-,:p�.r= .� n,.�E'y,Ct ,�t,'t�3r� 4 >,..,. 1�:,• ' .e'.'r sem` ri.'xs ��-.�. 4 �cc+r ,x••z'c� :.., �..1,':a"'`II" - 1Fcf• c cd''J•a'I.'e` fi• --t, z1a,�,...�,•, > -.1�-".rr' 'y'�'t,1`...:�y -3,,,hS� "t�;:,+' _- ,3 .s�1'�s. "�• a;�'i• oY" fi,�.- y _ s,L. � ar„Jt�' -ry'7- 5$ 4 e.'=urr'�-1�• -`-�- F 's �i-.-�,i '�'F=�-.!��e F •.g,� t^' y 5`}�"s:•i E"T��..�o„ �Yr. a � ,� �S.+,"S`may i''�-�'•�,,.; ,�.:`y � .�-U" -a�' •tr4 a W" f' S" . + - g�ismgi== , itr.,1 �, 3L�• y f�•Z�,r,,, y3'"`e? av �•4r "a �, , Y..•�i�;a. .�. - m+' Fv ,F•4'�Trrr- , -og rlga r :e�vr,,�,t• �r L� ��.•e -}`N ¢+�,1s .', +�h`Y'�^1 Yr ','aar}o.ft "z�T`1-�gggwLysryl` r3.'�5 �" ��•sCJ `� �,-''{4, :. _.r r ',� `f�yt cs 'i'hr,�'� -tir^,•w�r •�irr.M F -}YEgg m 5�hwv-y ma- d; T,'p`� .',.'.,.Y �'a-' ¶ -^, - � :.` �'a� •r (', l�yTrr°1 'y-y. �+'.• r4�,r;[- M am..,J�" -f4- 47 ✓yu�`•;1 } "N{��L�{,1t' i �' +3'^"1 ar7y. �,•' 1 .a-g• - °I1� :. "`ra�- ;c 'u 4 _ I,. '^'ro't: ... .3w •-r�- E e3ir�s -%�� a.-.Ir r.'v`'••' 15 .a rl 6" �` K p 1 0 AS ;S-..3`r•d' 'L-i`2.'• may" �-..� t. �. `� .�., y,�y. ''"�,". ��'. `ar,- •�- .X-�- Cc, � �� ,s 4...... .. � '^.'n�,�,. � !°. ro T�,i4Y r'F.*S��'9..r.-�" 1 `z f2 rA'ssµl,,'"n[ y�x,1�n rr^.=mak.• ,r..•t.Y.,".-N,�'= .Atp raEi r-,L•1.'72sn>Rr=jl-f.; ...x•V U'�R:r > -,r:..,... r,{.r-.3c• �Ymc I _dr L,. �'i•' �1af .•-`_,.." "n4'S4<:.r„a»-••�t:�c. °4^rkc J u"r.,,z.� ,.:.., 2::.^ ':n:,.(�,��r`il'v.;.:�»�' %�.;.=..cs• g.-_.z, y t..7�.ir.:c':r6=_:5 _ems- '`3x �,k ='' c- 1,: ' F.A:rr�,3�`a:,q,.{y-tt�'�--1--r�'r7r,5 '"r`e„ :ti.7'', �,(r,*`bi,`xa�,ru"�'_`a``.:�•l;'x.rc` _` A'`r�iCnN :):� � �'1G' y. v �+ .y.¢ y Ysi �:,ens-a:.=: 5. t •iy","_ca'�'-'•s'S'.°V�r;"�r"''' •,'eF ,(_r.a1i�'a.-,'. s,.-:e:�nr,,,�,r- : -r.'^cnc•.-�• 'e�...r,:'.T:x.N'=fir tia�c+�A�.-as' J bra.Ir ?+... ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULD/NG PERMIT:$12.00 PER$1000,00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F. Total Project Cast: $ }(� FEE: $ 192 . ©c Check No.: ( Receipt No.: a 3 q i ---q- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund t ,- - - -�agna ure�of�•co� raeto �� ��;�r -i�,��:r.t F J _ _ 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 PLANNING & DEVELOPMENT COMMENTS I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature G 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 IN fRE,-0EP;06►RT3NEh . . . . ., d,10- =�_.� •�=�.�_.r ..� %. £ "..v.-..'. :r.......='.�... - :�.:i..r.q�.:-•tet _ _ _ - cat - _ e.d. :�12 - - - - atat; - - - cp�:i ?�l��r•'::_.._ate._'+:,. -- _- m. ..__ ....._.!_., r+• f•y-'1.. {.e,..+.a._..... ..x�.,:_�"..:.:Y::.-.. ....�.+,�.s, �..a.r_...._ _ 4. _ ..�'!i�` vl:�_ w _..__+.:x.v,-.k". : _��..�.. -,_.._•>`_.s. .� _:rt-_ ._._.v-:-...._ter_. .._.: ..Y._: - .J - 'x ...._,._ ._:... . .ems. .- .;.. .... ...... -• - _ L ' 1 ` • 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) I. i I I, M i ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 - -- -- - - r J Building Department The following is'a fist 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 1 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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ "ass 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 ' P1 Plot t D ❑ -Ce'-"e'd :lU r-roposed r:oL clan. ❑ 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 [VOTE: 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'applicaut 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 2008 Location t "Q Y No. �e'O Z . Date NORTy TOWN OF NORTH ANDOVER 3?0�,•,•o �•,hO O • , ; Certificate of Occupancy $ t 9 Buildin /Frame Permit Fee $ s 1405 Foundation Permit Fee $ Other Permit Fee TOTAL $ Check # 2349 Building Inspector Information an_ d 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 wntten." 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 t3ae legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association ox-other legal entity,employing employees. However the owner of a dwelling house having not more than three aparin L ents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintcmance,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(--anstructbiu'ldiags in the commonwealth for any applicant who has not produced acceptable evidence of covnp)�ce 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 un--1 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 incu=e. Limited Liability Companies(LLC)or Limited Liabrdity Partnerships(LLP)with no employees other than the members or partners,.are not required to carry work='comp c--wation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be stn-e to sign and date the affidavit. The affidavit should be returned to the city or thin that the application for the nermait or License:$being requested,not the.De-part—m—e 2t of Industrial Accidents. Should you have,any questioms regardir?g the law, or, if you are-, i:ired to obtain a wor3kers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-inS,rance license number on the appropriate line. Cite 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 member which will be used as a reference number. In addition,an applicant that must submit multiple permitllicease 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 pert 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 ofInvesfigations would hke to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Deparim=rs address,telephone andiaxnumbez...... The Commonwealth- of Massachusetts. Depwtment Oflmdustrial Accidents Office of Investigations 600 Washmgtan Street Boston,M-A 0211 l Tel. # 617-72.7-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Pay. #617-72.7-77/49 VrVrV-.mass..govfdia I, The Commonwe¢lth Of Afassachusetts Department o f rndustri al Accidents Office of£ytvestigations ..600 97ashington Street Boston, M4 02111 Www.Massgorl&a Workers' Compensation Insurance Affidavit:: Bulrs/Contr actorsEleApplicant Information etricians/Plumbers Please Print Legibly Name (Business/organization/Individual): Aa Of GtS IGca.L tS' Address: 2 City/State/Zip: A .A Phone#:—.9F7 — 29 Are.you an employer?Check the appropriate box: 1•❑ I am a employer with 4. ❑ Iam a gee contractor and I Type of project(required): . ❑ employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction I am a sole proprietor or partner- listed on the attached sheet x ?• ❑Remodeling ship and have no employees These subcontractors have working for me in any capacity. workers com . ' g• ❑Demolition [No workers' comp. insurance 5. ❑ We are a c p insurance 9 ❑Building addition required] orporation and its Officers have exercised their 10.0 Electrical repairs or additions 3. I am a homeowner doing all work right of myself �e�tion per MGL 11.❑Plumbing repairs or additions Y [No workers comp, c. I52,§I(4);and we have no insurance required.] t employees. 12.❑Roof repairs *'nv=^pIiccaut that comp.insUran a enquired.] 13 0 Other iHomeowners the who s trbmit tots affidavit indicating they are doing aL'•Wcilk anQY._act'"_ +Contractors that check,this box must attached au Thmname additional sheet showing the am brie outside contractors niu.,,submit a new affidavit indicating such. e of the sub contractors and thew.workers co I am an employer that is providing workers'compensation insurance or ns a °OL1L� information. information, f y mployee& Below,is the policy and job site Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/StatelZip: 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 ofMGL c. 152 can lead to the imposition of c fine up to$1,500.00 and/or one-year imprisonment,as well as civil �P criminal penalties of a Of up to $250.00 a day against the violator. Be advised that a co penalties in the fowl of a STOP WORK ORDER and a fine Investigations of the DIA for insurance coverage verification. Py of this statement may be forwarded to the Office of I do hereby certify under the pains and penalties of periury thw tile information t motion.provided above is true and correct Signature• Phone#: 0 d Official use only. Do oaf write in this area, to be completed by com,or town offlcwl City or Town: P ermit/License# Issuine Authority(circle one): 1. Board of Health 2.Building Department 3. Cify/Town Clerk 4.Electrical Ins ecto 6. Other r �. P Plumbing br>zb Iinspector i Contact PersOi:: Phone'#: Paul M. Goldberg, P.E. 17 Chipping Norton Ln Bedford, NH 03110 (603) 765-8650 September 17, 2010 Re: Paskalis Residence -- — 349 Waverly Road North Andover, MA 01845 Dear Mr. Paskalis: Per your request I have review the drawings for the Second Floor Dormer addition to the above referenced residence. My review has was based upon the Seventh Edition of the Massachusetts State Building Code And the Seventh Edition of the One and Two Family Dwelling Code. My review confirms that the structure as proposed meets all loading requirements of the above listed building codes. ` If you have any questions or comments, please feel free to contact me. • ����N OF M4Ss9c I p UL M ti D a .a No. Paul Goldberg, fs ���r�`` S, IpNAI F µoR*H TOWN OF NORTH ANDOVER tt4 ,6a H OFFICE OF 4 BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 SACHUS� Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please Print DATE:-9 l-'Z-7 10 JOB LOCATION: 3q j (,0 Q0.e,e,, � � 1�b g Number Street Addr s Mapfr of HOMEOWNER aaitpn Name Home Phone Work Phone PRESENT MAILING ADDRESS 3+k c� G 1� A r.Ar%% v e /"414Icy r' Ciy Town Qr�r�. 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. Aerson who constructs more re that one home in atwo-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 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 685-9530 HEALTH 688-9540 PLANNING 688-9>35 ORTH TONM of And No. 42 -o " dover, Mass., • C. COCMIC".W ICK ORATED S BOARD OF HEALTH Food/Kitchen .PEliMIT T U Septic System BUILDING INSPECTOR THISCERTIFIES THAT........... ..... ......A......... .................................................................................... Foundation has permission to erect..............:......................... buildings on ...3�........ ...... .......................... Rough to be occupied as........`�.. 'DOr AAJ Chimney 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 CONSTRUCTV TS Rough ............... ................................. Service .............. ... BUILDING CTOR Final Occupancy Permit Required to Ocmpy 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. Burnet Street No. SEE REVERSE SIDE Smoke Det. OORTH BUILDING PERMIT o` ""D 16 q�. t , o TOW OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION Vel-. n _ h V - nVi 1 Permit NO: "O P. � Date Received Ar ACHus���� Date Issued: IMPORTANT:Applican ' t complete all items on this page LOCATION. ! G t Pnnt PROPERTY OWNER /-1 —t ctS Icc�1 i 's A Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes 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 DESCRIPTION OF WORK TO BE PREFORMED: LJ Identific tion Please Type or Print Clearly) OWNER: Name:�� �d� �SlCo.IIS Phone: -o�l�(`/ Address: CONTRACTOR Name: e,eb^ Phone: �2go --o(lg9 Address:"-Po: _ q Supervisor's Construction License: 9 ;Z I Exp; Date: !�161 AOI C3 Home Improvement License: g 4 2-1 3 Exp. Date: &/4/2(316 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: $ AS-CO, oc-S FEE: $ 920(f. Check No.: Receipt No.: 7 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ignature of Agent/Owner" ''�Signature of contractor l Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL �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 PLANNING &.DEVELOPMENT COMMENTS 4 CONSERVATION Reviewed on Si nature 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 a Fire Department signature/date F COMMENTS 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) r. I, ❑ Notified for pickup - Date ...._._........_..._..............._..................................................._................_.....—-----------........._._......._._........ ._......_----..................._..._.........................._......._._._ .._......._.............................................................-............._._........_........_ Doc.Building Permit Revised 2008 Building Department The followingis a list of the required forms to be filled out for theappropriate ermit to be obtained. QP 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location No. 0 Date �aRTM TOWN OF NORTH ANDOVER � P Certificate of Occupancy $ Building/Frame Permit Fee $ SJ�CMust Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 3/ o 21 297 ,wilding Inspector ✓fie Z�omvnzo?zusea� a�._/ craaac/ucdek6 13oard'o#Butldin'g Regulatiogs end-StandOds Contttuction Supervisor i icerjse # LI en CS 9 213 } 1 µ o p 1 p Tr# 96213 AARON PASKAL 1 349 WAVERLY RQ. NORTH ANDOVER,MA 0184'5 Cotntn►ss�oner � -.# i" ,�q�: � "� � { fit'• G F' �i �vt+ l ! x E t � 1 PLAN/O,- LAND fv so° NOR TAI A/VD0VZ MASS ° /1�9ILTON R. -IR.O EVEL Y/V M CROSS°M, ^y0 10y9 FRED W.4-7-0 WE RS 50 dSG�L6 /"'o k0 M£T H C/E r rr AR tASr 0 �° PORTra/V of Rc&,srRr PL4N '20 z m� Ir 0..- , - o0 °/ lz 03 9015y b0 ALLN� 204 / /.Z,046 2/O o ssoo aOf t � � v. 723s9.f j .. h� '0`20/ \ h / x%98 Mac t9 4 9 RAIL �4'OAD AVE"IVUE 1�t��h b-'71'7P 390. ° � NORTH o ToAndover No. 0 D 8 D _ = o ` dover, Mass., 7 IJIr COCMICMEWICK AORATED FC, `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT X.A.oM J..... ..........c.............................................. ................................. Foundation has permission to erect........................................ buildings on .... .�1 ...�� f,^/.... ... ......................................... Rough to be occupied as.................................../-1 '....... ..... ............. Chimney 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 CONSTRUCTION TS Rough ............ L....................... Service .... . .................. . ...... . .. LDING INSPECTOR 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.