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HomeMy WebLinkAboutBuilding Permit #331 - 360 WAVERLY ROAD 11/13/2008 BUILDING PERMIT o`"OR T e;9tip TOWN OF NORTH ANDOVER 3? '` ° 0 ° � APPLICATION FOR PLAN EXAMINATION # Permit NO: :3V Date Received Ar o �SSACHU Date Issued: IMPORTANT: Applicant must complete all items on this page, LOCATION D. vt r Print .. PROPERTY OWNER Wk, -,# . L f �C Print MAP NO: PARCEL:. ZONING DISTRICT, Historic District yes nc Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building O e family Addition Two or more family Industrial Alteration No. of units: Commercial e air, rep acemen Assessory Bldg Others: Demolition Other Septic' Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: C4 01 ';J, Identification Please Type or Print Clearly) OWNER: Name: \A4,, Phon 1 e. q - 07qR Address: 3 D t CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp.. Date: Home Improvement License: _ Exp. Rater i ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ �� Check No.: 6��� Receipt No.: �(�Q NOTE: Persons contractingwith un gistered contractors do not have access to the guaranty fund $1natureof Agent/Owner 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 PLANNING & DEVELOPMENT COMMENTS. CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature 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 department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 e I 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 o Building Permit Application Li Workers Comp Affidavit i` ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o 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) 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 w New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed Plot Plan Li Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affldavit ❑ 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:Building Permit Application Revised 2.2008 Location �F^Ila No. 3 Date /� 3 TOWN OF NORTH ANDOVER ~ w 9 Certificate of Occupancy $ ;�asncMust�' Building/Frame Permit Fee $ Foundation -- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 663 Building Inspector t FORTH own of , tAndover 30 w , No. 3 � `���'� Co �y�` dover, Mass., f T O - LAKE T - I� COCHICHEWICK V %S RATED PPa\ �� E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT............ . ...C'1! ........ 0 C/v ........................................................... ............................... Foundation has permission to erect........................................ buildings on ..'3�0.... ...................I................ Rough t0 be occupied as..............................iiii .............yl ........�`�res�pect �� E. d�'c... ..�/�1' �.f................... Chimney provided that the person accepting this permit shall m every 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 CONSTRU= N erARTS Rough Service BUIL 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. ir SEE REVERSE SIDE Smoke Det. + NOrrTq TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20 Suite 2-36 North Andover Massachusetts 01845 1SswcNuset Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION 07 lease print DATE: Zob JOB LOCATION:—3 G l7 �✓avc r� Number StreetAddress pR of HOMEOWNER Leic �g7, 9. D 7 9 --'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 rap irements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption RO:\RDOF \PPE.U.S 6880541 CONSERV:MON 684-9530 ITE.u.;T-H 688-9540 PLANNING 688-9535 N° 2842 Date...... ..�`�. ....... NORT1� °ft"��;•�"� TOWN OF NORTH ANDOVER I. PERMIT FOR WIRING 7SgACHUSE� ........ ..S i This certifies that ....., .S.y .................................. �::�..........�........ 1 F has permission to perform ....., ....... ................................. wiring in the building of..... ............... ........1............... ...................... B at........... ..... ` ..................... North Andover,-Mass. i ! ? `Y Fee. Lic.No. !. .!.�............... -. �...... 1.............. iELECTRICALINSPBCCOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer _ Commonwealth of Massachusetts ot];cial us`a n �� Department of Fire Services [0�c=upancy it N o. BOARD 0� iR= PREVCNTION Rr=GUL4TlONS and F=Checked 11/49 V j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be=fo.;red in accordance%•ith the Mamchus_ns ElectricalCode(tvMC) 527 CMR 12.00 (°LEASE PRWT IN INK 0R TYPE AIL INFO RMgTjON) Date: I g-0 City or To`{'n of: �9111tsnoN n � 'C I MH To the Inspector of Wires: 3y this application the arca rsi�tof his orhe intention 0 perforLm the electrical work described below. Location(Street R Humber) W a�0_r ' � 1-r e e Onner or Tenant L\' so, �U,� ' e-I--� Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Unde d❑ No.of Meters 'New Service Amps / Volts Overhead❑ Undgrd ❑ No. of Meters ?dumber of Feeders and Ampacity Location and Nature of Proposed Electrical Worn: U, t ComnIetion of the following table may be waived by the Inspector of iFires. INo. of Recessed Fixtures INa of Ceil.-Susp.(Paddle)Fans No. of Total (Transformers KVA INa of Lighting Outlets INa of Hot Tubs Generators KVA V I Above ❑ n- ❑ a of mergence ic, ina No.of Lighting Fixtures SR imming Pool ornd �rnd. Batters'Units e Na. of Receptacle Outlets INa of Oil Burners FIRE ALARMS INo, of Zones Ilio. of Snitches INn.of Gas Burners INo. of Detection and Initiating Devices IN-'o. of Rarves INa of Air Cond. Total Nng . of Alerting Devices Tons INa of Waste Disposer IHcat Pump I Number I Tons KW INo. of Self-Contained Totals I Detection/Alcrting Devices '_ y INo. of Dishwashers ISpace/AreaHeating RW • Local ❑ Municipal ❑ Other Connection '.No.of Dryers IHeatin2Appliances KWISecurtty Systems: �r Na of Devices or Ecuivalent No.o NaterI No a No Heaters I' a( Signs Ballasts Data�rlring: 1`a of Dcs•ices or Eouiralcnt INo. Hydromassage BathtubsINo.of Motors Total HP ITelecommunications Wiring: No.of Devices or Eouivalent 10 THER: Anach additional derail f desired,or as required by the Inspector of 11•'ires. EhSURANCE COVERAGE: unless waived by the owner,no permit for the performance of electrical work may issue unless the Iicm=provides proof of liability insurance including"completed operation"covera'at or its substantial equivalent. The under =d ceniLts that such coi,era is in force,and has exhibited proof of same to the permit issuing office. ClaCK alt::: D\1SURANCF. ❑ BONTD ❑ OTH M ❑ (Specify,:) Estimated Value of Electrical W ori;. (What required by municipal policy.) (Eapr,auon Date) Work to Start Q I Inspections to be requested in accordance with WSEC Rule 10,and upon completion. I cert fi,under the pains and penalties of perjury,that the information an Zhu application is true and complete =1 NAME: ADT Security Services 111 Morse Street,No24oMA 020C LIC. NO-: 1533C Licerisee: John S.Bassett Si-nater LIC. NO:: 1533C (Ifappliwble,aner•'exempt•'in the license nuntherline.) / Bus Tel. No.- JR1– 7A-1 1 Address: Alt Tcl.No.: 603-594-iffresi OWNER'S INSURANCE WAIVER: I am anare that Ute Lixensee does nor hm.-e the liability insurance covernge normally ONLY reouir-A by law. By mi.signature below.l Ircrcby naive this requirement. 1 am iht(clieck one)[Iown_r [Downer's?-2' Owncr/A-crit SI_nature Telephone No. PERMIT FEE: S 35.00 N2 2761 Date./-.... .................... � .. d HORTM A,. TOWN OF NORTH ANDOVER 0 . PERMIT FOR WIRING ,SSACMu Thiscertifies that . ........ .................................................................. has permission to perform wiring in the building of .................................. G..............1. ...................North Andover,Mass. Fee�z:��...... ........ Lic.No. ............ .......... ......e ............. X/ ELECTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer The Commonwealth of Massachusetts OftLCe Use Only Y= Nrcit Ro: C2 �(0/ Department of Public Safety Occupancy a Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 heave blank) APPLICATION toFOR be m�PERd In MIT rdance�TOth � PERFORM MaLsachuserts a�ELECTRICAL WORK All work 7 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of Wei , 4-IJCyJye4l To the Inspector of Wires: The undersigned applies for a permit to perform the electrical Work described below. Location (Street & Number) y/��C�'� RD Owner or Tenant � �1 N Ou el/ ) a-�1_02.4� Owner's Address 514"6" Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building S E Utility Authorization NO. U U 88�1 9 _ Existing Service Amps / 7iy0 Volts Overhead Ell"Undgrd❑ No. of Meters_ New Service )QfJ Amps ]� / 2 Volts Overhead [9--Undgrd❑ No. of Meters Number of Feeders and Ampacity L.t) 9 Rcs A-pP Location and Nature of Proposed Electrical Work C8 UB R al No. of Lighting Outlets No. of Hot Tubs No. of Transformers TKVA1 No. of Lighting Fixtures Swimmin Pool Above In- g grnd. ❑ grnd. KVA ❑ Generators No. of Receptacle Outlets No. of Oil Burners No. of Emergency LightingBattery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices No. of Disposals No. of Heats Tions ot Total No. of Sounding Devices No. of Dishwashers S ace/Area Beating KW No. of Self Contained P g Detection/Sounding Devices No. of Dryers Heating Devices KW Local 1:1Municipal Connection❑Other No. of Water Heaters KW No, of No. of Low Voltage Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES❑ NO [] .I have submitted valid proof of same to this office. YES❑ NO [] If you have checked YES,-please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) Expiration Date Estimated Value of Electrical Work $ Work to Start 1119164, Inspection Date Requested: Rough Final I If Signed under the penalties of perjury: FIRM NAME �a Zj71��J > GG LIC. NO. Licensee Signature LIC. NO. Address Bus. Tel. No. Alt. Tel. No. 014NERIS INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) GY1 Telephone No. PERMIT FEE S Signature of Owner or Agent M M Do Not Write In Here M 7� CA For Electrical Inspector Only 00 rn Streetand No. .............................................. Name ............................................................ Electrician .................................................... PermitNo. ..................................................... Comments .................................................... .................................................................