HomeMy WebLinkAboutBuilding Permit #215-11 - 38 FARNUM STREET 9/14/2010 BUILDING PERMIT o`"°RT 6gti
TOWN OF NORTH ANDOVER 3� "`-
APPLICATION FOR PLAN EXAMINATION y
Permit NO: Date ReceivedLoe
` gSSACHUs��
Date Issued: t �
IMPORTANT: Applicant must complete all items on this page
LOCATION �.,�� _ ;l� �a'��!•► rya . - � �'-'.
R.ROPERTY OWNER A.Wa --. a� Acv.
~ Pnn
MAP 21'0 ( 7 RARCEt.,ZONING_DISTRICT- Histone Distract_: yes
-
Mpc.pneShop Village yes.`v +�e-
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Buildingne ami y
Addition Two or more family Industrial
era io No. of units: Commercial
epair eplacement Assessory Bldg Others:
Demolition Other
Se 1Nell Ffbo.plainWetlands Watershed D1n(it
DESCRIPTION OF WORK TO BE PREFORMED:
�.,y S�Y� �� t`�cw w t ,u��..✓� �.�� 5 i d �v q ��'c�.�3at -t.n, �- 1��� S;d.�
i
BJH Q
Identification Please Type or Print Clearly)
OWNER: Name: 2'Py :!D-J A14 YU � Phone: 1-) 661 - L('7 > s—
Address: 3 ea,r N,, S /V of N' A� -
CONTRACTOR. Name. �''� �" -
_ Phone. r "�?
Address: _ P Q �`�-vim-'_ /U, f
Siapervisor's=Constrtaction°License ExIIS
p;
borne lm royernent,License ( 4:3- °� '� I p I
P - 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: $ ':;-1 <93 5 FEE: $ ep
�S
Check No.: � ( 2,— Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Sjof Age
gnattarent/Owne cv '+ 'S�gnature-of contractor _
• T
Location
No. 0
0 Date
E
NORTM
TOWN OF NORTH ANDOVER
6
• ; . Certificate of Occupancy $
sACMUs Building/Frame Permit Fee $ 2e 2tn -
Foundation Permit Fee $
Other Permit Fee $
r TOTAL $
` Check # ►
23 /
Building Inspector
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/MassageBody Art Swimming Pools
Well ' Tobacco Sales
Food Packaging/Sales
Private(septic tank,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE .ONLY
IN.TERDE.PARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on )/,o Si nature
COMMENTS Ov ccs - /l, t,j1/� DCS `
HEALTH Reviewed on Q Signature
a
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 DUfnpster on-site ryes no
4 ,
L>ocated at 124 Main Sheet
Fkre,Department signature/date
COMMENTS'- .r -_
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
I
NOTES and DATA— (For department use)
❑ Notified for pickup - Date
Doc.Building Permit Revised 2010
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:Building Permit Revised 2008
OR T►�f
TO" ofj&ndover
0
No.
moi-: �AKE o dover, Mass., • 1�• ll�
COCMICMEWICK
�OOA T E D PPf`�.(5
X77 ` BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
I
BUILDING INSPECTOR
THIS CERTIFIES THAT .. 4..�? ..G.! ....................
........... .. . ............ .... ... .................................. ................
Foundation
has permission to erect........................................ buildings on ...3..8.........���,�,u O.W.%.............. .....0...... Rough
to be occupied as rr^4^._ � ....... . IA ...&-tio-i-the�........�,ar.��.dQvt�ac. Chimney
.��
.. . . . .. . . . . . ... . ............
provided that the person accepting this permit shall in evi6 respect confoterms 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
�6Z PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRU TARTS Rough
r Service
.... .. ..... ....... ..........................................
BUILDING R
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 net.
North Andover MIMAP 38 Farnum Street September 9, 2010
107.A-0026
.�54' 10��.Q1.F� .... •._..•:`-'•..)1,1.G! . ..:: .._..•.:it{...�S.�fl,
107.A-0140 .,i.l�i:_. 101. �-'?Sl..: .-.•••• l. .".:. t_
107.A-0025 Ir...,j)��((,.: �I,-• .. '.._ -..._•il, -.
_.. _
s
i(! :_:_. ••'=:. __.. 1. .':',....;;.._:. .:::.. .':�:.. '.
107..4-0045 i;-. ....
10 A-0062
107.A-0044 = Ju.:_:_. SS6tr.:_.::••.'
.:_:_. ::... �.
w
107.A-0024 If, �41u .: i,..:aSlu.:.'_:::• •.i,, 107.A-
107. -00$
=—.7
107 A-0028 :: '.:- ::•..�3Ju.: '•::='
!per 10".4-0088
r
107.A-0087 107.A-0083
107.A-0092 107-4,0084
107.A-0086
i. 107.4-0085
tJ
107.-4-01 7
1'O
11101
t.
107.A-0089 /c/,` I58' 155'
107.A-0156 \\-- - Summer StCtet �r
���• \ - 284' 7.4-007
107.4-0056
- 107.4-0076
it
107.A-0093
10i.A-0055 107.A-007.5
107.4-0174 1 91 107 - 29
-^Rail Line
Interstates
Interstate Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83,
—Major Roads Meters Data Sources:The data for this map was produced by Merrimack
RoadspORTIy Valley Planning Commission(MVPC)using data provided by the Town of
Of ��o q� North Andover.Additional data provided by the Executive Office of
r Easements ? 0V ��� 0o Environmental Affairs/MassGIS.The Information depicted on this map Is
- Trails L for planning purposes only.It may not be adequate for legal boundary
0definition or regulatory Interpretation.THE TOWN OF NORTH ANDOVER
0 MVPC Boundary • p MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING
E3 Municipal Boundary ♦ >♦ THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY
❑Parcels * ^ OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT
Hydrographic Features * o •,•,. �t 'r ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
Streams + 47.n �g THIS INFORMATION
Wetlands SSA�NUSe
Exempt Lands ^=148 ft •�'°
North Andover MIMAP 38 FarnUm Street September 9, 2010
-006
f
0
C
0
i�-
d
hUhi�s��e
7•
•t
Summer stir
t
�r
Interstates
Interstate
—Major Roads Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83,
Roads Meters Data Sources:The data for this map was produced by Merrimack
r Easements f NORTH, Valley Planning Commission(MVPC)using data provided by the Town of
t�a o ,e 1r North Andover.Additional data provided by the Executive Office of
Q MVPC Boundary ?`}t •� �p Environmental Aflalm/Ma"GIS.The Information depicted on this map Is
Parcels F 9 for planning purposes only.It may not be adequate for legal boundary
d ition or regulatory Interpretation.THE TOWN OF NORTH ANDOVER
MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING
} - • THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY
* ^ } OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT
} o ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
THIS INFORMATION
SSAC114
1"=148 ft •�
NEW PORCH STRUCTURE
NEW'AND TW 84810 MATCH WW00W TRIM
THREE LOCATIONS AT TO EXISTING WIDOW UNITS
FRONT WALL AT FRONT WALL OF GARAGEe
- - - - - - - - - - - DiGiovanni Residence
_- -=-===--==-=-=- - =_====-=--= - _= -====-----= ======= ===--=--=—=-=-—=--= 38FARNUM3TREET
-_-______
. pNIN�PtlR
DiGiovanni Residence
38 FARNUM STREET
NORTH ANDOVER, MA
srxo:�a•� a��mno
- NEW WOOD CEILING
CONTINUOUS 2 X LEDGER 2 X 8 AT 18.O.C.
LAO BOLT TO EXISTING FRAMING. MATCH EXISTING ROOF SLOPE
FRAMING CONNECTORS NEW 2-2 X 8 HORIZONTAL TIES.
FLOOR PLAN.
EXISTING D FL FRAMING PROVIDE LOCATE DRDECORATIVE ENCLOSURE
FRAMING CONNECTOR
2-2X8 HEADER
NEW WINDOW UNIT 2-13'4`X 774'MICROLAM HEADER
4 X 4 TREATED WOOD POSTS.
FU1SH DECORATIVE TRIM ENCLOSURE.
WEATHER RESISTANT DECKING
r;: RELOCATED GRANITE STEPS
'e• EXISTI i, FI MH GRADE
2 X 10 AT 18.O.C. CONTINUOUS TRTD 2 X 8 LEDGER. �'
THRU BOLT TO EXISTING FRAMING. ",'' I 1 TREATED 2 X 8 18`O.C.
n.'• JOIST HANGERS •'.w
(( I) POURED CONCRETE PERS
L
r • + r J
POURED CONCRETE .r INSULATE FULL DEPTH
FOUNDATION WALL OF FRAMING(TYPICAL)
A
TYPICAL CROSS SECTION
FIRST FLOOR PLAN
BATH
EATING Q pum^°^
DiGiovanni Residence
DINING ROOM KITCHEN ��� NORTH ANDOVVEER.MA
- II
NEW BUILT-IN I I � a►n�nono
CABINET TO MATCH V 8LD(3 DR
NEW C.O. STING
_
Adom + C�"
LIVING ROOM o •
REMOVE E)aunNG WINDOW
aa�B RE-FRAME FOR NEW WINDOW UNIT J
FILL BALANCE OFOPENING TO MATCH E)MI 40
SEE INFERIOR
W I ELEVATION VIEW A,A
z FACTORY F�MR
J INSTALL aFAMILY ROOM
-J CODE/MFGR.. I FOYER
NEW WINDOW UNIT I I UP ALLOW FOR'FULLOPEN'NEW
d' ANDERSEN'AR51. NEW HEADER/C.O. I I DOOR POSITION
NON-VENTING STYLE �' NEW'ANDERSEN'TW 9448,2
_ a TEMPERED GLA MULLION
MuoN bi \
II IINEWAN "mw—W-TW`3448-3
' 'mr
2- X 8 1 1
I I
HEADER: I I I I I hEW ENETRANCE UNM
NEWWOODFRAMED
FIREPLACE ENCLOSURE I I I EXISTING I I I I I I I I I I I
I I I WINDOW R.O.I I I I I I I I AL TINES(ABOVE)
_7T
1'-4•+h 1,1'-0'N 1'-d'+ti_,,I EQUAL EQUAL 4 X 4 TREATED WOOD POSTE
j ------- WITH DECORATIVE TR11M
HEADER
CONTINUOUS
HEADER
REUSED/RELOCATED
OWNERIBUILDER TO VERIFY I GRANITE STEPS
ALL ZONING 8ETHJ1CK8
PROPERTY LINE
f
NAW MR
EXISTING HEADER TO REMAIN D!Giovanni Residence
38 FARNUM STREET
NORTH ANDOVER, MA
REMOVE EXISTING PICTURE WINDOW UNIT.
RE-FRAME WALL OPENING FOR NEW WINDOW UNIT. sc •-TIW DATMMONO
EXISTING
BUILT-IN
L-----------------------------------
� - - - - - - - - - - - - - - - - -� TOBINETS
REIIAAIN
I
I
I
I
I
TV xSCREEN
ar
. I NEW MANTLE
1
NEW OAS FIRED \l"—NEW'IN-FILL:FRAMING
ARCHITECTURAL
FIREPLACE
TESTA
Building and Remodeling project to start mid Sept
5 Appleton Street project to finish mid Oct
North Andover, Ma 01845
(978) 682 2023 CSL: CS54718
H IC: 120296
Proposal
September 9, 2010
Proposal Submitted To:
Kelly and Ray DiGiovanni Home Phone: (978) 681-4775
3,$Farnum Street Work Phone:
North Andover, MA 01845
Job: Siding front and left gable
Job Description:
Obtain building permit
Complete removal of all demolition and construction materials
generated by Testa Building and Remodeling and its subcontractors.
Strip the siding off and tyvek the wall . Install home sliker and new p v c trim . Reside the front with
new cedar claps. Install new windows and a new front door. Extend the farmers porch to the far left
of the house. Build a bump out on the left side of the house to accept the new gas fireplace.
A finance charge of 1 1/2%per month(18%per year)will apply to all accounts over 30 days past due. In the event collection activity
is required the customer shall be responsible for all costs associated with collection,including reasonable attorney's fees.
I propose hereby to furnish material and labor complete in accordance with above
specifications,And according to architectural drawings with changes as noted
for the sum of:
$21 839 Twenty one Thousand Eight Hundred Thirty Nine Dollars
One-third to start/one-third after windows installed/one-third upon completion.
Authorized signature—q4---:Mt
I reserve the right to cancel this contract if not accepted in 30 days
J
Signature r
Signature
di \ The Commonwealth of Massachusetts
Department of Industrial Accidents
' " .A.. '' Office of Investigations
600 Washington Street
w Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print{{Legibly
Name (Business/Organization/Individual):
Address: 5-
City/State/Zip: /V, ��o,,U A 0 f Phone
Are you an employer?Check the appropriate box: Type,of project(required):
1.❑ I am a employer with 4. ❑ I atn a general contractor and I 6. ❑New construction
e tployees(full and/or part-time).* have hired the sub-contractors ,—, _
2. I am a sole proprietor or partner- listed on the attached sheet. $ L�Kemodeling
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
10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs
insurance required.] t employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and 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. Lic.#: 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
P
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 hereby certif der the pains
�and enalties o PerIur1that the information provided above is true and correct.
cl�VSi nature: Date: / O
Phone#: 7 6� �-O� 3
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 perfonnance 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 may be submitted to the Department of Industrial
Accidents for confinnation 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 pen-nit/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. # 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-26-05 Fax#617-727-7749
www.mass.gov/dia
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
at: 38 rArevv^q 5I- is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c 11, S 150 A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
I OA.
The debris will be disposed of in:
s o'j 3 c- -cr s
(Location of Facility)
ature of Permit Applicant
Date
INTEF
\ UNIT
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vi X N/F MICHAEL & JACC
9a \ #50 FARNUM
\ \ MAP 107A L
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WITH
NTRACTOR ENCOUNTERS OLD \ \
LEACHING LINE(S) THE PIPE \ \
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ABANDONED IN—PLACE
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INSPECTION PORTS TO
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PELEVATION = 100.00
f 1 T 1 x (ASSUMED DATUM)
OMIN 20' ON. olxo 1 .► 1.1'f FROM GROUND
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