HomeMy WebLinkAboutBuilding Permit #336 - 38 FARNUM STREET 10/3/2013 BUILDING PERMIT oF�pORTF�
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TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: _ Date Received
w 1•
ED
�gSSACHUS����
Date Issued: G
I PORTANT: Applicant must complete all items on this page
LOCATION J?�' �'¢��i/ 57
T / Print
PROPERTY OWNER C ` Ji'61 oVQ,7n i
2 Print 100 Year Structure yes no
MAP PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ,, One family
❑Addition ❑Two or more family ❑ Industrial
9�AIteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: 4 Phone. 5-;
Address:
Contractor Name: Phone:
Address:
NmSupervisor'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 B/S��ASEDON$125.00 PER S.F.
Total Project Cost: $ 0 o FEE: $
Check No.: ���-17Receipt No.: 94-0
6
-!
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
Signare nt/O
of Agewner
tuSignature of contractor i
Location �/'r!
No. Date by,
• - TOWN OF NORTH ANDOVER
•
` Certificate of Occupancy $�
Building/Frame Permit Fee $, �Q
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check# U11
4, JU :ri '
Building Inspector
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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
I
CONSERVATION Reviewed on Siqnature
COMMENTS
HEALTH Reviewed on Signature
r ,
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
C
{ Conservation Decision: Comments
r
Water & Sewer Con nection/Siqnature& Date Driveway Permit
DPW Town Engineer: Signature:
Locate_d 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
FireDepartment 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 Call Email
Date Time Contact Name
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
❑ 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/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
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 2014
T WJ-`i 01.E NORM AND R _
OFFICE OF
BUM)ING DVMTM ENT
` o�p<<„.�`,• Z600�Osgoot RrOet%ffding20,-Surte,2 36
7�SSRCHt15 ` 'Nox�h Anbw; Massachnst 01$4
Gerald A.13xownTelephone(97g)688 955
Inspeetoroi Buildings
• HOMEO ` Fax (978)689-9542
WNER ETCENSE EXENlP TION
13bM)UG pE ' ` - U A.TTON'
pleaseprint -' -
DATE:
B LOCATION: 3y -
7-Number SizeetAddress
MaplZot
XOMEOWN-ERi G: „
ame. ,I 77� /7— ✓ �� 'ems/Q
Homo Phone Work Phone
PSENT MG ADDRESS /qk�V u'Y, 57 _
����v� e�21(14/r
The current exemption for"homeowners”was extended to?nchzde owner occupied divellings t0 t4V0 units px;ess and
to allow su�T,homPo1�uers to eagle andividual.forliire a�no does notpossess a 7 cense,
acts as supervisor). State!301 ding (Code Be
c�on 708.3.5.1) provided that the,owner
DEFMITIoN OFRO.IVJEOWNER
Persons)who awns aparcel o Iand on which.helshe,resides or intends to reside,on which thew xs,or is intended to
be,a one or two family structures. A person who constructs more that.one home in a fwa yearperiod shall not e
cansidered a homeowner.
The undersigned".h0medwner"assumes responsibility£or compliances with the State I3 "
Applicable codes,bylaws,xules andze usIdiug Code and other
gulations.
- Tlieundersigned"bomeown(,-z"cezCiResthat,
he/shetutderstands the TownofNozfb t�adover�3uildin De rt
umins pectionpzoceduresandrequzreznentsand thathelslzewillcompTyV�xthtsazdProcedures andp meat
requirements=
I10ME0VkrbMRS SIGMA
AI'PROV.AL OF 33UMD)NG OFFICIAL
Revised 7.2009
Formnomeovmers Exemption
'EOARb OFA.PPBAKS 688-9541 Coh"SERVAITON 688-9530x y:
HEALIT 688-9540 PLANNING 689-9555
The Commonweal&offfassmchuseus ,
00 Washil2em Simet
Roston.,MA 02111
WfYflt.Afd6l N.g0-PI CE
workeNo,Compematzon bsurance Affidavit:
;A Reaut rMat,0 PX���e�xzn�7���imbxy
Nanma(Basinesd0rgauiaationft&idua):^
Cl.�rl�tat�l�i�:/cJ �n�v-E✓ /�� y/�'f'.�Pham�: 7�7���'/-- �?7..1�
.Are your art employer?Cheek. MO appropxiateYooxk Type of project(xeq*e0):
1.[l T mu a employer with J 4• d lain a general c ontractor and T 6. El Now c6nstmotim
employees{falland(oxpax time).T have,nedthomb-contractors
2-El S am a salepropxiotox orpartnor-
listed onthe atiached shee0 �-emadeling
shlPaux1aveno•employees These sulrconteaetoxsh:ave 8. ElDemolitlon
working foxme in any capac%ty. workers'comp.insurance, g. �]Biding addition
o worlexs'eonnv.Vance 5. ❑ V e are a corporation and its
10•0 Electxicalxepai
xecffine,d-]
officers have exexclsedthe%r rs or additions
S am a homeowaler 4049-all work light of exemptionperMOL 11.. j 1'lumbingxepairs or additions
myseL. lowgrkexs2 comp. c.152,§1(4),andwehaveno 12.�]RoQfxe ais
insuranc�xerluired.� employees.[Noworkers' 13-El OtTiex
comp.insuxancexeguixed.� .
�Anyapplicantiha�cbecksbex�tmuscalso�Tlouithese�tiolibel�wshavting$teitwbrliers'compensation.�olicynfoimafion. ,� .
i�omeevrners who saBmiftbi�a#fidaYttmdtcatingi[tey ire dpang allworkandthenhire outside ooniractors mns�su7�m�anew af�xdagitindica5ng such,
xConftactflrsibataheckflusbo m'gattachedan additionalsbeeEshovingthenamea tflesulk-coAEracforsandthei vlorkers'comb.policyinfo�maiion,
_ram text ernpfoy6v t&d IS praviciir g 117or'k'ers.,cornpera at�or�insrtr ar2ee fir m errzpioyees;. .�6 w z� ke palie fool ob site
ir2,�Qx�raiatiorx - .
hSmance CompanyName:_
T'olicy 4 or del,"-ins.yID.#: ExpixatzonDate:
Y'ob;Site.A.ddxess: CztylState%gip: '
Affaeh,acopy af#tewoxSrexs'compensatiowpolxeyaeclarationpage(showing-tltepolicy'nmu erandexpixatioadate)
yajjuta to securer coverage as xegaixed.undex Section 25A.of MOL c.7.52 can leadto the imposition of crk allienalt w of a
,me-rig to$1,500,00 and(ox one-year npriso nnent�as we71 as civilpenalties
in the foam ofa STOP ter%ORS OR77El and a 'me
ofup to$250.0 0 a clay against tfze v'0!Qtor. B e advised that a copy oftlus statein ent maybe forwarded to the Of ao-,of
Investigations oft7ieDTA fox insurancecoverageverification.
-T To e yee rice �ie�irrir2 au(jpenartie a per uyOaitlieinfax.� atio��Yovi�'ec�n�iovei��iueancieorreez`,
Data:
O cic�X e a�rtry. Flo r2ot trite in this area,z`a i'ie compTetec ry city oar z` ff faf,�ff
City or Town: Berxnzt/Licezzse#
fssWngAnthmority(circle 6x1e):
1.Board ofoealth.?.BuildingDepaxtment 3.Cji£# 'owaa Clerk 4.Mectrzcalxusp€ctor 5 Nuoahingfnspector
6.Other - - -
FLOORPLAN SKETCH
BOrrOWer, Raymond&Kellie Ann DiGiovanni File No.: ip121007
Property Address:38 Famum Street Case No
City: North Andover State:MA Zip:018453605
Lender:Union Trust Mort-gage Corporation
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AREA CALCULA S SIML%RY UVWG AREA BREAKDOWN
Cads: Oe-rion- 1"Stm MKTO S Breandwm Subtotals
GIAi First Floor 1204.0 1204.0 First Floor
RLA2 Second Floor 1204.0 1204.0 28.0 a 43.0 1204.0
HSHT Basement 1204.0 1204.0 Second Floor
OAR Garage 528.0 528.0 28.0 a 43_0 1204.0
P/P Porch 2880
porch 252.0 540.0
t1ttt '
l
t
Net LIVABLE Area (rounded) 2408 2 Items (rounded) 2408
Jofrt E.Purcell,Jr:2 Efi mbedi Lane„Newburypoit MA 01950
SUBJECT PROPERTY PHOTO ADDENDUM
Borrower:Raymond&Kellie Ann DiGiovanni File No.: jp121007
Property Address:38 Famum Street Case No.:
Cdy: North Andover State:MA Ziff.01845-5605
Lender.Union Trust Mortgage orporation
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FRONTVIEWOF
" SUBJECT PROPERTY
'Q. y Appraised Date:October 3,2012
,n ,• .�n<,, ' Appraised Value:$563,000
a
oil
221.1
L
x
REAR VIEW OF
SUBJECTPROPERTY
YY
4 STREETSCENE
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4
L VIE—
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John E.Purcell,Jr.2 Elizabeth Lane,NewburypoM MA 01950
Borrower:Raymond&Kellie Ann DiGiovanni File No.: jp121007
Property Address:38 Famum Street Case No
City: North Andover $tate MA Zip:01845.5605
Lender:Union Trust Mortgage Corporation
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4r,
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P
On�
ix
Bathroom Finished basement room
Porch Garage
� ,�� t�_ "..� .�' �'�"•.,�,����'� �aMr=yy't#'.t�:'�.:.5�„af'S 'y�r"v
4 ..
Porch
Garage
aoamdm,yaowrwa e00.234.e727ewY�kvb� MT8
r 1 NORTH
- - own c Anc ve. .
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to
No.
ver, Mass,
COC L^K@
x.95 RATED
U
BOARD OF HEALTH
Food/Kitchen
PERM. T LD Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT ............................ �,,,,, ,,,,�, .�.h „�,,,.,,,,,,,,,,...,.,
Foundation
has permission to erect ..... .................... buildings on . . ......... .....�.r1!1..1 !�I......., .Ts
Rough
3
..... eoolalm.............. Chimney
to be occupied as ....... ..... ,�!!!��. ...... QAC/. . .........
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in 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 M T S ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIO TA Rough
Service
................ ...................................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building 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.
Smoke Det.
Information and Instructions
MassacbuseffsGeneralLawschapter Z52xeciuixesallemPIoyexsfapxovidowoxkexs'com ensatioxx ox heixempZoyees,
Pursuant lthis sfafazte,an erd1vrnyee is defined as"..,ever person iii Elie service of another under any coiifraot o:�bixe,.
• express ox•ira�lied,oral orwxiften"
er�layeA,�,�defined as"anpointenfexpxiseixtdiv-ideal,paxinexsliip,assoczafzon,covoxafzox�,or otSzer.legaX entity,ox any two nz
a oxoxe• .
ofthe cregoingengagedina ,andincludingthelegalxepresentatvesofa•deceasedePplgortrio
xeceivexoxftiistee o anindMduatpartnersbip,association,or other legal enfityver
,employing employees, owyex,.eoria
ovMro;adwalbghome havingnotmore,thmfhteeapar[menfsandvrizaxesxcles erein,oxf�eoccupaato the
dwelling house of another who employs persons to do maintenance,coustruction oxrepaix work on such dwelling house
or onthegrounds orbuilding appuxtonantthereto shallnot became of such ma be do= dtobe an employer•.
MGI,chapter 152,§25C(6)also states that"every sfate or Weal IlGensing agency shall withhold the issuance ox
renewal of a li'ceuse or pemit to operate a business or to consfxu(et huildings in the coma monwealth for any
a.,pplse"t who has n.ot produced.acceptabla evidence of compliance with the insurance coverage recluixe.d;'
Additionally,MGL chap�tex 152,§25C(7)sfafes'WBitherthe eommonwealthnor any of its political subdivisions shall
eltexintoanycontractfortheperformanceofpublicworkunfilaccepfableevidenceofcompliancewith the insu mce
xecluirements of this chapterhavebeextpreseutedtathe coutradlugauthority."
Applicants
Please oui the workers'comp eRsation affidavit completely,by checlang the b ores that apply to your Situation and,li
i%ecessary,supply sub-0onfxactor(s)name(S),addxess(es)and ItonexRumber(s)alongwiththeix cextztxcate(s)of
insurance, Limited Liability Companies(LLC)orLimztedLiabilitypattnexships(LU)v,ithno employees oth rthmthe
members oxpaxtnexs,axeriotxeguixeclfo cartywoxkexs'compensatgoninsuxance. 1!anLLC oxLLP doe�have
employees,apolicyisxecluired. Be advisedtliattbis adavitxnay be submitceclfo fhel7epattmert o jndustrial
-A-eoidents for confination of insurance oovexage, Also be sure to sign and crate thio aMdavi. 115 afrtdavit should
b e xef�nedto the city or towxl fhat the applsaatzpn z"ox thepemut ox license is Tieing xecpxes�ted,�,o�the�e�atim,ent of
7ndustrxalAccidenfs, ShonYdPahaveany questions regarding the kwori yottaxexegait'edtoobtaiva*oxltexs'
compensatian.policy,Please call the Department atthamunberlisted below. Selfiustrxec companlesshouXdenferd�eir
self in anraizce license number On the appropriate line.
City or Town Qfdcials
Pleasebesuxethattheafzdavitiscompleteandpxintedlogibly. The,Depailm.enthasMovideda,gaceatthe hotLom
oi:fheaiiidavitl'oxyoutoi711outintheeventtheOfficeofZnvesfigationshasfacontacxyouxegardugiheap�lzcanf, -
Please be-sure to zr11 iitthepermit/Iicebse number tvhicb v,�ill be used as a xezexence number, lv,addition,an applicant
thatnzust submitntulfiple permAIRcome applications is any givenyear,meed only submit one affidavit indicating cuu'ent
Palicy info mation.(ic necessary)and under 11YA Site Address"the applicant shouldwxife"alllocat%ox in (city or
towxr):'A copyo flieaff"idavitthathasbeenofCxciallystiainpedoxmarkudbyt ocity ortovvnmaybepxovidedfothe
appllcantaspr90the avalid a£r"zdav%tYsoneoxfuxepermifsarlicenses. Anew aztxdavitmustbefiljedou�eaclt
�'e�'.1�Xhere a home ovmex or citizexi is abtaixzing a license ax�e�n,of xelafed fo anybusiness ox comm,erclaZ vent
(i.e.ad og license orpermitto burin leaves etc)saidperson.is N'OTxegairadto complete this affidavit, rIte
The Oftxce of lnvestigafioni wouldMoto fhankyouin advance for youx coopexafion andshouldyotxpave auy gt�esfious,
please do Roth oefdfe to give us a call. .
the T epaxtm.elLes address,telephone and fax number:
na CQM-MO a a' Q }�(Y '�'T�t
.+r�i�i{�r Vt�JC�J,.,
D14) bOM dIMi,7Mal Ar4donto
Tel 617-7-2-1-49.00 W.406 Q.r X-W
_ . .
RevzseclS 26-OS Fax#617-M-7749.-.