The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #304 - 394 BOSTON STREET 10/19/2007 OORT#f BUILDING PERMIT 0 "ZD '6 - TOWN OF NORTH ANDOVER 0 to. " 0 APPLICATION FOR PLAN EXAMINATION IL Permit NO: Date Received C U Date Issued: 0 IMPORTANT:Applicant must complete all items on this page n 2, E -R� t- ZI!FIN.- ?ROPERTX, OWNER 1, nw�fl c-, Z" '� " Iactl�ne Shop Village ..des no .42 TYPE OF IMPROVEMENT PROPOSED USE Res' p#iaL— Non- Residential New Building Addition Two or more family Industrial _A11eration No. of units: Commercial Repair, r)japlacement Assessory Bldg Others: —15e—molibon Other S 0 Jr 7 dtlse W, W'T '9 J DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Joy c ecru cc Phone: q;7-V Address: 3 9 N Zo 1-1 Al. Cts/I of 0 1 k/ -r- ' `-"O.NTRAC" TTOR Mame h g R Construction .icense Foiernpro:�verner�t.License E" 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. ,I a VW Total Project Cost: $ FEE: $ Check No.: 6 2 0�- Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund nature co0tractornno.- 'ignature:..br;,�i ben Jana Si16- - A �ih Location � � No. Date 0 T 40RTN TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ ;�a"••a°'Eta' Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 0 20710 Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL aPublic 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS I � Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water $ Sewer Connection/Signature& Date Located at 384 Osgood Street Driveway Permit no FIRE DEPARTMENT Temp Dumpster on sit e Located.at"124 Main Street - Fire Department ignAture/date COMMENTS~ 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 lDATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS a DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS a: i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments i Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTME:NTTemp • Durnpster on sit a no Locate at 124 Main'Street . h`Fre Department signatureldate i ;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 2 1 A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 u 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) o 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 2.2007 BUILDING PERMIT o� " D N. 1 q TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION q yft-dWIN Permit NO: �V Date Received �4p`"` "`" ,yss S y 41 � / ACHU Date Issued: 6 "` 1�-0 IMPORTANT:Applicant must complete all it pp p ems on this page x ar x ti I.- C �JO ' +'�! � L F 1 � •.' ..f i�l s"1' - �^ 4 PnnL �ROPERYOV/NER 1 , � � ,� r� �rc> t' s K y�; � .s �t � e e� s w.e � d '� � � 5 F s .i,4 t� �. w �_•• 4 ?'t- r � �P" •F' Vy s y ; Machine Shopillae des =no tii F 1 TYPE OF IMPROVEMENTPROPOSED USE Res' nti Non- Residential New Building QQne famil Addition Two or more family Industrial _Attertion No. of units: Commercial Repair, placement Assessory Bldg Others: emolition Other FepticNell j r, f=�o�dpta�riw 17Vetlands r 1y11atersfied`Distnct Uater:/Sea�uer a � r DESCRIPTION OF WORK TO BE PREFORMED: pie W(3vt.1L`. ,�V\" ��c `�� ✓�� UvS`^ Identification Please Type or Print Clearly) OWNER: Name: _/ogee -Rr.-o rc-4 Phone: Address: 3 / Zo,-{ ,,,� S�. . �f�vo. '-,'Cl. �s�_ h ,.r, i -. •�of fk..4�r� 'i'�-Y-tt C' x ^ � •aa� �S > Y � � �`�a� 1 '` � 4 ; CONTTORTN- ,,e `Y r S faerv�sor's`C6h, 1-jctlOA Jcense l=x{� date HoMe lrxiprovernent L>cen e.. E�cp 'Date = r. ARCHITECT/ENGINEERP hone: 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: $ FEE: $ Check No.: 6 2 ° Receipt No.: QO 4 I > NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sinatre ofient/O,wner = ( . Signature of contractor 1 y' " TOWN & COUNTRY CONSTRUCTION P.O. BOX 1516 BIDDEFORD, ME 04005 (207) 284-4681 Joyce & Paul Perocchi 394 Boston Street North Andover, MA 01845 10-1-07 ** Install 30-40 year Landmark Architectural roof shingles ** Install tar paper ** Install ice & water barrier ** Install drip edge ** Install cobra ridge vent ** Strip existing wood shingles Labor & Materials - $20,000.00 completed, $10,000.00 down, $5,000.00 when 1/2 p leted , $5,000.00 due upon completion ** McCarthy Landscaping - Front wall Labor & Materials - $4,660.00 ** Build front entrance Labor & Materials - $4,000.00 -J; C, $2,000 down TOTAL DUE - 10/1/07 - $16,660.00 NORTH Town of . _ - Andover No. o dover, Mass.,10 I� COCKICKEWICK y11. 7�ADRATED `S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT �. Peev < ikAw- ................................................ Foundation has permission to erect.................i4;�* ...�. 010. build' s on ...1W. . cm.. �i ..�........... Rough ............ ..... to be occupied as.A� ...... A .............�................■9..Q . .....P.......F. .... ..�... Chimney provided that the person accepting this permit shall in every respect conform to a 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 TARTS Rough ......................7=NSPE�CT Service BUILDING 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. S 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 Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. $ ❑ 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 10.❑ Electrical repairs or additions 3., I am a homeowner doing all work right of exemption per MGL l 1.❑ Plumbing repairs or additions kI/ lyself. [No workers' comp. c. 152, §l(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.0 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. lContractors 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 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 certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: l0 9-- Phone#: 1n7 Q G -7 is 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#: t �oRTM TOWN OF NORTH ANDOVER 3:°.-1;`'" ;�.'."oo� OFFICE OF I. BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 SACNU`.+� Gerald A.Brown Telephone(978)688-9545 Fax (978)688-9542 Inspector of Buildings HOMEOWNER LICENSE EXEMPTION Please DATE:—/0 JOB LOCATION: 3 9 Al. Number Street Address MaPtLot HOMEOWNER J 3��c G �e` c �, 9 7 6 7 �`Y Name home Phone Wont Phone S MAILING ADDRESS 3 � PRESENT y 3 0 Al.- J 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 helshe understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. f� HOMEOWNERS SIGNATURE ' APPROVAL OF BUILDING OFFICIAL Rev;sa 10.2005 Form Homaowom Exemption BOARD OF \PPEALS(M-9541 CONSER\ \FION 638-9530 ITE.\L1'IT 688-9540 PLANINING 688-9535