HomeMy WebLinkAboutBuilding Permit #988-16 - 41 CEDAR LANE 3/22/2016RT
BUILDING PERMIT
0
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
4TEP
Date Issued: 'S CHUS
F -r-1—Mr[PORTANT: Applicant must complete all items on this Daae
LOCATION ua&, P,^A13vw
4FA_
PROPERTY OWNER A,, I 6,r,,0dk
Print 0-1
MAP NO: PARCELA� ZONING DISTRICT: 1- It, Historic District yes
1 4
Machine Shop Villacie ves ,
TYPE OF IMPROVEMENT
§ED U
PROPP SE
ResiKhtial
Non- Residential
0 New Building
V05ne family
D Aoition
El Two or more family
11 Industrial
vAlteration
No. of units:
El Commercial
11 Repair, replacement
El Assessory Bldg
El Others:
El Demolition
El Other
0 Septic El Well
El Floodplain El Wetlands
[I Watershed District
0 Water/Sewer
NMI 11
Pill!
Identification Please Type or Print Clearly)
OWNER: Name: y--U\n& G - Phone:
Address: 4 t CeAar I ^ %ArAi. L.\Pu or v\A- ei ke4111'%0'
CONTRACTOR Name:
Address:
Supervisor's Construction License. -
Home Improvement License:
Phone:
Exp. Date:
Exp. Date:
1�, 6-e
ARCHITECT/ENGI NEER 5eauxvs� �j(b�\Z __3 Phone :
R)� t4lpaxl -(;93
Address: k�\X MrkAl -Reg. No.
FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
lal
Total Project Cost: $ kj&noo FEE: 111)
,a - IF
Check No.:— -b- of Receipt No. -
NOTE: Persons contraci�ng wit"nry&ter1tfq6ntractors do not have access to the guaranty fund
Signature of
Signature of contractor
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
'Print 100 Year structure yes no
MAP PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop,Villa no
gp yes
TYPE OF IMPROVEMENT
'0
Residential
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
'Print 100 Year structure yes no
MAP PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop,Villa no
gp yes
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
El New Building
El One family
El Addition
El Two or more family
El Industrial
El Alteration
No. of units:
El Commercial
El Repair, replacement
El Assessory Bldg
El Others:
0 Demolition
0 Other
0 Septic ftWell
0,flloodplaip, 0 Wetlands
s
0 W e istr t
0 Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification - Please Type or Print Clearly
OWNER: Name:
A rid ra--Q -
Phone:
Contractor Name: Phone.
Email:
Address:
Supervisor's Construction License: Exp;. Date:
Home Improvement License:
Date:
ARCH ITECT/ENG I NEER- 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: $
EE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
-- I IF
i'.
TYPE OF IMPROVEMENT
PROPOSED USE
Resioe!(htial
Non- Residential
Ei New Building
VOne family
[I A�dition
[I Two or more family
[I Industrial
VAlteration
No. of units:
El Commercial
0 Repair, replacement
0 Assessory Bldg
0 Others:
Demolition
El Other
_E1
0 Septic E1, Well
E! Floodplain ElWetlands,
El Watershed District
—[I Water/Sewer
LVLfx r
Identification Please Type or Print Clearly)
OWNER: Name: G Phone:
00-A
Supervisor's Construction License: Exo., Date:
Home Improvement License: Exp. -Date:,
ARCH ITECT/ENGINEER �-_W_-aSV qfud�i(OAZ n'e-e-Kcs Phone: 3- S-& 3- 5LLIS-3
Address: E RA VzY_ei0_r kU\ oW�� 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: $ klz_:�aoo FEE: $ -% —
Check No.: Receipt No.: tb 147,
NOTE: Persons contracting wi1h1qnr1&ter14Vntractors do not have access to the guaranty fund
Sig natUreofAgent/own4jigii����r'--'-,�i6n�iu�eofcontr*a*ctor'
Location r
No.
Check # / /y,"
14 2
ZDate
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee
Other Permit Fee $
TOTAL
,-'building Inspector
1-laufld�lng Inspector
Plans Submitted -0 Plans Waived Certified Plot Plan Stamped Plans F1
OF SEWERAGE DISPOSAL
i.
FTYPE
.c Sewer
PublhieSewer El
Tanning/MassageABody Art E]
Swimming Pools El
well El
Tobacco Sales El
Food Packaging/Sales El
Private (septic tank, etc. El
Permanent Dumpster on Site El
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
Signature
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/ Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
fl�!: Cer a I MQ7 ffi_�,—pg tfej-r 1,0 n t's i15, �—%Ve
Plans Subrnitted-11�' Plans Waived Certified Plot Plan El Stamped Plans
TYPE OF SEWERAGE DISPOSAL
;Jd4 USgood 6treet
-r-7-
Public Sewer El
Tanning/MassageMody Art El
Swimming Pools
well El
Tobacco Sales El
Food Packaging/Sales El
Private (septic, tank, etc. El
Permanent Dumpster on Site El
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Signature
Reviewed on Signature
Reviewed on' Signatur6
Zoning Board of Appeals: Variance, Petition No: Zoning Decisionfreceipt submitted yes
Planning Board Decision:
Comments
Conservation Decision: Comments
Water & Sewer Connection Drivewav Permit
DPW Town Engineer: Signature:
+
UfA
LOcaiea
;Jd4 USgood 6treet
-r-7-
V
-.4
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
MGL Chapter 166 Section 21A—F and G min.sloo-sl000 fine
NOTES and DATA — (For department use)
EJ Noti fied for pickup Call Email
Date Time Contact Name
Doc.Building Pennit Revised 2014
No
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 LITERATI IPF=: Yes No
MGL Chapter 166 Section 21A -F and G min.$100-$l 000 fine
NOTES and DATA - (For &innrfmn"4- v-1
L) 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
E: 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)
4. Mass check Energy Compliance Report (If Applicable)
-& Engineering Affidavits for Engineered products
OTE: 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
2012 IECC Energy code
Engineering Affidavits for Engineered products
TE: 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
Doe: 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
4, Floor Plan Or Proposed Interior Work
-& Engineering Affidavits for Engineered products
OTE: 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
OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
Building Pel'Mit Application
Certified Proposed Plot Plan
24. 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
• 2012 IECC Energy code
• Engineering Affidavits for Engineered products
10TE: 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
Doe: Building Permit Revised 2014
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Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
is 25�ftO)0.00'.
m
$
$
300.00
Plumbing Fee
$
37.50
Gas Fee 100 comm.
Electrical Fee
$
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Total fees collected
$
475.00
41 Cedar Lane
988-2016 on 3/22/2016
Kitchen Reno
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ 25YO00.00
m
$
$
300.00
Plumbing Fee
$
37.50
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
37.50
Total fees collected
$
475.00
41 Cedar Lane
988-2016 on 3/22/2016
Kitchen Reno
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Ts,
Final Construction Control Document
To be submitted at completion of construction by a
Registered Design Professional
for work per the 8 th edition of the
Massachusetts State Building Code, 780 CMR, Section 107.6.4
Project Title: Tarbell Residence Date: March 21, 2016 Permit No.
Property Address: 41 Cedar Lane North Andover, MA
Project: Check (x) one or both as applicable: New construction X Existing Construction
Project description: Temporary partial window & non-bearing wall removal & re -install, required for MR1 equipment
removal, from ? floor specialty room.
1, Paul F. Kirby, MA Registration Number: 35313 Expiration date: June 30,2016 am a registered design professional,
and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and
specifications concerning:
Entire Project Architectural XX Structural
Fire Protection Electrical Other:
Mechanical
for the above named project. I certify that 1, or my designee, have performed the necessary professional services and was
present at the construction site on a regular and periodic basis to determine that the work proceeded in accordance with
the requirements of 780 CMR and the design documents prepared by me and approved as part of the building permit and
that I or my designee:
1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals
t
by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
Enter in the space to the right a "wet" or
electronic signature and seal:
Phone number: 603.583.2453
Email: pkirby8l4@gmaii.com
Building Official Use Only
Building Official Name: Permit No.: Date:
W,0�k OF M4
PAUL F.
K183Y
STRUCTURAL cn
— No. 35313 ,, _
Note 1. Indicate with an Y project design plans, computations and specifications that you prepared or directly supervised. If 'other' is chosen,
provide a description.
Trial Version 10092012
All dimensions -size designati�ns gi en are -.Mgbk- This is an original design and must
v rele�ased or copied unless applicab e fee has Printed: 3/18/2016
subject to verification on job site and 1 016
adjustment to fit job conditions. as or cop I
e paid rJob order placed.
_ P.
jj�ft�' been
tarbell.kit
All I Drawinp #: I
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TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
North Andover, Massachusetts 01845
Gerald A. Brown Telephone (978) 688-9545
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please prin
DATE:
JOB LOCATION: X \ C,
4k 6�_GE � o %') -unler I& -
Number Street Addriss Map/Lot
HOMEOWNER ?�j —7"
Name Home Phone Work Phone
PRESENT MAILING ADDRESS Lk ( "r- �
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 North Andover Building Department
minimum inspection procedures and requiremen t
h t hr wjW11p y with said procedures and
requirements.
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
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