HomeMy WebLinkAboutBuilding Permit #90 - 45 HERRICK ROAD 7/30/2009BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
I P R ANT: Applicant must complete all items on this pate
LOCATION 4�5' /7€�,E'� •CI AQaal -
PROPERTY OWNS
MAP NO:
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Print
ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
Cone family
Addition
Two or more family
Industrial
Alteration
No. of units:
Commercial
Repair re' lacement
Assessory Bldg
Others:
Demolition
Other -
Septic Well
Floodpiain Wetlands
Watershed District
Water/Sewer
DESCRIPTI N OF WORK TO BE PREFORMED:
Identification Plepse Tvneo
r Print Clearly)
OWNER: Name:_ Alf&Ar // �o/ICq vPS Phone: W/
AririrPsc•
CONTRACTOR 'Name: Phone:
Address:
Supervisor'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 BASED ON $125.00 PER S.F.
Total Project Cost: $ � � FEE: $ 30
Check No.: 3 9 Receipt No.: ,�2-1-2 7s
NOTE: Persons contracting wit registe7gco tractors do not have access to the guaranty fund
ature of Agent/Owner �- _ Signature of contractor
i
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
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH
COMMENTS,
Reviewed on Signature
L
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:
t_ocatea 664 usgooa Street
FIRE DEPARTMENT Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMM
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 2009
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)
❑ Muss 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
Location Illeve I � 4 /�,/
No. qP Date 7 /-�
TOWN OF NORTH ANDOVER
M
Certificate of Occupancy $
ITS CHU Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
4
Check #
2 2 2Y 6
Building Inspector
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Gerald A. Brown
Inspector of Buildings
Please print
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
North Andover, Massachusetts 01845
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Telephone (978) 688-9545
Fax (978)688-9542
JOB LOCATION: �% �/: �.t�/C%r •C�Aa�
Number Street Address Map/Lot
J
HOMEOWNER �&,Of � e;g)tlef 79/ yISg crfF9 79/
Name Home Phone Work Phone
PRESENT MAILING ADDRESS �k iIli eir CtJ Ver I ,2 on . ne
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)
DEFMTION 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 Towji of rth Andover Building Department
minimum inspection procedures and require men that he/she w- I'coith said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 . PLANNING 688-9535
STELLAR ADJUSTMENT SERVICE
P.O. BOX 516, METHUEN, MA 01844 TELEPHONE (978) 686-5000
Date': _May 19, 2003
Building Commissioner/Inspector of Buildings
City/Town Hall:
120 Main Street, North Andover, MA 01845
Board of Health/Board of Selectmen
City/Town Hall:
30 School Street, North Andover, MA 01845
T(Y; MF�I� F 6R }_A60`.
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2 8 2803
NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS
GENERAL LAWS, CHAPTER 139, SECTION 3B
Claim has been made involving loss, damage or destruction of the property captioned
below, which may exceed $1,000.00 or cause Massachusetts General Laws, Chester 143,
Section 6 to be applicable.
If any notice under Massachusetts General laws, Chapter 139, Section 3B is appropriate,
please direct it to the attention of the writer and include a reference to the captioned
insured, location, policy number, date of loss and file number.
Insured:
JOHN & GILDA BELLINO
Property Address: 45 HERRICK ROAD, NO. ANDOVER, MA 01845
Policy No.: HP0058344-01 Company: PROVIDENCE MUTUAL FIRE INS. CO.
File No.: M-073-03 Company Claim No.: 03001687
On this date, I caused copies of this notice to be sent to the persons named above at the addresses
indicated above by first class mail.
RONALD GAGNE, hu� 5-d d - 42
Adjuster ignature Date
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North Andover Board of Assessors Public Access
Parcel ID:! 210/015.0-0055-0000.0
SKETCH
on Sketch to Enlarge
Community: North Andover
' 1 t
No Ricture
Available
Location: 45 HERRICK ROAD
Owner Name: BELLING, JOHN J, JR
GILDA M BELLINO
Owner Address: P O BOX 341
City: NORTH ANDOVER State: MA ZIP: 01845
Neighborhood: 5 - 5 Land Area: 0.11 acres
Use Code: 101- SNGL-FAM-RES Total Finished Area: 1896 sqft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 300,200 287,300
Building Value: 156,900 150,600
Land Value: 143,300 136,700
Market Land Value: 143,300
Chapter Land Value:
LATESTSALE
Sale Price: 0 Sale Date: 12/31/2047
Arms Length Sale Code: N -NO -OTHER Grantor:
Cert Doc: Book: 00023 Page: 0133
Page 1 of 1
http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=3&Linkld=460352 7/6/2005
North Andover Board of Assessors Public Access
Page 1 of 1
http://csc-ma.us/NandoverPubAcc/jsp/Home.jsp?Page=2&RecNo=11 7/6/2005
North Andover Board of Assessors Public Access Page 1 of 1
http:Hcsc-ma.us/NandoverPubAcc/j sp/Home.j sp?Page=2&RecNo=21 7/6/2005
North Andover Board of Assessors Public Access
Page 1 of 1
http:Hcsc-ma.us/NandoverPubAcc/j sp/SaveSearch.j sp 7/6/2005
COMMONWEALTH OF MASSACHUSETTS
DIVISION OF PROFESSIONAL LICENSURE d (�J • �`%5 a
OFFICE OF INVESTIGATIONS
Application for Complaint
617-727-7406
www.mass.gov/reg
Date Received (stamp):
Entered into the Database (Date): /-J Docket #: -
Acknowledgement letter sent (Date): / / Signature:
Please complete this form as fully as possible. (PLEASE DO NOT WRITE ABOVE LINE.) Please type or print legibly in ink.
SUBMITTED BY:, 1 .
Name:
Name
First Name
M.I. r�
M
d9�,ver
llDaytime Phone
�uo HA
City State Zip Code Evening Phone
Best way to reach you: ❑ Evening Phone VD aytime Phone 0 E-mail:
LICENSEE SEE G COMPLAINT AGAINST (use separate form for each licensed individual):
Name: In ()
L st Name First Name M.I.
Address:
ymber, Street, Daytime Phone
Business Name
Business Address
*ate Zip Code License Number/Type Class
Daytime Phone
City State • Zip Code Business License # / Type Class
Please check the trade or profession that this application for complaint pertains to
Accountant
Aesthetician
Architect
Athletic Trainer
Audiologist/Speech Language
Pathologist
Barber
Barber Shop
Chiropractor
Dietitian/Nutritionist
Dispensing Optician
Drinking Water
Ed. Psychologist
Electrician
Electrologist
Engineer
Fire or Burglar Alarm
Funeral Director
Gas Fitter
Hair Salon
Hair Stylist
Health Officer
Hearing Aid/Instrument
Home Inspector
Land Surveyor
Landscape Architect
Manicure Salon
Manicurist
Marriage & Family Therapist
Mental Health Counselor
Occupational Therapist
Occupational Therapist
Assistant
Optometrist
Physical Therapist
Physical Therapist Assistant
Plumber
Podiatrist
Psychologist
Radio/'IV Tech.
Real Estate Agent/
Broker/Salesperson
Real Estate Appraiser
Rehab. Counselor
Sanitarian
Social Worker
Veterinarian
Page 1 of 2
Y4k
It
To Whom It May Concern: May 22 2005
This is to inform you that a Hair Salon is being operated in the basement of
45 Herrick Road in North Andover. This business has been on going for numerous years
without proper licensing and sanitation facilities. Contingent on the fact that the town
of North Andover is unaware of the situation I'm providing this information in the hopes
that proper procedures will be followed in rectifying this situation.
Cc: Board of Selectman
Health Department
I.
A Concerned N.A. Resident
RECEIVED
MAY 2 5 2005
c)r,: WORTH ANDOVER
i;/i _NT