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HomeMy WebLinkAboutBuilding Permit #1335-2016 - 45 LACY STREET 6/27/2016/ �j1� I 4 ♦ '� � p'�NDo�eq�0 BUILDING PERMIT o1 � ( TOWN OF NORTH ANDOVER °'jAPPLICATION FOR PLAN EXAMINA IO - Permit NO: Date Received � oyq coc Date Issued: �9ssac►+us I ORTANT: Applicant must complete all items on this page LOCATION 45 LAc-q "JI ) f L. ttoyoc_ mA c 1 5 Pri t PROPERTY OWNER m t LK SEL + -t5 Print MAP NO: 10''T_l PARCEL: )'I ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family 'Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: 'Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer 4m* x l '�`� IL tT ro X12 jc R WM_o vA L Identification Please Type or Print Clearly) OWNER: Name: d- (� ;': t C� Phone: 9 A-r r�':�,- I(,A,, Address: 1'� LAS ' \ ����,, � IM,k dl914 CONTRACTOR Name: Phone: ddress: upervisor's Construction License: Exp. Date: ome Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ES77MATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 3. -CIN- FEE: $ 349 Check No.: k�Z�A Receipt No.: lzf_�40 NOTE: Persons contracting with unre istered contr ctors do not have access to the guaranty fund 5gnature of Agent/Owner i ignature of contractor 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. X Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVE /PLANNING & DEVELOPMENT ❑ ❑ COMENTS gLDA I E KUU;I ED DA I t= AFIF'KL)VtU VCONSERVATION ❑ ❑ !"1 1 `/ COMMENTS oc� CnJ�rkav� DATE REJECTED DATE APPROVED EALTH ❑ C�l� ' COMMENeg_ -' 10/ 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 Located at 384 Osgood Street FIRE D PARTM NT - Temp Du pster on site yes no lD Located at 124 Main Street Fire Department 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) i ® Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Pu, .,;Sewer ❑ Tanuiug/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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafter& Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTiMENT - Temp+Qumpster on-site ryes __ _ _. _. . no. Located.at 1240bin.Street. Fire,Depa,trrient,signature/date COMMLNTS f 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 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 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 I ECC Energy code Engineering Affidavits for Engineered products OTE: 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 Location / No. I?� — 2016 Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#/t.,2 _! L j G` Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 299000.00 m $ - $ 348.00 Plumbing Fee $ 43.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 43.50 Total fees collected $ 535.00 45 Lacy Street 1335-2016 on 6/27/2016 covered deck NORTH own of ok144 h , ver, Mass, cocHic149WIC" �qS RgTED 1►4p�.(5 U BOARD OF HEALTH Food/Kitchen PER IT LD Septic System THIS CERTIFIES THAT ........ ... . j......,.11.r�.S ...... .. l�' ........ ................ BUILDING INSPECTOR. . .... .... .. Foundation has permission to erect .......................... buildings on Rough to be occupied as Z37nfp..K.. �.�- ..C,d�!�/.��. ..... ." .. �1 Chimney 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 BLaws relatinWejeck ction,Alteration and Construction of Buildings in the Town of North Andover. C 4 w4h. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST 10 T Rough Service r ............ . .. ....... .:.. :.: .:...................... Final j BUIL ING 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. TOWN OF NORTH ANDOVER OFFICE OF �- BUILDING DEPARTMENT 1600 Osgood Street,Building 20, Suite 2035 �. North Andover,Massachusetts 01845 Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BU(DtNG PERMIT APPLIGA' tON Please print DATE: JOB LOCATION: SIS L�P4K 'it, Number Street Address Map/Lot HOMEOWNER Y=V_i5T t q L(V Name Home Phone Work Phone PRESENT MAILING ADDRESS `.J - A4,jt_�.ovetz- City Town State Zip Code The current exemption for"homeowners'.'was extended to include owner occupied dwellings of one or two family dwellings and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. 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 dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner.(780 CMR Section I IO.R5.1.2) The undersigned"homeowner"assumes responsibility for compliance with State Building Code and other applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 8.2015 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 The Commonwealth of Massachusetts n F Department of2'ndustrialAccidents Z. M- 1 Congress Street,Suite 100 d Boston,MA 02114.2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly NaMe(Business/Organization/Iiidividual): '2-p-1 ST ) Address: L{S L,A••ctt Sz City/State/Zip: /J . &,j+s0%O2 MA 01�6 Phone#: Sur) -9 aq `-)9 Areyou an employer?Checkt&appropriate box: Type of project()pquired): 1.❑I am a employerwith employees(fall and/or part-time).* 7. ❑New construction 2,❑I am a sole proprietor or partnership and have no employees working for me in 8. Remo delirig any capacity.[No workers'comp.insurance required.] I F1I am a homeowner doing all work myself.[No workers'comp..insurance required.]t 9. F1 Demolition 4. am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 E]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.C1 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13.�]Roof repairs These sub-contractors have employees and have workers'comp,insurance. 6.E] an We are a corporation d its officers have exercised their right of exemption per MGL c. 14.EJ Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] n *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the.sub-coritractors fiave employees',* ey must provide their workeis'comp.policy number. .. T arrt an employer that is providiiig workers'compensation insurance for my employees'.Below is the policy andyob 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 elate). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a Ene of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. X do hereby certifji under tlheApa.ns andpenalties ofpeijury that the information provided above is true and correct. Signature: % Date: Ll 4 "a0I(o Phone#: 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 cl x 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, expres's 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 enferprise,and including the legal representatives of a deceased employer,or the receiver or trustee of air individual,partnership,association or other legal entity,employing employees. Hovrever 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 lias 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 performance 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=contractors)name(s),address(es)and-phone number(s)along with their certificates)of insurance. LimitedLiability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry 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 confirmation 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' compensatioA'policy,please call the Department at the number listed below. Self-insured companies should•enter their self-insurance 1'oonse 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 permit/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 ofthe 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 Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel.#617-727-4900 ext.7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia 140.00' �O ti S5530058"w C3 di, wilding eS tbock APPROXIMATE EDGE OF Line�TJ WETLAND AREA PER NOp °\\ / �� / TOWN GIS MAPS. LOT AREA \.a05 / 44,603 S.F.f 163.6' / IP \FND • Shed / 0 10 • oMP�OFFER PS Approx. Septic / APprax.l 6' IPA \ Tank LocationSep tic PPPO� g R G\S Ex. eck t�o If Leach Fielding N / F10Nl P be Remove 'Location / cD �,N Prop. Deck Ex.—Beck' to ^' Prop. Screen 73 Deck be removed = N Porch o \ C Ex. V DH ^1975 Ek 2 Story Overhang ZONING INFORMATION: FND 34. N Wood St Frame / ZONING DISTRICT : R1 Structure MIN. BLDG. SETBACKS: 1'23 FRONT 30 FEET cn SIDE 30 FEET Ex. V 2' REAR 30 FEET Overhang / ASSESSOR INFORMATION: MAP 105D PARCEL 113 81.9' 72 DEED REFERENCE: 2 BOOK: 9935 PAGE: 156 IP FND OWNER INFORMATION: MICHAEL & KRISTI HALE 37 150.00' CALC 155' DEED — 45 LACY STREET SSS.�H N47°45'10"E NORTH ANDOVER, MA 01845 \ ND 0, LACY STREET PLOT PLAN OF LAND <l\ OF ,-ra45 LACY STREET PMA NORTH ANDOVER, MASS. "°F s Y R PREPARED BY: 99� JOHN D. SULLIVAN III, P.E. P.O. BOX 2004 NCIVIL186 WOBURN, MA 01888 gags s �\a� (781 ) 854-8644 SCALE: 1 "=40' DATE: 6/16/16 .Q N E -0 - U U NEW SLIDER E 5068 N CA 0) O 10 C � N I TREAD @ II" o E E 2 RISERS @ 7 114" �7 Jd LIVING ROOM Y BATHROOM E.T.R. E io E.T.R. , T.O. FINISH FLOOR 5TAIR5: +0'-0" NEW ENTRY DOOR 2 TREADS @ I I" 3 R15ER5 @ 7 114" 2868 I Lo HANDRAIL TYP. BOTH SIDES OF STAIR 3'-0" 3' 7" o0 = O U ¢ I TREAD @ I CLI 2 R15ER5 @ 7 1/4" 0 02W 5TAIR5: Lu Z w O 2 TREADS @ II" 3 R15ER5 @ 7 1/4" L N z DECK V) U = Lu cz Jgcz r T.O. DECKING _ Lo 0 5/4x6 PRESSURE TREATED DECKING 1'-2 1/2" @ DECK#SCREENED PORCH 2 A3. SCREENED PORCH GENERAL NOTES: z Ilk 4 EQUAL BAY5 SEE SCOPE OF WORK FOR FULL PROJECT CL SPECIFICATIONS AND GENERAL REQUIREMENTS. cz .0 O E.T.R. = EXISTING TO REMAIN O OJ a ALL WALLS ARE 2 X 4 FRAMING UNLESS NOTED w APPROXIMATE GRADE @PERIMETER -3-4" OTHERWISE. DIMENSIONS ARE FROM EXTERIOR 10 CL LL FACE OF FRAMING TO CENTERLINE OF INTERIOR 10'-4" 1PARTITIONS UNLESS NOTED OTHERWISE. 9'-6" WALL TYPE LEGEND I n • EXISTING WALL FLOOR PLAN NEW WALL scale: 1/4" = 1'-0AV" Icy NEW LEAD FLA5HING @ CHIMNEY A5 REQUIRED C EXI5TING HOU5E BEYOND 0) .N ROOF ASSEMBLY: 7C)A5PHALT ROOFING 5HINGLE5 OVER 15#FELT PAPER OVER 5/8"T*G ROOF SHEATHING a`to O O OVER 2x8 KD RAFTER5 @ I G"o.c. U U E C _2 :9 E Q •: •: -0 -0 u rn c Q -070 WHITE ALUMINUM TRIM TO MATCH EX15TING J Y_ 5/4x6 DECKING OVER 2x 10 PT E FRAMING @ I G"o.c. SEE FRAMING PLAN5 FOR DETAILS RAILING5 @ STAIR co = o U Q SIDE ELEVATION WALL ASSEMBLY: w 1 VINYL SIDING TO MATCH EXISTING � � � scale: 1/4" = 1'-0" OVER HOU5E WRAP Z w O OVER 1/2"WALL 5HEATHING OVER w Ck 0 2x4 KD FRAMING @ I G"o.c. U V) ZQ V) U = Lu T.O. LEDGER 8.. 2 Lo OZ 1 2 3/4"�2 T 0 PLATE Z O Lu \ j \ J W PAINTED WHITE PVC TRIM \ ne W/INSECT SCREENING \ (N 0 a w / 10 EL wLu STT 0: DECK APPROXIMATE GRADE @ — — — — PERIMETER OF DECK o r� 2 FRONT ELEVATION scale: 1/4" N E -0 Q� - . U O :9 :9EXI5TING FOUNDATION E n N C P L Ln _0 -a 2x 10 PT LEDGER W/ 1/21'x G"THREADED KOD5 E E EPDXIED INTO CONCRETE WALL TYP. @ ALL LEDGER LOCATIONS y 2x 12 PT STAIR 5TRINGER5 @ I G"o.c. 5ET ON 12"W x 12"D CONCRETE PAD Lo v 00 2x 10 PT JOISTS @ I G"o.c. = p U Q ry (2) 2x 10 PT @ PERIMETER 0 w AND UNDER PORCH WALLS Lil I 2x 12 PT STAIR STRINGER5 @ I G"o.c. > SET ON 12"W x 12"D CONCRETE PAD Z w C) w � p Lu N Q SOLID MID5PAN BLOCKING vUi U 2 N Lu v = � z Z 6x6 PT P05T BELOW ON g PRE-CAST PIER FOOTING a 5ET MIN. 45"BELOW GRADE (� W/ '51MP5ON"OR EQUIVALENT _Z POST BA5E AND CAP TYP. @ (G) LOCATIONS Q LL LL a O N � w Lu (2) 2x 10 RIM T T-1" 7-17-" I EL w '• (3) 2X 10 PT DROPPED BEAM W/ (2) ROWS'TRUSS-LOK'SCREWS @ I G"o.c. • FIRST FLOOR FRAMING PLAN N 1 scale: 1/4" C N Q� E -0 EE x .000 -du -du E < D cc ai3) c 0 Q) E Ud J E EXISTING HOUSE Lo0000 2x 10 KD LEDGER W/(2) ROWS"LEDGER-LOK"SCREWS @ I G"o.c. I 2 O U Q (2) 2x 10 HEADERS AND TRIMMER @ CHIMNEY I o w Z w O Lu p LJJ II � NZ U 2x 10 KD RAFTERS @ 16"ox. U N U = II II Lu = g 0 4x4 PT P05T5 BELOW W/"51MPSON"OR EQUIVALENT P05T5 BA5E5 AND CAP5 TYP. @ ALL LOCATIONS II II II II (2) 2x8 CONTINUOUS HEADER BELOW II II Z SHOWN DASHED �i 10 �uQ Ln W N ~ LL. LL a � 0 7- w0 2X 10 50LID 5U5FA5CIA 10 CL W N 1 ROOF FRAMING PLAN ` �I 1 scale: 1/4"