Loading...
HomeMy WebLinkAboutBuilding Permit #893-16 - 450 CHESTNUT STREET 2/17/2016 J . , io 4 BUILDING PERMIT ,�20•`'``�M"•a�o� TOWN OF NORTH ANDOVER p APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: �9SSACHUS ORTANT:Applicant must ccomplete all item on this page //�! LOCATION `t� �� vzl Print PROPERTY OWNER Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial Y Alteration No. of units: ❑Commercial ❑Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ❑Septic ❑Well ❑Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer o/1 CL s Identification Ple se Type or Print Clearly)A, � 7 S- -72-5� 36 OWNER: Name: e /9 Phone. Address: AA I CONTRACTOR Name: Phone: --,-j Address: Supervisor's Construction icense- CS— O�o,O� Exp. Date: lO �Ol 7 .7 7 Home Improvement License: 1�� Exp. Date: / CJ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDII NNGG PERMIT.-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED CW$125.0,0 LP Q S.F. Total Project Cost: $ J� �� FEE: $ ���_Ivz Check No.: Receipt o.: NOTE: Persons contracting with unregistered contractors do not have access to the gu anty fun Signature of Agent/Owner Signature of contractor r 4 NORTM BUILDING PERMIT O� tLED -b6 TOWN OF NORTH ANDOVER A APPLICATION FOR PLAN EXAMINATION -y _ Permit No#: Date Received 'fs °mare°�Pa 4h i �SSACHUSEt 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 Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition 0 Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other g ❑ Septic 0 Well' l7`FI'oodplain �Wetl`and'_s, ❑ LUVatershedF�®tstnct h --- DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: � 1 Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: I 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: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund i_ffiffi--i °Signature gficontract©r� — I Location Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ / • �J Building/Frame Permit Fee f Foundation Permit Fee $ Other Permit Fee $ TOTAL $ A Check# `"7 2 Building Inspector I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISP—OSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent 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 6 ° Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRErDEPAR+ MENT Tmp'Dumpster on site' �yes,�,a � Located at 124 Main Street % ' � i _ ' ,. DepartmentatureLdate *- 4 .: ti _ r� s �`Y.i r� t 'l � ?7," ra�yj s;I�k/N �p•}"e°"'4y'--�•nYr-- "f; ' t•: 'Alk !1I i *r ''i�`ti+r 2 an ► `t ? f1.. } �N, *vi+ q•, t r a rj{ �pi.w�:JC�e I:• qk K'�¢ tri : tt t5 t . ie H, . R + rtrr3'.+r �'11�.t1:* '`Y• GOMMEE`d l•�:7 �r. '�n�* 4,r��;�• P!ts••tj [ t fr.. 2 i a .3w,,. us. ,..{ ns,v zJ '"�`ti$!'i'ia t-'�t4.o, l�k+:+1�.�.3_.r. ,�•<, i Dimension Number of Stories: Total square feet of floor area based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, roust 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 i 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 4. 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 1.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 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 Doc:Building Permit Revised 2014 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 50,357.00 m $ - $ 604.28 Plumbing Fee $ 75.54 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 75.54 Total fees collected $ 855.36 450 Chestnut Street 893-16 on 2/17/16 Basement Remodel r NORTH .c . : ver o " - No. Sl 5 -2zl� � i o�h ver, Mass, 'a- Q CDCMIC149WICK 1' /. P`y 7� R�7ED P Cl S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System F or . . � � .... � .. BUILDING INSPECTOR THIS CERTIFIES THAT ................. ... .. .......................... U.................... Foundation has permission to erect .......................... buil ings on . `� G.. . . . .. . W Rough to be occupied as,2.!...900!��............4 ...... ............ .................................. 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 By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. t/A ��� PLUMBING INSPECTOR /� VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR ® UNLESS CONSTRUCTI S 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. ".� �► 8 Manning Road Suite#2 InJYEWaltham, MA 02452 Office: (781)373-1966 Cell: (617)480-3233 dave1hye@comcast.net February 15,2016 Mahesh Narayanan 450 Chestnut Street North Andover,MA. Subject: Renovation of existing basement Contract The renovation and completion of the existing basement as per plans and spec in the letter dated February 3rd, 2016. The total cost for said work is$50,357.00. The Building permit cost is$612.00. Payment terms as agreed are 1/3 payment after permit is issued and work begins. 1/3 payment after rough inspections are signed off. Final payment after all final inspections and work is completed. Contractor Home Owner David Naj Mahesh Narayanan Date 02 r/ �J� Date I f 6 6 n� ,nw oo of f i i C�Cose�� u is .�„ 1427„ The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. hcant Information /J Please Print Legib Name(Business/Organizadon/indiv' al): Address: YL City/State/Zip: Phone#: 617 Z / L5-027�✓ Are you an employer?Check the appropriate box: Type of project(required): LE]I am a employer with employees(fidl and/or part-time).* 7. ❑New construction IN I am a sole proprietor or partnership and have no employees working for me in 8. ll Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 4. I 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.F 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 t 6.❑We are a corporation and its officer,have exercised their right of exemption per MGL c. 14.Q Other 152,§I(4),and we have no employees.[No workers'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. tContmctors 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-contractors have employees,they must provide their workers'comp.policy number. Ian: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 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 a STOP WORK ORDER and a fine 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 DIA for insurance coverage verification. I do hereby cer' dert1 .p nd p nalties of perjury that the information provided above is true and correct. Signafore: 1 Date: 02-/3 ' 00vv1 Phone `t'O Official use only. Do not write In this area,to be completed by city or town officiaL City or Town: PermitlLicense# 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#: a # Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-049102 Construction Supervisor ar DAVID M NAJARIAN 8 MANNING ROAD FLOOR 2 - = ' WALTHAM MA 02452 L/�-- Expiration: Commissioner 10/1412017 c - ��e �rn�lr��ra�rruea�l�a�U�l/�araae�a�cl�; Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 'HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: _ Registration: 170229 Type: Office of Consumer Affairs and Business Regulation N Expiration: 9129/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 HYE INTERIORS DAVID NAJARIAN 8 MANNING ROAD 2ND FLOOR WALTHAM,MA 02452 Undersecretary of vali *ittio si `re