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HomeMy WebLinkAboutBuilding Permit #410 - 483 CHICKERING ROAD 1/6/2009 NORTH BUILDING PERMIT °� t,ao "tio TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date Received �gSSACHus�� Date Issued: �� IMPORTANT:Applicant must complete all items on this page i LOCATION P t PROPERTY OWNER 4 c--r 60 Print MAP NO: 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 Two or more family Industrial Alteration No: of units: ommercia e air; replacemen Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: n Identification Please Type or Print.Clearly) OWNER: Name: Phone: Phone: Address: CONTRACTOR Name: a Lrt:;:- r'�ivse Phone: rj' c o Address: 1,/ 9 r )c 6!3 on (,, a• /*�rvt;/a v -c r�'1yl. er /,f Supervisor's Construction License C < JZ S" Exp. Date: 2 t a Home Improvement License: Exp. Date:- -"/ a 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: $ '702 �6- a U FEE: $ Check No.: �`�G Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund i nature ofA ent/Owner Si nature of contractor Location 71JOE3 cllv4t4l lle�, - No. a Date !►ORT►, TOWN OF NORTH ANDOVER oma,...° :•�tio 9 i + ; , Certificate of Occupancy $ Eta Building/Frame Permit Fee $ AC Nus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 0 Check #' d Building Inspector 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature i COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments s Conservation Decision: Comments t Water & Sewer Connection/Signature 8,Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street EIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street , ' Fire Department signature/date / -tom— COMMENTS 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, mast or service drop approvalrequires f Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21 A—F and G min.$100-$1000 fine NOTES and DATA— For department use I i I ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 k 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 u 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) ❑ 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 Application I Revised 2.2008 The Commonwealth of Massachusetts Department of Industrial Accidents • IK i ;,�17j' Office of,investigations 600 W ash invon Street Boston, MA 02111 wwrv."WSS-gov/dia Workers' Compensation Insurance-Affidavit: guilders/Contractors/Eieetricians/Piumbers Applicant Information Please Print LeQibi Name (Business/organization/Individual): yt Address: l f xA0qf City/State/Zip:.�is Phone#: '7 Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4. ❑ I am a Q Type of pr6ject(required): neneral contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑ New construction ?. _am a sole proprietor or partner- listed on the attached sheet l 7• [E' emodeiing. ship and have no employees These subcontractors have woric-ing for me in any capacity. workers' comp. insurance. S' ❑ Demolition [No workers comp. ins P 9. p uranc„ 5. ❑ We are a corporation and its ❑ Building addition 3.❑ required-]q. d-] officers have exercised.their 10:❑ Electrical repairs or additions I am a homeowner doing all work right Of exemption myself P P MGL I l.❑ Plumbing repairs or additions y [No,workers' comp. c. 152, �1(4);and we have no insurance required.] t employees. [No workers' 12-❑ Roof repairs comp. insurance required.] 13.[] Other t*Any appiint that checks box 91.m=also fill out the section below showing their workers'compensation oil .. Homeowners who submit.fitis a1udavit indicating ale}-are doir:�a!_;:r:ri a P cy information. l'onttactors that check this box must attached an additional sheet showing t gnu En`n hire-outside conirtu fors rnusi su'omit a new aindavit indicaiing tile name of the sub-:ora=tors and their workers'com t am an a to er p.policy information. mP Y that is rovidke w ° orkers compensation insurance-for"p'a to eas. Below is the ofi information, mP Y p cy and job site Insurance Company Name: Policy#or Self-.ins. Lic.#: Expiration Date: Job Site Address: City/S Attach a copy of the workers' compensation policy declaration avshowing the Policy.Failure to secure coverage as required under Section 25A of p :,e( p y number and expiration date). fine up to$1,500.00 andlor one-year imprisonment,as well as civil p c.1 citi52 es inethe to of a STOP WORK10RDEalties of a imposition of cri of up to 5250.00 a day against the violator. Be advised that a co of this statement may be R and a fine Investigations of the DIA for insurance coverage verification. Py forwarded d=d to the Office of I do hereby certify under the pains¢fidpenaWes Ofperju'Y tizat the information provided above is true and correct SiQurature: ��- Date: 'Phone#: [Eia:1 only. Do not write in this area,to be completed b3,city,or town offecial n: Permit/License# hority(circie one1:Health 2. Building Department 3. City/TownClerk 4. Electrical inspector �. Plumbing Ens ector pson- Phone FORTH Town of Andove r No. L A o 1 dover, Mass., COCMICMEWICK V ADRATED P*? `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING.INSPECTOR THIS CERTIFIES THAT A..� J �0 � r .................. Foundation .......................... buildings on ....... .. ....... !v qa.w...� has permission to erect............. g ..��*,v.` Rough ft � . ..L� j imneyto be occupied as 41AA A !� Provided that the person accepting this Permit shall in every respect conform to the temioh, i.cation.o0n 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 CONSTRUCTION STARTS Rough ............ ..... ...... ...... . .................................... Service BUIL Occupancy Permit Required to Occupy .Building GAS INSPECTOR a -- - - Rough Display in a Conspicuous Place on the Premises — 'Do Not Remove Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. Massachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License:.CS 11353 Restricted.to. 00 -ROBERT A STEPHENSON 11 BIXBY AVE . N ANDOVER,:MA 01845 Expiration: 5/22/2010 (•'ommissioner ' Tr#: 26943 i Proposal Licensed Over 20 Years Experience S and S Building & Remodeling Kitchen • Baths • Custom Woodwork BOB STEPHENSON Complete Interior/Exterior Carpentry 11 Bixby Ave. (978)688-8097 No.Andover, MA 01845 NAME OF OWNER X 11 ot e�•�✓ d ../ —�nJ /F ADDRESS OF JOB r .3 a-,6', /L lid - /L f oZ TEL. DATE- 2 C -)6 y �I We hereby submit estimates for: 2 rZ 4-K &L"ccGti/0 tZ X ".f Ire r/`s; (�C//� l/ � .. l�G'+ � C'2• /e�� � ,f✓h J —'r,v lYT?,•t '1—C S'acv r i C f!`�n�, �'l �i n-7 1 c,.t7'- -n,`a c 6; � S f�: �. Y'Z c�.✓ 1 P/} C LA-1 C/an /o i .✓ iI�✓�L 1c r..i s2 �✓G f p We Propose hereby to�furnish omated and labor—complete in accordance with above specificatio s,for the sum of: 1 J C v� Ci "`�'' ���p dollars a J U a 0 l Payment to be made as follows: All material is guaranteed to be as specified.All work to be completed in a `. workmanlike manner according to standard practices.Any alteration or devia- Authorized tion from above specification involving extra cost will be executed only upon Signature �-��►' Vii /'��`1 written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents,weather or delays beyond NOTE:This proposal may be our control. Owner to carry fire,tomado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. Acceptance of Proposal —The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payment will be made as outlined above. f Signature_CZ441�&4IMIO& Date of Acceptance: v' �.�� e � Signature Commercial Condo Property Record Card PARCEL_ID:210/071.0-0038-0000.0 MAP:071.0 BLOCK:0038 LOT:0000.0 PARCEL ADDRESSA83 CHICKERING ROAD FY:2008 PARCEL INFORMATION Use-Code: 340 Sale Price: 0 Book: 01420 Road Type: T Inspect Dater 06/29/2006 TaxClass: T Sale Date: 12/31/79 Page: 0135 Rd Condition: P Meas Date: 06/29/2006 Owner:OwneN 2321 Tot Fin Area : 897 Sale Type: Cert/Doc: Traffic: M Entrance: C LOCAL UNION C/O DAVID O N2321 Tot Land Area: 0.29 Sale Valid: N Water: Collect Id: RRC _ _ _. _-- _ _ _ _ - Grantor: Sewer. Inspect Reas: R Address: 483 CHICKERING ROAD Exempt-B/L% / Resid-B/L% / Comm-B/L400/100 Indust-B/L% / Open Sp-B/L% / NORTH ANDOVER MA 01845 COMMERCIAL SECTIONS/GROUPS LAND INFORMATION Section: Method S ID: 101 Use-Code: 340 NBHD CODE: 31 NBHD CLASS: 1 ZONE: GB Type W Ca_t_egory_ Grnd-FI Area Story Height Bldg-Class_Yr-Buil _tEff-Yr Built Cost BldgSe_ 9 , YP Code- q-Ff Acres Influ-Y/N' Value Class 4 987 1.0 D 1948 1981 123,900 1 P 340 S 12700 0.290 190,804 Groups: DETACHED STRUCTURE INFORMATION B-FL-AUnt 1 34 1 0 0 897 1 0 Str Unit Msr-1 Msr-2 E-YR-Blt Grade Cond%Good P/F/E/R Cost Class 1 34 2 340 897 1 0 AS S 2900 0.00 1969 A A ///73 4,600 3 VALUATION INFORMATION CONDO INFORMATION Current Total: 315,700 Bldg: 124,900 Land: 190,800 MktLnd: 190,800 Style: Tot Rooms: Fn Liv Area: 0 Bsmt Area: 0 Prior Total: 315,700 Bldg: 124,900 Land: 190,800 MktLnd: 190,800 Apt Unit#: Full Bed: 0 Unf Liv Area: Fin Bsmt SF: Unit Desc: Den/Part Bed: Load Dock SF Fn Bsmt Grd: Res Unit Type: Full Baths: 0 Bldg Escaltrs: Parking Class: C/I Unt Type: Half Baths: Bldg Elevaltrs: Parking Rstr: Comp.Name: Bath Quality: No Ovrhd Dr: Parking Open: Comp.Code: Kitchen Type: Parking Covrd Comp.Class: Kitchen Qual: Atypical: Parking Gar: Condo Type: Wall Height_: Eff Yr Built: 0 Pct Com.lnt: Value Method: Flooring: Year Built: 0 Pct Int Ownd: Base Floor: 0 Ceillings: Grade: Int Adj Fctr: Num Floors: 0 Fire Alarm: _. Condition: Val Adj Pct: Pct Sprinklrs Pct Complete: Val Adj Amt: Heat Type: _ View Quality: Heat Control: View Adj: AC Control: Unit Loc Adj: Fireplaces: 0 Market Adj: Stacks: 0 Condo Val: Hearths: Sound Val: 0 Misc Struc: Misc Str Val: 6 Parcel ID:210/071.0-0038-0000.0 as of 12/31/08 Page 1 of 2 Commercial Condo Property Record Card PARCEL ID:210/071.0-0038-0000.0 MAP:071.0 BLOCK:0038 LOT:0000.0 PARCEL ADDRESS:483 CHICKERING ROAD FY:2008 SKETCH PHOTO 77 in a so 100 Sq Era �� ,_;' �" Mu r t 1S/B A 89 t S% . .xa t 23 23, y 6 483 CHICKERING ROAD39 Parcel ID:210/071.0-0038-0000.0 as of 12/31/08 Page 2 of 2 I� 3275 Date.. . . ..... A66 G 4 NpRTM TOWN OF NORTH ANDOVE O pf ��to ,+stip PERMIT FOR GAS INSTALLATI 1 1 ; ,'**" ,SSAc uSEt � M This certifies that: . : .. . . ^:.. . . 4'I.-.. . .. .. . .... . . . . . . u, has permission for gas installation'. . . . . . . . . . .. . . in the buildings of . . .. . . ..`. .. . . .... .. . t. . . . .. . . ... . .. . . --r1 r l fL!e'L� I�� 1 at ` . . . . . . . . . . . / 1. - . ., North Andover, Mass. Fee!C?. . . Lic. . . . . . . . . . . . . GASINSPECTOR t WHITE:Applicant CANARY:Building Dept. PINK:Treasurer MAP vll� MASSA CATON FOR PERMIT TO DO GAS FITTING ��Type or print) Date (.JC�T 3 19 NORTH ANDOVER,, MASSACHUSETTS Building Locations �J C I' � lf�c bz(Q Permit# Amount S Owner's Name New❑ Renovation ❑ Replacement ® Plans Submitted ❑ y � _ Cn Z W w C Z C z w N — — y ` z = Z Z L Z ZIC C Cu C w SUB-BASE ;M ENT — — BASEM ENT IST. FLOOR 2ND . FLOOR 3RD . FLOOR .4T If FLOG R ST If FLOOR 6T 11 . FLOOR 7 T II . F L O O R 3TIF1 FLOG R (Print or type) / w ��� Check one: Certificate Installing Company Name a t•J J�j �%,�� yQV� Corp. Address _— �o�-� Tyde �� J X14' 'ORO ❑ Partner. Business Telephone 7 ® Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes © No If you have checked ves,please indicate the type coverage by checking the appropriate box. Liability insurance policy ❑ Other tvpe of indemnity ❑ Bond ❑ Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent \ Owner ❑ AQent ❑ hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Signature of Licensed P1u r Or as Fitt ��� Title ❑ Plumber City/Town © Gas Fitter License I umcer ❑ Master APPROVED(OF'riCE USE ONLY) ❑ Journeyman