Loading...
HomeMy WebLinkAboutBuilding Permit #211 - 51 FOXHILL ROAD 9/26/2008 BUILDING^PERMIT o* "°oT1 32 yts . 6*� OL TOWN.OF NORTKANDOVER ° , APPLICATION FOR PLAN EXAMINATION Permit NO: 1 ` Date Received 3 Okf Arno -��SSACHUS Date Issued: IMPORTANT: Applicant must complete all items on this page L w r LOCAT�ION u mn Print pRQPERTY'OWNEFt CG SU NA Il ... Pnnt A a lig IUTAP,NO: PARCEL: : 'ZONING DISTRICT Historic District yes no achne Shop Village yes, TYPE OF IMPROVEMENT PROPOSED USE Residen ' Non- Residential New Building One famil Addition wo or more family Industrial ration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic 1r!lfell a Floodplain Wtlands 1ltilatersheditrict" aterlSew e DESCRIPTION OF WORK TO BE PREFORMED: S �oujL -,!- ADD �teoyf✓t� �e,r'-r' Si��" �P�'�A� G � ova Identification Please Type or Print Clearly) OWNER: Name: .,moi' I c S41AAN1z.e 414Hiy&- -z— Phone: k7 h-7® Address: / CONTRACTOR Name: . �r 'a .� Phorie.. c � ; ° Al Address r .�yjf1:.✓ <S' 01 �N �. Stpervisdr's C.onstruction;License Da# F Homet.Improvernent',Ljcense. `' x Date j ARCHITECT/ENGINEER Phone. Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �, o b FEE: $_ � d ;.. - Check No.: re � �� Receipt No.: � NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund i Signature of Agent/Owner- 'a , � �'"° Signature of contras#or 'a LocationY— ' No. �r' Date „oR,M TOWN OF NORTH ANDOVER o?o.�...o .•,Moog Certificate of Occupancy $ s' E<�' Building/Frame Permit Fee $ d "� ACMUS Foundation Permit Fee $ .' Other Permit Fee $ TOTAL $ Check # f r 2 ! 555 Building Inspector Plans Submitted Plans Waived =Plot 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 r CONSERVATION Reviewed on Si nature (� COMMENTS ' - N _ - HEALTH- `_ ; Reviewed.on Signature -: COMMENTS .� \ Zoning Board of Appeals: Variance, Petition No:—,- 'Zoning Decision/receipt submitted yes Al. Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPAPTME',NT :Temp Dumpter,on site ^yes. n� Located gat 124Main Street' Fire`Debartrn+ent signature/date n s r y COMMENTS m i as 9 i Dimension r Number of Stories: Total square feet of floor area, based on Exterior dimensions. I 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 (:'0 CIO s s ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 signn off from Fire Departmentprior 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) ❑ 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 7. ❑ 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 lication Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 I� I, Hashem Construction, Inc. 133 Main St. (Rt.28) No. Reading, Ma. 01864 978-664-4191 Contract for Siding and Farmer's Porch 51 Foxhil) Rd. No. Andover, Ma. Owner: Eric and Sue Buchholz Sept. 25,2008 Contractor: Hashem Construction, Inc. Lic.#CS 40870, Home Improvement# 116025 Job Description: Remove siding and corner boards, Blocks for light fixtures, install Tyvek housewrap, New 5/4 Aztec or comp. corner boards and % 1x10 freezeboards, Block tops and bottoms of corners, And Install new hardy plank primed siding approx.5"exposure.Add Farmer's porch across front of main house and left side in front of family room area out 6'on big foot style sona tubes with roof approx.4 pitch with asphalt shingles and ice and water shield. Decking to be 5/4 Timberteck,vinyl Railings,6x6 Fiberglass columns(approx.6)on 2x8 pressure treated deck.Trim garage doors with 5/4 and crown molding tops.Ceiling of porch to be vinyl white bead board 3" look. Price for the above work is $45,000.00 Work to begin approx.10 days after permits and to be completed in approx.60 days. Contractor not responsible for delays due to availability of materials or weather. NOT INCLUDED: Painting,tree removal or shrubs,gutters,or plans. Deposit due at Building Permit $ 15,000.00 Payment when farmer porch framed and corner boards on: $15,000.00 Balance on substantially complete $ 15,000.00 Total Payments $45,000.00 Owner Mntractor Owner NOTE: 1 THIS PROPERTY IS CONNECTED TO THE MUNICIPAL SEWER SYSTEM. >>s� 2) THIS PROPERTY IS NOT LOCATED WITHIN g �p THE WATERSHED PROTECTION DISTRICT. �5��41 LOT AREA 1 27,863 S.F.t ZONING BOARD OF APPEALS APPROVAL: ZONING BOARD OF APPEALS APPROVAL IS NEEDED TO CONSTRUCT THE PROPOSED 110.0' FARMER'S PORCH AS SHOWN. / h h PROP. 1 STORY h N ADDITION NGr /AJ N? ' �N 0 0. 55.8' o N EX. BULKHEAD 2 CAR EX. 2 ST. 20.4' ZONING INFORMATION: ,GARAGE WD. FRAME EX. BRICK STRUCTURE CHIMNEY ZONING DISTRICT : R2 13.0'x, ' #5 20.9' MIN. BLDG. SETBACKS: 51EX. 1 FOOT 4 FRONT 30 FEET EX. ROOFED 20 21 1' SECOND FL. / PORCH OVERHANG SIDE 30 FEET REAR 30 FEET $01 PROP. FARMER'S ASSESSOR INFORMATION: PORCH 55.0' MAP 37C PARCEL 38un w DEED REFERENCE: o_ BOOK: 110 PAGE: 345 �> �+ R=127'38, I OWNER INFORMATION: L=116.13 _ ERIC & SUZANNE BUCHHOLZ � 51 FOXHILL ROAD �g6p�1 FOXHILL ROAD NORTH ANDOVER, MA 01845 5g I CERTIFY THAT THE STRUCTURES SHOWN WERE LOCATED PLOT PLAN OF LAND BY AN INSTRUMENT SURVEY AND EXIST ON THE GROUND AS SHOWN. #5� FOXHILL ROAD NORTH ANDOVER, MASS. F, q ' tt� PREPARED BY: ' J' " JOHN D. SULLIVAN III, P.E. 6 y 13P2 22 MOUNT VERNON ROAD �.'v"E I a BOXFORD, MA 01921 gSsroNAG� ' rp� �to (978) 352-7871 SCALE: 1 "=40' DATE: 9/22/08 �1 = � 7e: e V®RTH o'" o � � Andover . No. �® C, o , dover, Mass., 02 ocO Q LAKE COCHICHEWICK V ADRATED iPF��S S BOARD OF HEALTH PERMIT T D , Food/Kitchen Septic System • BUILDING.INSPECTOR THIS CERTIFIES THAT........ ..�i► ..... �. '�i.............. .......................... .......................................... Foundation has permission to erect......................................... buildings on ....S.l............�.k*.....&%A.(.(...... ... ... Rough to be occupied as..... .,r. ....... M:!!�!!/�.......,�... .�. ........ ...... .....ft �►.� Chimney permit h II irf eve respect con orm to the termshea lication on file inprovided that the person accepting this pe d s a ry ppp 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 PERMUT EXPIRES IN 6 MONTHS vI ELECTRICAL INSPECTOR. UNLESS CONSTRU . S Rough .................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE smoke Det. dwti�� < 3vciiffo� � co�►r�tiv� ,e , If _ �. ►� 'I cp r A.� N s/, -R.-e,,P It FT Fc, s� The Commonwealth of Massachusetts . L1 Department of Industrial Accidents � ... Office of Investigations v'� 600 Washington Street �a1 K= Boston, MA 02111 www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /�-5/fm L G/�/.1� /��✓e 7'i��r/ �N� Address: 7 IM41,L1 S7- City/State/Zip: IU©-�� �-; e�- Phone #: Are you an employer?Check the appropriate box: 1.❑ 1 am a employer with 4. El Type of project(required):I am a general contractor and I Type of construction employees(full and/or part-time).* have hired the sub-contractors 6. 2. I am a sole proprietor or partner- listed on the attached sheet. $ 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g, ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised.their 10.[] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp. insurance required.] +Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. Homeowners who subinit_this aiiidavii indicating they are doii-ag ail work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am 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. Lie.#: 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. I do hereby certify under the pains a d penalties of perjury that the information provided above is true and correct. Siartature: 9 " Z Date: 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 chapter 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, express 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 enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However 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 has 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability 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' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license 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 permitllicense 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 of the 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 pen-nits 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 Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia