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HomeMy WebLinkAboutBuilding Permit #327-13 - 53 OLD CART WAY 10/18/2012 (3) TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 2� ` ?j Date Received Date Issu ` IMPORTANT:Applicant must complete all items on this page LOCATION Cis OAR.1 )84y S - Print. . PROPERTY OWNER I ( h PriWJ 100 Year Old Structure yes Ono MAP NO: �PARCEA ZON NG DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 0 One family 0 Addition 0 Two or more family ❑ Industrial ❑Alteration No. of units: 0 Commercial 0 Repair, replacement ssessory Bldg S ❑ Others: ❑ Demolition 0 Other 0 Septic 0 Well 0 Floodplain 0 Wetlands ❑ Watershed District- ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: S Phone: p( o Address: GS- I 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: $ no FEE: $ �� Check No.: Receipt No.: -56� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ownek Signature of contractor Plans Submitted ❑ P ans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 El , 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 ILI COMMENTS c-C')VQ-) (n^ -a' i�1Ilo�Ia. HEALTH Reviewed on / l 9 ! z Signature COMMENTS 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 Towp.]Engineer: Signature: Located 384 Osgood Street_ FIRE DEPARTMENT = Temp Dumpster on site yes - no Located at-124 MainStreet Fire Departrnent signatureldate 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 filo MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use AOJ -� VOCr% I I VN- 4r LN kv �A�&/'V A+- !�C<IrJCA--Uj i ® Notified for pickup - Date i Doc.Building Permit Revised 2010 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 u Building Permit Application o Workers Comp Affidavit E3 Photo Copy Of H.I.C. And/Or C.S.L. Licenses u Copy of Contract u Floor Plan Or Proposed Interior Work Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Li Building Permit Application u Certified Surveyed Plot Plan u Workers Comp Affidavit u Photo Copy of H.I.C. And C.S.L. Licenses u Copy Of Contract u Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) u 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) Li Building Permit Application u Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) u Copy of Contract u Mass check Energy Compliance Report Li 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: Doc.Building Permit Revised 2012 Location ow No. -(7, Date • • TOWN OF NORTH ANDOVER h Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ r Other Permit Fee $ TOTAL $ Check ; E 25859 Building Inspector ��Jr NORTH O 9 F i 9SSACHU CONSERVA-MN DEPARTMENT Community Development Division October 11,2012 Timothy and Hollie Baggs 53 Old Cart Way North Andover,MA 01845 53 Old Cart Way,North Andover Shed Installation Conservation Conditions of Approval,NACC #102 Pursuant to sections 4.4.2 Q) of the North Andover Wetlands Protection Timothy and e Baggs, applicants / homeowners, fled a small project application kP ed at Old Ca shed on concrete North Andover. The work consists of installing a 0'x12' (120 access s will be over the existing dx veway The shed will be installed within existing lawn and � Vegetated Wetland associated Bordering and lawn area. Work will be conducted more than 75 from the Bo g g with a certified Vernal Pool. In addition,three (3) trees will be removed as shown on the photos referenced herein. During the October 10, 2012 public meeting,the North Andover Conservation Commission(NACC) voted unanimously to approve this project.The following conditions are hereby RECORD DOCUMENTS: Application packet including Checklist shed location riatiand trees to be removed ve Photographs showing theproposed Septic As-Built Plan with hand edits Received: October 3,2012 CONDITIONS- 1. Prior to the start of construction the owner shall ensure that the site co tractor the phos has opcse. we kthe small project permit and is aware of the wetland resource areas the limits of2. Shed shall be located more than 75' from the edge of the Bordering viesi b the Conservation Department- 16W epartment 1 and shall be staked in the field prior to a preconstru Y 1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845 Phone 978.688.9530 Fax 979.6x8.9542 Web www.htgK//www.townofnorthandover.roan/eonservel.h" 3. Prior to the start of construction,the applicant shall install four (4)wetland markers (available at the Conservation Department—3 round 1 square) at the existing tree line. 4. Once the shed location has been marked the Conservation Department shall be notified to review the shed location. 5. The three trees identified in the photographs shall be removed and stumps cut flush with the ground. Care shall be taken to not damage adjacent trees in the removal process. 6. Excess material and tree debris shall be properly disposed of offsite. 7. Upon completion of the approved project and site stabilization,please contact the Conservation Department for a final inspection. 8. This permit shall expire 6 months from the date of issuance. Should you have any question or comments regarding the contents of this letter,please do not hesitate to contact the undersigned at 978.688.9530 at your earliest convenience.Thanking you in advance for your anticipated cooperation with this matter. Respectfully, ORTH ANDOVER CONSERVATION DEPARTMENT ,\PA � - AZ Tnntfer Hu des /'onservation Administrator i 16M Osgood Street,Building 20,Suite 2-36,Forth Andoees,massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web www.htt&a://wwwtown4northandovescom/consesvel.htm The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 53 Q�A City/State/Zip: A Phone#: 9 l O` a,S L q I I to Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.El am a sole proprietor or partner- listed on the attached sheet.# ? Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [N workers' comp.insurance 5. El We are a corporation and its quired.] officers have exercised their 10.❑Electrical repairs or additions 3. / I am a homeowner doing all work right of exemption per MGL 1 l.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]i employees. [No workers' comp.insurance required.] 13 Other S kny 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. :ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site formation. Lsurance Company Name: Micy#or Self-ins.Lie.#: Expiration Date: ►b Site Address: City/State/Zip: ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). tilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ae 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 'up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of vestigations of the DIA for insurance coverage verification. to hereby certifj i, �i r he pa' s and enalties ofperjury at the information provided/above is trite and correct nature: Date: V Lone#: 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r 1 V NORTH - _ : t : :. .c . ve, � o h , ver, Mass, b - I f • 20. A_ coc"Ic Nt WKM ld A0"ATEO 1'P�' S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT �....... 5'.�-j-j S BUILDING INSPECTOR . .G.! TI.GIL .. has permission to erect .......................... buildings on ... .... ...-.......................... Foundation Rough to be occupied as Y..l.2..,-......� .............. 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. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final 3lo - PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST 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. SEE REVERSE SIDE