HomeMy WebLinkAboutBuilding Permit #594 - 55 Peachtree Lane Lot 7 5/7/2009 NORTH
BUILDING PERMIT oFst�eo t%
TOWN OF NORTH ANDOVER or �`'`` ` "'.'° o`'�
APPLICATION FOR PL '' 70
AN EXAMINATION * �
Permit NO: 4 Date Received 04 ktrao 0,V
'js�sSACHU`���,�9
Date Issued:
IMPORTANT:Applicant must complete all items on this page
77-77-7777777-1,
:LOCATION � .
E
� L Print , .
i
PROPE
RTY;.0INNER
"Print
MAP No-- t . .PARCEL;ZONINGroD15TRICT: :Historic District a yes no
'Machine.Shop Village yes a rio
I
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building ne fami y
Addition two or more family Industrial
j Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic
WellFloodpiai�i Wetlands;- Watershed Distn
Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED: �
ill a-2- e3 6e Ya lv� r-Jnri s` C.i.,v
] Siff
5/-Ts a
Identification Please Type or Print Clearly)
OWNER: Name: �A-u L L-)C-m Phone• 7Zk-' 3 0 g9�-
Address: L
o9
SII
GO.NTRACTOR Name.
Phone.
'Address:
Supervisor's Construction':1=icense: Exp., :Date.: `6
Home Imp w. Exp Date:
ARCHITECT/ENGINEER Phone:
Address:d ess. 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: $
2
Check No.: Receipt No.: 20 o
NOTE: Persons contracting wit unregistered cont actors do not have access to the guaranty fund
—
gnature of Agent/Owner _ a ignature ofmcontractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools t
Well ... ... _-
Tobacco Sales Food Packaging/Sales �L
Private(septic tank,etc.- Permanent Dumpster on Site
THE
FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVEDca,
PLANNING & DEVELOPMENT ?0 /
COMMENTS PO ��/JC'1/GQ° 1 Ll °J iO4f ':5 2)2C-)55-
CONSERVATION Reviewed on 0 Si nature
COMMENTS-
41L
HEP,LTH '� Reviewed on 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
i
DPW Town Engineer: Signature:
Located 384 Osgood Street
F1RE'DEPART AI NT 7 Temp.Durnpster oln:site yes no
7
,Located'-at124'Main•Street,: s '
..m
'Fire'Department,signatureldate
COMMENTS -
a
N
Dimension
Number of Stories: Total ,
square feet of floor area based on Exterior dimensions.
q
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 i
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine I
NOTES and DATA— For department use)
I
❑ Notified for pickup - Date
.........................................................................................._.......................................................__..................._..............................................__._......__........................................................................................................._............__................................................._....---- !
.....................................:
Doc.Building Permit Revised 2008
I
Building Department
v,
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
El 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 f
❑ 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
❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
Locations V�PA-z T G-
No. !!ML4 Date
s
NORTH TOWN OF NORTH ANDOVER
F y '
Certificate of Occupancy $
Building/Frame Permit Fee $
s�CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
22UU9
Building Inspector
TAORTH
01" . Of
No. sq
dover, Mass., 9,• + - 01
T O LAKE
COCMICHEWICK V
�d ADRATE D
`s BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT...... 01(1.L
..........�.t.. �................................................................................. Foundation
has permission to erect........................................ buildings on
g ...........CC..... ..C.A.&.k.T4*.t........................ Rough
to be occupied as....... ..xIto..... ...f ��..................� ... ���.. Chimney
ney
provided that the person accepting this mit shall in every respect confofm tot terms of the application on 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
36 a ELECTRICAL INSPECTOR
UNLESS CONS TR STARTS Rough
....... .... ............................................... ......................... Service
BUILDIN ECTOR
Final
Occupancy Permit Required to Ocmpy Building GAS INSPECTOR
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.
%40RTH q
N p
SSACHUSEt
CONSERVATION DEPARTMENT
Community Development Division
May 7,2009
S
Paul DeMont I
55 Peachtree Lane
North Andover,MA 01845
55 Peachtree Lane, North Andover
Expansion of an Existing Deck
Conservation Conditions of Approval, NACC #50
Pursuant to section 4.4.2 A of the North Andover Wetlands Protection Regulations,Paul DeMont,
applicant/ homeowner,filed for a small project for work proposed at 55 Peachtree Lane,North
Andover. The work consists of expansion of an existing deck 6.2' x 6.2' to 9.1' x 16' with associated
stairs. Approximately 150 total s.f. of work (deck and stairs) is within the 100-foot buffer zone to a
wetland resource area which is located to the south of the existing house. Soil disturbance for the
work is limited to the installation of three (3) new sonotube footings. Installation of the sonotubes
will be performed by hand. Work will be conducted approximately 80 feet from the edge of a
Bordering Vegetated Wetland (BVW).The Conservation Department conducted a field inspection
with the developer of the Peachtree Subdivision at an earlier date and agreed with the location of the
wetland boundary.
During the May 6,2009 public meeting,the North Andover Conservation Commission (NACC) voted
unanimously to approve this project as described above. The following conditions were hereby
mandated for the proposed work:
RECORD DOCUMENTS: Plan in North Andover,Showing Proposed Deck, Scale 1" =20' dated
4/16/2009 prepared by Paul DeMont,applicant/owner;
Computer generated drawings titled"Existing Deck"and"Existing
House,New Deck";
Letter of proposal/description of work prepared by Paul DeMont
dated may 1,2009.
CONDITIONS:
1. Accepted engineering and construction standards and procedures shall be followed in the
completion of the project.
2. Excess material and construction debris shall be properly disposed of off site.
1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542 Web ww%v.http://,,vww.townofnorthatidover.com/conservel.htrn
3. Upon completion of the approved project and site stabilization, please contact the Conservation
Department for a final inspection.
4. This permit shall expire on November 30,2009.
Please do not hesitate to contact me should you have any further questions or concerns in this regard.
Thank you in advance for your anticipated cooperation.
Respectfully,
NORTH ANDOVER CONSERVATION DEPARTMENT
e er A. ughes
onservation Administrator
1600 Osgood Street,Building 20,Suite 2-36,North Andover,TMassachusetts 01845
Phone 978.688.9530 Fax 978.688.9542 Web www.http://-,v\vw.townofnorthandover.com/consenel.htm
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MoeTM TOWN OF NORTH ANDOVER
ti: • :+ �. °A OFFICE OF
BUILDING DEPARTMENT
" # 1600 Osgood Street Building 20 Suite 2-36
$ ding
'�.,5�,ne• tom North Andover,Massachusetts.01845
SACNUS
Gerald A Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
ease mint
DATE: L/—/ 7 -0
JOB LOCATION:
Number Street Address Map/Lot
HON EOWNER 1-- b� 0 Iv /
— 3 �Q
Name Home Phone Work Phone
PRESENT MAILING ADDRESS ��
/ j m D1
City Town State Zip Code
The amm exemption for"homeowners"was extended to include owner-o=ipied dwellings to two units or less
and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the
owner acts as supervisor). State Building (Code Section 108.3.5.1)
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 structures. A person who constructs more that one home in a two-year period shall not
be considered a homeowner.
The undersigned"homeowner"assumes responsibility for compliances with the 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 saidP rocedures and
requimmen s.
HOMEOWNERS SIGNATURE
—Aix---ajo /t /f
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Foam Iiowwwnets EmwWtion
ROARDOF \PPEA1.S r00_9511 CONSERV.MON 6880530 HEALTH 688-9540 PL.INNING 68&9535
-
The Commonwealth of M¢ssachusetts
(
Department o Ind.IF urtriaf 14ccutentc i
1
Office.f of
Fnvestigations
W 600
.,
1;�.,a
1, ash ington Street
- Boston, MA 02111
W WYV. 4SS.e Ol��dla
Workers' Compensation Insurance.Afficiavit: Builders/Contractors/Elec�ricians/Plumb
A Iica.nt Information er
s
Please Prinf Lesibly
Name iBus;ness/OrganizationMaividual):
j Address:
SII
City/State/Zip: Phone#: - �- 3 -0------------
Are you an employer?Check the appropriate box:
1.❑ I am a employer with 4. [] I am a a., Type of project(required):
j -----_ c�nera,l contractor and I
2.❑ employees(full and/or part-time).* have hired the sub-contractors :6' ❑ New construction
1 am a sole proprietor or partner- listed on the attached sheet 4 7• ❑ Remodeling.
ship and have no employees These stab-contractors have
working for me in any capacity. workers' comp. insurance. 8. ❑ DcmoIition
o workers' comp..insurance 5..❑ We are.a corporation and its 9• ❑ Building addition
Qequired.] fnhave exercised.their 10:❑ Electrical repairs or additions
3• am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions
yself. [No workers' comp. c. 152
, ;1(4), and we�have no
insurance required.] t employees. [No workers' 124❑ Roof repairs
comp. insurance required.] 13 ❑ Other
*Ary appli=t.that checks box#I.must also fill out the section below showing tiz-ir workefs'compensation pot try inionrsation,
t.
PlDn1COWnetF Wt1Q SLLL)nlli.t'l1fS flid(f.vfl InCitCt3Itn-,liiey af8 r_oino=:i'FE%E:?;; ; cn him outside
xConttactors thal:neck this box mus,arched an additional sheet showing t eontfaf lots rnusi su'omii a new amrinvi*
he name of the s:b c in-:=ting,:ch.
I am an employer that is Prov i in;workers'compensation i cnsactors'and their workers'comp.poli:},infonmation.
assurance or ,
information- .f � employees. Below,is the policy and job site
Insurance Company Name:
i
Policy#or Self-.ins. Lid.
Expiration Date..
.lob Site Address:
Attach a copy of the workers' compensation policy deciarationaa, City/State/Zip:
nu the
Failure to secure coverage as required under Section 25A of MGL F el
152(
lead to thPol1Cy cumber and expiration d2te).imposition of
fine up to$1,500.00 and/or one-year imprisonment as well as civil penalties in the form of a STOP WORK nal penalties of a
of up to 5250.00 a day against the violator. Be advised that a copy of this statement may ORDER and a fine
Investigations of the DIA for insurance coverage verification. ) be forwarded to the Office of
I do hereb,
J under the pain:and penalties or of per' r),that the in f madon provided above is true and correct
Si�rtature:
3 _
Uncial use nnlp. Dn not write in.this area, to be completed by city or town official
Citi,or Town:
Permit/License 4
Issuing Authority(circle onej:
t. Board of Health 2. BU
iiding Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbinu
6. Other b Inspector
Contact Person:
Phone