The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #365-11 - 56 ELM STREET 11/2/2010 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: J / Date Received Date Issued: ID IMPORTANT:Applicant must complete all items on this page LOCATION 66 Elm �A j Print PROPERTY OWNER 71,,A + 22 �►e. Vk%M+ Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village 0 no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �S.e tic ❑'Well [ Floodplain ❑Wetlands D VJatershe'dlDistnct .Water/Sewer J, . .... - - - DESCRIPTION OF WORK TO BE PERFORMED: ?\Q;ACkCP-fAP4k 84 c cL w%g& n"L xNei 1460 ✓o l ap6rem-1116 Identification Please Type or Print Clearly) OWNER: Name: Davin k S"Ase 414 Phone: 411-115—'6070 Address: Gkp Mm Si- Al dcver MA - CONTRACTOR Name: Phone: 417-0p/-!�? Address: `% 'f�obX �A 5omebde- , MA 01113 Supervisor's Construction License: Exp. Date: q/a?)law, 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: $ �r'o Check No.: X31 Receipt No.: 23� �`�- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature_of_Agent/Owner.: �.� `. - i16 -.- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanning/Massage/Body Art ElSwimming Pools ElWell ❑ 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 COMMENTS HEALTH Reviewed on Siqnature 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Location No. Date �aRTM TOWN OF NORTH ANDOVER F s Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s,K»usa 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2364 %Building Inspector NORTH ONM 0 over 0 No. 365'ao << x_ dover, Mass., Ze 10 COC NIC HE WICK �� 7�5 RATED BOARD OF HEALTH Food/Kitchen Septic System .PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT .............Dau-d........A-roi.....#............................................................................. Foundation has permission to erect........................................ buildings on .....,I (a............q�M ........... t...:...4..................... Rough to be occupied as.. t Chimney provided that the person accepting this permit shall in every respect conform to the 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 ELECTRICAL INSPECTOR UNLESS CONSTRUCTRough .. .... ...................... . ............................................... L11 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. Christopher J. Burgholzer General Contractor 48 School Street Somerville,MA 02143 617-201-1829 chris.burgholzer@gmaii.com MA Contractor's license#96241 For. David and Stephanie Hirst Date. October 15, 2010 56 Elm Street North Andover,MA Proposal Install new vinyl replacement Windows as follows: MI XACT 1650 Series vinyl double hung replacement windows. (with grid, 6/1 in accordance with historical society approved replacement guidelines.) Qualifies for federal tax credit. -Remove old windows. Prepare frames and insulate for new installation. -Remove from property and dispose of all debris. Total estimate including materials and labor $6362.58 *Estimate valid for 30 days. �la„arhu,ctt,- Dclt.u'nnrnt of public ,afrt, Bruud of guiding Rr.-ulatinn, and standard,; Construction Supervisor License License: CS 96241 CHRISTOPHER BURGHOLZER 48 SCHOOL STREET SOMERVILLE, MA 02143 Expiration: 4/23/21212 ( unmi��imcr Tr»: 31329 MpRTy - Ot.,,UE° ri�k0 ' ` own of North. Andover ..t Kwhine Shop Village Neighborhood Conservation District Commission 1600 Osgood Street North Andover, MA.01845 S1CHU5 Ap plication For EXCLUSION From Certificate to ,Ater Certain alterations are excluders from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicantsfor exempt projects must fill out the form below and submit to the Commission Chairperson(contact info below). Date: Au4vsl i-. dbfa - - d Contact Name &Address: Ph (017-77,:-, 67n dh1 rSf fm.�;I,t'r. r E-n-I. �} N rrli,, AnJNu. MA dlic4S' - Ptoject Address: �Ie eI r►t.& Project Description(attach additional pages,if needed): see. CQi*jawA (AeA- Exclusion From Review Requested for. ❑ 1. Interior Alterations existing conditions including materials, design and dimensions. ❑ 2.Storm windows and doors, screen windows and doors. ❑ 9. Replacement of existing substitute doors,substitute siding or substitute ❑ 3. Removal,replacement or installation of windows with new materials that are gutters and downspouts. substantially similar to the existing condition. ❑ 4. Removal,replacement or installation of window and door shutters. Ed 10. Replacement of original fabric windows or doors with substitute ❑ 5.Accessory buildings of less than 100 windows or doors that maintain the square feet of floor area: architectural integrity with respect to form,fit and function of the original ❑ 6. Removal of substitute siding. windows or doors.. 7.Alterations not visible from a public ❑ 11. Reconstruction,substantially similar in way. exterior design,of a building,damaged or destroyed by fire,storm or other disaster, ❑ 8. Ordinary maintenance and repair of provided such reconstruction is begun architectural features that match the within one year thereafter. MSV NCDC Page 1 Current Chair.Liz Fennessy,77 Elm Street,lizettafennessv@yahoo.com.978-688-2915 ' tLORT�y OEtS�eo r4�N0 iL own of North Andover Machine Shop Village Neighborhood Conservation District Commission 1600 OsgAood Street North Andover, MA 01845 1S�ACHUSE� 8 Application For EXCLUSION From Cerrificate to Alter For Items 9,10 or A provide the foilowing documentation: ✓ Photos/drawings of existing doors, windows or siding, as applicable —w!!�Description/Catalog Cuts of proposed materials to be used for doors, windows or siding Plan and elevation of reconstruction for Item II Determination: This project is determined to be exempt 13 exempt from review by the Machine Shop Village Neighborhood Conservation District Commission. Projects that are not exempt must complete the Application for Certificate to Alter, available from the Building Department and be reviewed by the Commission. Determination made by: Vgnawroe T J Neighborhood Conservation District Commission 'l Q Date MSS!NCUC Page 2 Cturent Chair:Liz Fennessy,77 Elm Street,lizettAfennes§,y@yahoo.com,978-688-2915 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA. 02111 UV www.massgov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/FIectricians/Plumbers Applicant Information Please Print Leaib ► l� Name(Business/Organization/Individual): N(,S�zAe �j;c� o'erg Q Address: If 5�,nc1 'SV- City/State/Zip: 4�)omfry& , MA 03,15 Phone#: (of7-ki 'my Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 1-11 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2 I am a sole proprietor or partner- listed on the attached sheet.1 7• KRemodeling . 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 10.F1 Electrical repairs or additions required.] officers have exercised their 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.] employees.[No workers' q ]- 13.El other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeovfners who submit this affidavit indicating they are doing all 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. lam 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 flue of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DTA for insurance coverage verification. X do hereby ce ify under the pains andpenaldes ofperjury that the information provided above is true and correct. Si afore: Date: #2110 Phone#• (Q/7—fir Coll) Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other C ontact Person: Phone#: F µORTN TOWN OF NORTH ANDOVER o�° �eO !s°�°� OFFICE OF 4 BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 Sgc►+us Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE:_ 1114/Its JOB LOCATION: Number Street Address Map/Lot HOMEOWNER (c17-775—K070 Name Home Phone Work Phone PRESENT MAILING ADDRESS 6� Elm A&A- Ar .wee PYA- Dl$X5 City Town S+ate Zip Code The current exemption-for"homeowners"was extended to include owner-occupied 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 said procedures and requirements. HOMEOWNERS SIGNATURE hQj ff_Ae APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535