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HomeMy WebLinkAboutBuilding Permit #484-12 - 56 ELM STREET 12/16/2011Permit N0: _ /2 Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received I . IMPORTANT: Applicant must complete all items on this page LOCATION 54) %1V Print PROPERTY OWNER 'DcvJ N,c- Unit # Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village a no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building gOne family ❑ Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial 0( Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other { ®ISeptic� Well IiFiloodplain, �tWetlands; ©I `WatershedlDistnct DESCRI(PTION OF WORK TO BE PERFORMED: 11 t1 �em�.1.�_,_-�����x��1rrJ� �1' ��, •�lo.rt., bU'�, r .Wlk]\- v� t�p'l'L,n�tdyi�. �(,j i'hQ\d1`TC1�\liC��� ��QCt:,YYut►� Kr1 � E'_'d,��1�i6. t,IJM �E1[L� tification Please Type or Print Clearly) - lie, 71 Address: 64P elyr, S� CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Home Improvement License: )Exp. Date: Exp. Date: ARCHITECT/ENGINEER Phone: PM Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ Jq6eaS //0, oao FEE: $ Check No.: 0 9 0 � Receipt No.: "? y fel NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 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 PLANNING & DEVELOPMENT ❑ DATE APPROVED COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comm Conservation Decision: Comments plater & Sewer Connection/Signature &Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site Located at 124 Main Street Fire Department signature/date COMMENTS / Located 384 Osgood Street yes ?/ no Location s� No. 9,f Z/ ` �2 Date /a//6 11 N0e7N TOWN OF NORTH ANDOVER L �o Certificate of Occupancy $ X CHU T., Building/Frame Permit Fee $ �0 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # (/ 0 24 C 9 1 uitding Inspector m m m m //m (/ mii Cl y d O d CO) CD Z y CLO �• r a O y o c CD a� o cr CD CD O W c C CDCD y. -• CL O CO) CO C CO) O CD z CDO CD O CD �7 w C 0 Cn C/) z cn n2 0 c J Cn Cn O m W o --1 dH <,O N = coa,no o m O_ d d lo ca 1 M �m m a z cc, O N C9m ' H OC � _� n Cl) m H y' C- J -0 0 4 o m a m GO . ; , D1 N � CL Q � � d CD CA Cos 0 .�► CD 1 CD O O .� ..r O cD O o � ^� O "'•� CD c CD W N � O C CM d CL -S: nn C. O O ~" co Z 0 w a CL b� � R 0' L . ro H MA z H 0 0 c "°RT" TOWN OF NORTH ANDOVER QlS7lIID tib ��O ° OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, -Suite 2-36 Sys°n+nD •P"t45 North Andover, Massachusetts 01845 �SACHUSE Gerald A. Brown Telephone (978) 688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER•LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE:__ i Lljj/ II JOB LOCATION: IJOMEOWNER Number Street Address Name Home Phone PRESENT MAILING ADDRESS— Map/Lot Work Phone City Town . . State �~-� Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwelling 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 gwns 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.11 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 APPROVAL OF BUILDING OFFICIAL, Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530F HEALTH 688-9540 PLANNING 688-9535 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 1 Please Print Le0bly Name (Business/Organization/Individual): Oav, 1 Address: 5 (o Eltv%- `:4 City/State/Zip: h/. kJow't(- /4A Phone #: C17 ` 71 �— %(i7() Are you an employer? Check the appropriate box: 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 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. 0 I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other -any appucanr mar cnecKs nox i� t must also iiia out the section below showing their workers' compensation policy information. t Homeowners 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. 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. Lic. #: 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 DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sgi17� nature: Pit f Date- /7 /,t./// Phone #: f,/7 - 77 5 `ROM 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 #: The'Comrxtonwealth of Massachusetts 'Department of Fire Services' Office' of the State'. -Fire Marshal P.. 0. Box.IO2S StatcRoad, Stow_ NIA 01775 - 'APPLICATION FOR PERMIT Date: N. An:d o v e r Termit:NO ( Cityor Town.) . (1f Applicable) Dig Safe Numb In accordance with theprovisioas ofMG.L. Chapter - 10 as provided in Section 5 2 7 C MR 3 4 application &hereby made Start Datb by tt n n w 1 (Full.name ofperson, Firm or Corporation) 'State clearly Address 7 ,j, N purpasefor (StreetocF.O.Bac City or Town} which permit isrcqucstcd Forperrnisbiif Locate i of bulding. dumpster or constr 6t. rrn/rpnnvatinnrimnliLinn . • /a • Cgmmeuts: dumpster• must be 25' from structure or 'covere • iah r notat ;n „tee . 5 (o .� F,_ t� Anil t Gi7c location oy strect and no., or dcscrr a in suehmauacr az to-provied adequitc ideatificaEon of1ccadou. Name of competent'operator CcrC'Na. (If Applicable ) DatcLssucd-rejected l Z-1 /� B (Signature of -Applicant) Date of expiration / , Z Fee S 50.00 Paid Due UPTh -e "Commonwealth of 'Massachusetts Departmeht•of Fire Services - Office of the State Fire Marshal 1. P. 0. Bas 1025 State"Road,.Stow, MA 0177.5 ' PERMIT North Andover Date: :Permit No •(Gtyof Town) ' (1FApphcable •) � �=xf;tIn accordance with the previsions of NIG-L-14 8 Chap"ter�Q asproyided in section S 7(,,�R34This Pcrautis granted to:. Full name of person, Firm or Corporation Pcaodssionto locate dumpster - for construction/renovation/demolition of building. Co=ems: dumpster. must be. 25 t from structure Restrictions: if unable to lace with required " clearance dumps"ter must be covered with 1 wood or tarp end of 'work -day at---- - --- _ k. ivc l ation by street and no., Fcc P ty50.00 This Pill c (Signattrrc n sucti ma to pr iel ade uate identification.of location ) Fire Chief granting permit) Olfical granting pcani[ ( Title ) 0� NORTM Town of North Andover Machine Shop Village Neighborhood Consamon District Commission 1600 Osgood Street North Andover, MA 01845 =�ewus� Application For EXCLUSION From Certificate to Alter Certain alterations are exchtded from review by the Machine Shop Village Neighborhood Conservation District Commission in accordance with the Bylaw. Applicants for exempt projects must fill out the form below and submit to the Commission Chairperson (contact info below). Date: IT Contact Name & Address: a'Ad- 6rak - 5keQt %e Nim\ 6x9 E1w,�J! N. Andr,,.r Md oae VC, ProjectAddtess• 56 E\rn Project Description (attach additional pages, if needed): Renlocdnrni n� i2� o1"fQ -11t Mnd UA 1,04 VIA'"JAI POn!,%Agni� I %e.Vto,)511i IA!1e1Ldl EitAtUm.nf W0016uK 611ya� r Exclusion From Review Requested For. w'l) m mlam e-xI SVI A W L ►'►e /( 'paat�. c). ❑ 1. Interior Alterations ❑ 2. Stone windows and doors, screen windows and doors. ❑ 3. Removal, replacement or installation of gutters and downspouts. ❑ 4. Removal, replacement or installation of window and door shutters. ❑ 5. Accessory buildings of less than 100 square feet of floor area. ❑ 6. Removal of substitute siding. ❑ 7. Alterations not visible from a public way. ❑ 8.Ordirtaty maintenance and repair of architectural features that match the existing conditions including materials, design and dimensions. Ur", 9. Replacement of existing substitute doors, substitute siding or substitute windows with new materials that are substantially similar to the existing condition. 0 10. Replacement of original fabric windows or doors with substitute windows or doors that maintain the architectural integrity with respect to form, fit and function of the original windows or doors. ❑ 11. Rccomstruction, substantially similar in exterior design, of a building, damaged or destroyed by fire, storm or other disaster, provided such reconstruction is begun within one year thereafter. MSV NCDC Page I Current Chair. Liz Fennessy, 77 Elm Street, 1i7ettarennt%sy(0vahon.c0m, 978.688-2915 NORTH �j O�,tyte �ati Town of North Andover Machine Shop MW Neighborhood Conservation District Commission 1600 Osgood Street North Andover, MA 01845 s4cau5 Application For EXCLUSION From Certificate to Alter For Ittems 9,10 or 11, provide the following documentation: Photos/drawings of existing doors, windows or siding, as applicable _i—IDescription/Catalog Cuts of proposed materials to be used for doors, windows or siding _Plan and elevation of reconstruction for Item I l Determination: This project is determined to be exempt C1 t 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. IMAM `0 �YW E Neighborhood Conservation District Commission 151�CC,�I Date MSV NCDC Page 2 Caner Chair. Liz Fennessy, 77 Elm Street, lizettafennessv@yuhoo.com. 979-689-2915 1650 Double Hung Windows aw4 o� ;6-u i�t�t}it+n[?►vii • [ilt�itll�sdYfkly �sii,iT•gllli mdtr, msyy�rrfru•pT is�gt)xmn :_rs�fta�s�xss�sia rijljp=rJum'_ifitpfetBTrr�l�t' i 71R1IlE l-firr '1 YKrii� iGTJ lli�/�:ilml:r"p rlloT�3C�!F1)iS.t�. Fully welded construction: Creates structural strength In sash Balance Channel Covers: Provide a stylish aesthetic andframe. -� - Beveled Dual nit* -vents: exterior edge: Creates the look othand-crafted added security I� windows. , and ventilation. I Double -pane insulating glass unit: i Double -pane glass with low -conductance spacer Improves thermal efficiency ` and reduces condensation. I I I I Steel -Reinforced Meeting Rails: For increased strength and weather tightness. Extruded Latching Half Scr For maximum ventilation ani Insect control; easily remove from Inside your home. Welded, true sloped For traditional appea and excellent air and performance. I Patented Detent Clip: h Prevents the top sash from drifting, making for greater ease in closing and locking of the window. t Tilt -in sashes: Sashes tilt in for easy deaning. (double hung) Y\'Roctssod tilt latches: Keep the view dean and uncluttered. Both sashes are extenor glazed: ` Md aesthetically beveled to the glass for an elegant design and appearance.