HomeMy WebLinkAboutBuilding Permit #221 - 58 COLGATE DRIVE 9/21/2007 TOWN OF NORTH ANDOVER F p
APPLICATION FOR PLAN EXAMINATIONC mc-
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Permit N0: �) Date Received ` ��- s RATED•
SACHUS
Date Issued:
IMPORTANT Applicant must complete all items on this page
s firo* tal
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IS
TYPE OF IMPROVEMENT
PROPOSED SE
DU
USE
ial
Residential Non- Resident
❑ New Building ❑ One family
❑ Addition ❑Two or more family ❑ Industrial
Iteration No. of units: 0 Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition 0 Other �5
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Please T I
Identif Type or Print Clearly).
OWNER: Name: kd8eer �✓��" Phone:
Address �
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'"iia air*��' y t'� .� rT '� = 4.. .,� � r,� �� .� S�" -� �' +• .
Gym a
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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: $ V 33 3� � _FEE: $ 2(�2
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Recei t'No. 020
:
Check No.: 1 1` p
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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Location 13 -d l r 09
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No. 27, 1 Date ' , 16
TOWN OF NORTH ANDOVER
F 9
certificate of Occupancy $
�i�s'••°•E<� Building/Frame Permit Fee $
JACMUS
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
206-18
Building Inspector
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 ❑
P '
nvatese tic to etc
� p � ❑ Permanent Dumpster on Site ❑ I
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING &-DEVELOPMENT ❑ ❑
COMMENTS
D E REJECTED DATE APPROVED
CONSERVATI
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
t
Conservation Decision: Comments
Water & Sewer Connection/Signature &Date Driveway Permit
Located at 384 Osgood Street
NOyja
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NO
.fi�`.s t
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
i
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 e (For department use
❑ Notified for pickup - Date
Doc.Building Permit Revised 2007 !
I �
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
o Building'Permit Application
❑ Workers Comp Affidavit
E3 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 sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks {
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
i
❑ Workers Comp,Affidavit I
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o 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)
r
o Building Permit Application
o Certified Proposed Plot Plan «
❑ Photo of H.I.C. And C.S.L. Licenses
i
o Workers Comp Affidavit
Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
L Mass check Energy P P Compliance Report
o 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 2.2007
NORT 9
Town of6 over
No.
o == over, Mass., •
� O
COC C E I K
7�ADRATED PP5
S C BOARD OF HEALTH
Food/Kitchen
PERMIT T Septic System
T 1 BUILDING INSPECTOR
THIS CERTIFIES THAT..........
.... ...............................�. �....................... ............................
••••• ••••••••• Foundation
has permission to erect........................................ buildings on ...rct........ .�. A...... ................. ............... Rough
to be occupied as & x.3z........1%fm ...... C. ►••� Chimney
..... ... . .... . .... . .... .... ...............................................................
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provided that the person accepting this permit shall in every r spect 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
PERMEXPIRES IN 6 MONTHS
IT
UNLESS CONSTRU N TS ELECTRICAL INSPECTOR
Rough
Service
,BU1 DING R
Final
Occupancy Permit Required to Ocatpy 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.
Smoke Det.
'I
I
Bob Winne
58 Colgate Dr.
N.Andover Ma
686-0910 Sept. 13,2007
4
Contract For 8'x32'Farmers Porch:
l.Obtain Building Permit
2.Excavate 48" below grade and install six 12" concrete filled sonotubes attached to six 30"
bigfoot footings
3.Attach 4x4 support posts using six galvanized post anchor bases
4.All joist framing will be 2x8 pressure treated 16" on center
5.Install 5/4x6 Weatherbest Tuscan walnut composite decking,installed with colored
Trapeze screws
6.Construct header for roof support using 2x10 KD sandwiched with '/2" cdx plywood
7.Construct hip roof using 2x10 hip rafters and 2x8 common rafters,2x6 ceiling joists
at 16" on center
8. Install 1/2" cdx fir plywood roof sheathing,felt paper and roofing shingles to match existing
house.
9.Install six 10 "round smooth fibergalss columns with cap and base
10. Ceiling material will be 1x6 beaded solid pvc material ,white in color
I LConstruct two steps to grade (five foot wide)
12.Bottom section will be closed in with PT heavy duty lattice and Azek pvc skirt boards
13.Install five recessed lights to be controlled by existing switch,remove existing receptacle
and install on front of new deck
14. Move existing hose bib to driveway side of house
15.Install new Therma Thru fiberglass with two glass lights at top (to match existing door)
16. Install new Schlage hardware to front door
17.Install siding around roof area where siding was removed
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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 Please Print Legibly
Name (Business/Organization/Individual): -Ra N fc TfLW�'1 eo CAKW,-,N SYJ4-06�
Address: 51-/2 A r1g,n/ 5_1,
City/State/Zip: OX F1 (Z Q 444 6VfW Phone#: g 7 7i(od�f
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 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2:X I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition i
working for mein any capacity." workers'.comp, insurance. 9. ❑Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.0 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 �,�,�Q
insurance required.] t employees. [No workers' : 13.�Other- � �"tel
comp.insurance required.]
*Any applicant that checks box#1 must also fill 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.
lContractors that check this box must attached an additional sheet showing the name of the sub-contractorsand 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 Dater
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 thepains andpenalties ofperju that the information provided above is true and correct.
Simature: Date: d
Phone#: 7, 9, �5-
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
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#: i
Jlxe �o7n�recax,r�,a6Ch af"wi!/Ccraaczc+psl<rkd2a ter, � ;� ,
Board of Building Regulations and Standards r
License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration.date. If found return to:
Registration: 101824 1 Board of Buiiiling Regulations and Standards
Expire#ics� x/29/2008 s One Ashburn%n Place Rm 1301
Type PnBoston, !\1a.C%1108
FRANK'HOWARD,.CARpl5, 5-01 L< j
f;
Frank Howard
512 A MAIN STREE
Boxford,MA 01921 " Not valid v ifhon s� nature
i Uepirtyilminictrator g
6�e 1°auuea _a / Tr
'AL80ARQ OF'BtItL1�11 G REdUtrAl l t
Licenser CONSTRUCTION SUPERVISOR
Num15+ERr CS 042443
Btrthdat� 0913/1954
Expires 09/0312008 Tr:_no: 1085.0 .1
Restricted OQj -�,7
FRANK L HUWARi � µ,
s 512A MAN'ST
_�! Gammisstaner`.
CERTIFIED PLOT PLAN
LOCATED IN NORTH ANDOVER, MASS.
SCALE.I"= 40' DATE.9/20/2007
Scott L. Giles R.P.L.S.
I Frank. S. Giles R.P.L.S.
50 Deer Meadow Road
North Andover, Mass.
LOT#17
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38,080 S.F. 0
PLAN#3373 0
I N N.E.R.D.
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39' •c'Lo'S's
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pp.
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COLGATE
�s
O'A
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I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE 0
THE OFFSETS tra
OF THE BUILDING INSPECTOR ONLY
SHOWN COMPLY L
AND SUCH USE IS FOR THE S � H
WITH THE ZONING DETERMINATION OF ZONING 3972
BYLAWS OF CONFORMITY OR NON-CONFORMITY
NORTH ANDOVER
WHEN BUILT WHEN CONSTRUCTED.