HomeMy WebLinkAboutBuilding Permit #755 - 58 FERNWOOD STREET 6/5/2006�+ S" W
h
r.
�ss�cNu��
Permit 'NO:
•v,'
Date Issued: loor'
LOCATION
PROPERTY OWNE
MAP NO.:
TOWN OF NORTH ANDOVER
,APPLICATION FOR PLAN EX.kMfNATION
Date Received. �+ J
IMPORTANT: A ppi icant must complete all items on this
Pr
Print
PARCEL: ZONING DISTRICT:
TYPE AND VSE OF BUILDING HISTORIC DISTRICT YES 0
TYPE OF IMPROVEMENT PROPOSED USE Non- Residential
Residen ial
= New Building - ne family
Addition
Two or more family Industrial
Alteration No. of units:
Assesso Bldg_Commercial -
lWair, replacement ry
�vDemolition _ Others:
Movin relocation _Other
= Foundation onl
DESCRIPTION OF WO
T() BE PREFORMED
!R
OWNER: Name:
Identification Please Type or Print Clearly)
arj�-e
Address: e,z✓L.) 6 a j S' -
CONTRIkCTOR :Name: Phone:
Address:
Supe;rN isor's Construction License: Exp. Date:
Home: Impro%ement License: Exp. Date:
ARCHITL-'CT.I;LC[NEER Virne:: Phcne:
Address: Reg. No
FEE SC'HEDL LE: BL LDV,G PER-IIIT: S10. )o FER S i w K00 OF THE TOT. t L ESTIM t TED COST 3AS ' 0,", 51-'�° 0 PERS. F.
Ttal Project Cost :$___ - x10.00- FEE:
Check No.:
Reccipt No.: a3
il:i:!c it.r 4
Location t -A-'Jo d a d ,,vv
No. ? 5~S� Date er-7.
�oRTM TOWN OF NORTH ANDOVER
9
Certificate of Occupancy $
'JscMus `� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 14
r
} '; f' Building Inspector
,.
TYPE OF SEWARGE DISPOSAL
Public Seiner
Well _
Priti ate (septic tank, etc. _
TanningAlassage Body .art SH imming Pools
Tobacco Sales — Food Packaging Sales
Permanent Dempster on Site
Electric deter location to
project
NOTE: Persons contras rug w' unregist dcontra rc r o not have access to the gurrrrrrrty fund
Signature of Agent, Ow e Signature of Contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED DATE APPROVED
❑Water Shed Special Permit
Ej Site Plan Special Permit
] Other
DATE REJECTED DATE APPROVED
CONSERVATION Li
COMMENTS
i
L
DATE REJEC'T'ED DATE :APPROVED
HEALTH
COL)l-MENTS
Luning Board of Appeals: � ariance. Petition N
tuning Decision receipt Submitted •(.,s
larminr, B,wrd Deci•,ion:------_-._--- Commcn
_•'.1sciviti n Ct'ci:iun: _----_—..-----C .)mnumts
imp .Dempster cn iu ,.c':- -'x :=ire Dvpartmcnt J naturi_ .fare
Building 1"Urnit Appro-%ud and lssuud by:
Building Setback (ft.)
Front Yard
Side Yard
Rear Ward
Required
Proi ided
Required
Provides
Required
Provided
I/L'#IL.'N3WI 1
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
, , .
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
a Building Permit Application
j Workers Comp Affidavit
Photo Copy Of H.I.C. And/Or C.S.L. Licenses
Copy of Contract
Floor Plan Or Proposed interior Work
Addition Or Decks
Building Permit Application
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 Hydrauli
Calculations (If Applicable)
Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
Building Permit Application
Certified Proposed Plot Plan
Photo of H.I.C. And C.S.L. Licenses
a 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
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of
%ppeals 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
til'.R\ il'l':'i 10.11 .R'I'11F.`• I':31 OR`116
•
0
W
0
w
O
E-+
LLJ
6 CLz
O
w
v
cn
U
p
w
O
w
C
Uw"
G
�
p
cl'w"
G
a
o
W
W
w
G
w
p
rs:
w
w
vi
0
cn
O
E-+
LLJ
6 CLz
8
0!
O
CD
O
co
O
Z °3
CL
O CO)
� C
CD cm
I = C
O.—
COD p 'C
CD
V! CD O
'g m m
CL
.o
O �>
o O
coL
m O d
a' cmQ
CO2
o c
ea
.CL. O co
C Z �
v CO)
C
1C
• C
CO2
c c
m C
C
O `
C N
O
C
V
C7
ac
�v m
4
m c
s o
V1 �+
+m+ C
m C
o CL
N
o m
.oma
a:9
0 mm
m
C �
m
'L C
y l0
it y
m
E�
nv
M m m
O
CM'S a
y
E.
m O
H
CS z
ti
C C
H
=
m
CL p
�
O
CL C2
W
wCLU
to m r
ZZ
MD li
'�
'y
'co,
R07 O O)
� O
O y 'O
1
_
$nsm
8
0!
O
CD
O
co
O
Z °3
CL
O CO)
� C
CD cm
I = C
O.—
COD p 'C
CD
V! CD O
'g m m
CL
.o
O �>
o O
coL
m O d
a' cmQ
CO2
o c
ea
.CL. O co
C Z �
v CO)
C
1C
• C
CO2
Location
S�S Ei=la
No. !!S 72- Date S
NORTH TOWN OF NORTH ANDOVER
O? �• OOHSv '"-
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
s�CHust
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Buil ing nspector
Div. Public Works
PER.41T X-6. 37Z,- APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
PAGE 1
MAP dsl0.
LOT NO.
2 RECORD OF OWNERSHIP DATEBOOK
:PAGE
ZONE
SUB DIV. LOT NO.
LOCATION E,'�Y'f !✓bt%f�C?tz �
PURPOSE OF BUILDING�L.�.s✓J � O IaIQ
�6��
OWNER'S NAM�E'G/�E-4::W /�y�
1 ,j�+K•
NO. OF STORIES I SIZE /
"
„/��
OWNER'S ADDRESS S�3
BASEMENT OR SLAB p
O
ARCHITECT'S NAME q �\ .� c7�-
J(,
SIZE OF FLOOR TIMBERS 1ST 2ND3RD
BUILDER'S NAME iL`a.. J �
®�
DISTANCE TO NEAREST BU�L
POSTS
DISTANCE FROM STREET a "�'�
DISTANCE FROM LOT LINES - SIDES "1' REAR �
GIRDERS
AREA OF LOT / �1 000 .5 P, FRONTAGE /d^�
s7
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING %� �X'1 X
IS BUILDING ADDITION
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION F
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE '1/'�r^�
i G/
IS BUILDING CONNECTED TO TOWN WATER 1/er-5
lyes
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED /or
SIGNATURE OF OWNER ORAUTHORIJED AGENT
Q
FEE 3oZ�Sa
Y PERMIT GRANTED
AUG 24M
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COS —!Ez0 d C--
EST.
+EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
ie L=�
BUILDING INSPECTOR
OWNER TEL. #
CONTR. TEL.
CONTR. LIC. # 061010
0/v
H.I.C. #
l— � ��
—jp(p5
BUILDING RECORD
1 0CCU PAN CSYY,,U — A 12
SINGLE FAMILY $iOHIES
MULTI. FAMILY OFFICES
APARTMENTS
CONSTRUCTION 0 ��
2 FOUNDATION
yt
I
8 INTERIOR
F(N)SEV
—11
CONCRETE
PINE
HARDW D
B
2,
_
CONCRETE BI K.
BRICK OR STONE
PIERS
PLASTER
DRY WALL
UNFIN.
_
3 BASEMENT
AREA FULL
FIN. B'M'T' AREA
'/. 1/1 1/.
FIN. ATTIC AREA
_
N_O B M T
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
_
4 WALLS
I 9 FLOORS
CLAPBOARDS
B
_
1
2
�_
3
_
_
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
CONCRETE
EARTH
HARDW D
ASBESTOS SIDING
COMMON
VERT. SIDING
_
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
_
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STIRS. & FLOOR _
CONC. OR CINDER BILK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I� POOR _
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLEHIP
BATH (3 FIX.)
GAMBREL
MANSARD
TOILET RM. (2 FIX.)
_
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
_
WOOD SHINGES
KITCHEN SINK
_
SLATE
NO PLUMBING
TAR & GRAVEL
STALL SHOWER
_
ROLL ROOFING
MODERN FIXTURES
_
_
TILE FLOOR
TILE DADO
6 FRAMING
I 11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS.
STEAM
STEEL BMS. & COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
_
AIR CONDITIONING
_
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GAS
Ell
B'M'T 2 d
ELECTRIC
I
I`HIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
�
1st 3rd NO HEATING
4
1 �=11 =--
b
s
Y
w
A
Qct
O
W.
V)a
V
cn
O
z
z
a
c
°
CIS
.c
O
w
O
r.2
a
C
U
G
x
a
v
z
z
p
cl'
co
w
a
o
w
z
U
U
a
W
p
cu
u
y
cn
C
w
p
U
�%
p
a
C
u.
w
A
a
..�
�'
4
CO
o
u
b
cn
v
Ca
v
O
cn
0
O
E=4
M
LU
O
z
D c 'O
•` c :U
:W O
C?+
CE
0
`• Q� ` U co
ac z
ev ev
CD
Z
to = � O
oc
L
0 cCO)f> ; y
CD
E y
ocJ*" co
0CM = n
3 a �. _co
CO) W CD L 1
COD
cm m CO
VI O
:gym ) v
c c
`" cv c !1
ca
m ocmO
'tel; :• y 03
CD
t = o cm ,. .
c c [� y
fA
t -L n
o.cs = n 00
CD o - . m �-R
Arno
wi A��Z O V
Q:coo c �I R
ID
WCL
MA 'c.s C c Z Vi
oc 'E CL3 -0
C .y o D
LD LU m omc 2 ch
g
COD a. m� o�
_ W m o y==
�- t $aim
O
s
O
y
C
CO rm
c
O •�
D �
m m
r:
WAY - . r WWI
Y
STEPHEN C MORIN
9 SHORE DRIVE
KINGSTON NH 03848
DOSO1-25-61 LIC»01 MNS61251
w. 12-23-1993 apes 0PR-MC
EXP.01-25-1998 REST.
f 88( M HOT. 5-08
C 016.54.4950
"II IV rfL,UQ0v
3NIl 38fi1VN01S 3A08V ll(ld NI 3WVN NDS
•.:..aps�aro
iIOJ�?a0A�110/ 1l1�j:� ���
ftIOJIR9 N+JS a+WaastaN
luo"Alaa sssssadas aJiyf0d
'OlOHd KmONI1S/1W
S»OiVU3dO JNI1SVf e
'3SN301 NO X08
31VlHdOdddV NI 1NIad
8Wf1H11HE)ld ind 'i-d3H1
1SNIVJy NOL03iOdd 80-4
Nounvo
0
)'�
33SN3011 30 3 NDS
83NOISSIWW00 3H130 3Hf11VNOIS - HO - 03dWV1S
Al1V1013300NV 33SN3011 A8 03N01S 11INn O11VA ION
9479£0 HN NOISONIA
BU 380HS 6
NINOW 3 N3Hd31S
010190 £661/90/90
ON 01l 31VC1 3AI103333
HOSIA83dns '81SN03
3SN33I1
SOLZO VW `NO1S08
30V1d NO1H08HSV 3NO
JLL3:lVS 0118t1d d01N3WlUVd3(l
Z
a
0
a
0
9
'NOI1Vdf1000 Slr'd N1 OHM)
-N3 N3HM H30lOH 3Hl
dONOSH3d3H1 NCCDIliHV0
38 Ism 1N36W1000 SIHl
T96T/Sc/Tel
•800
:1HODH
1NI8d ev4nH11H0I8 - S89HIO
V.
:333 1 UINO HdO ONUSV18) OIOH
05647-475-9 T 0 # SS
00
SN01101diS38
L66T/9c/T0 31`GNOUV81dX3
S113snHOVSSVW
d0 is
H1lV3MN0WW00
4l
CL
oV• m
tit�o
Z m4hooi
Q
IL.-
E- 20)1
Uma
oz
Lo
zQc
oco
_vo
vo§
WU)U
aaw
zo g
-W
W=W
o�cc
Om
-4o��
a�
o
v777777477
rn
N
CD
Q
i re
f
c
� � Q
W
t� ✓'
i
'0 to 6
.. PL ? J
o
of ^�
id�-
._. ?. J ._
1
o
t�
Z
-
LL
��
it
(,AJ
-Ile
Ire,
ell
V%
OF