HomeMy WebLinkAboutBuilding Permit #1025-15 - 73 WOODSTOCK STREET 6/8/2015 ,4 NORTH
BUILDING PERMIT
(� TOWN OF NORTH ANDOVER -
W APPLICATION FOR PLAN EXAMINATION
/^ ^°
Permit No#: kIMPORTANT-:
Date Received 'Z1 �'°RaTDate Issued: Applicant must complete all items on this page
LOCATION 73 71 J -
Print /
PROPERTY OWNERS h t��,
Print 100 Year Structure yes no
MAPC��
PARCEL: K—ZONING DISTRICT: Historic District yes no
Machine Shop Village yes 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:
❑ DemolitionElOther
C1 Septic W01 _w � I D Floodplain ❑Wetlands ' ❑ Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
i3o r /o o,, 1Z i Der-, k on 9-x -s ab
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
Contractor Name: Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date: -r
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.
)�Iotall Project Cost: $ FEE: $
Check No.: Receipt No.:_rod�
NOTE: Perso s contracting with un a istered contractors do not have access to the guaranty fund
i
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 m U FORM
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on
Signature
i
COMMENTS
HEALTH 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
]DPW Town]Engineer: Signature:
FhREt D _f Located 384 Osgood Street
EPAR�TIVIEIlIIT TemDumpsterjori#site, :,yeses ` wa %nog
IFRre° Deparfimenti
�Jnature
Dimension
Number of Stories: Total square feet of floor area based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement®f Meter location, avast or service drop requires approval ®f
Electrical Inspector yes No
DANGER ZONE LITERATURE: yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
I
NOTES and DATA— (For department use
i
i
L] Notified for pickup Call Email
Date -----�--_- - - Time Contact Name _
Doc.Building Permit Revised 2014
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
Building Permit Application
Workers Comp Affidavit
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
OTE: 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
� Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
Floor/Cross Section/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
OTE: 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
2012 I ECC Energy code
Engineering Affidavits for Engineered products
OTE: 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:Building Permit Revised 2014
Location 23 !/"�I.���`
No. �� r Date(/
• - TOWN OF NORTH ANDOVER
• � TLED
•
Certificate of Occupancy $ ��
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $ t
TOTAL $
.Check#
Inspector
NORTH
Town of . tAndover
/j C25�_IT
'ID h ver, Mass,
cOc KIC Ml WICK y1.
04,4.r %%,
/.Pa�gS
S U
BOARD OF HEALTH
Food/Kitchen
PERMIT L D Septic System
THIS CERTIFIES THAT ............ BUILDING INSPECTOR
. . .. ....... ...... .
` Foundation
has permission to erect .......................... buildings on .. .....��.....��..................
Rough
to be occupied as A a.x tr......D�.'.'✓. co.......a .......S�ar.�.
�................................ Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in 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 M NT ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIO Rough
Service
................... .................................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildinz Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final T
No Lathing or Dry Wall 1 o Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
NO TES:
1. ASSESSORS MAP 045.F, BLOCK 0015
N/F SHIRLEY E. AUST/N 2. ZONING DISTRICT — RES/DENT/AL (R4)
OWNERS OF RECORD:
J.CC ---- :�C- � �v ^� ------
IRONl '
ROD 120.0 11 Roo STEPHEN R. HAMEL & CYNTHIA JAMES
3 WOODSTOCK STREET
o NORTH ANDOVER, MA 01845
L
PROPOSED 4: DEED REFERENCE.
DECK 1 o ENDRD DEED BOOK 13977, PAGE 41
38 5' 5.• PLAN REFERENCE:
15 PROPOSED
EXISTING DECK
CONCRETE ENORD PLAN NO. 3698
PA TIO 1 25.5'
O
SUNROOM 10' (PROPOSED)
�� 11' 14.5'
LOT 16 - LOT 18
N
�p PORCH
1 STORY
W = WOOD
#73 ,
l�
0
LOT 17
13,662-* SQ.FT.
IRON IRON
ROD 120.00' ROD
ID��.aaa
�o�jKOF&AUSs4,-, v WOODSTOCK STREET
EDWARD FN p
a HELtv4ES. JR-
4 No. 37733 p
9FGISTEP��
p�ss�GMA,Lp'tAAO �
PREPARED FOR
l CERTIFY THA T THE STRUCTURES SHOWN ABOVE LIE ENTIREL Y WITHIN THE LOT CERTIFIED PLOT PLAN STEPHEN R. HAMEL
LINES AS SHOWN AND ARE NOT LOCATED WITHIN A FLOOD HAZARD AREA AS SHOWN
ON FLOOD HAZARD INSURANCE RATE MAPS OF THE FEDERAL EMERGENCY JOB# 376-01
MANAGEMENT AGENCY. MAP N0. 25009CO209F, EFFECTIVE DA TE OF JULY 3,
2012 73 WOODSTOCK STREET PREPARED BY
NORTH ANDOVER, MASSACHUSETTS Land Engineering &
SHEET 1 OF 1 En v/ronmento/ Services, Inc.
PROFESSIONAL LAND SORVEYOR DA TE 130 Middlesex Road, Tyngsboro, Massachusetts 01879
SCALE.- 1=20 SEPTEMBER 29, 2014 Telephone (978) 649-4642
� NORTy
Town of . ? E ndover
No. /j C25 sw
h ver, Mass,
coc"Ic"twitcK 1'
ADAATED Jkv%,yy
s U
BOARD OF HEALTH
Food/Kitchen
PERMIT D Septic System
THIS CERTIFIES THAT BUILDING INSPECTOR
............ ...... ...... ..................................... ............... ....... ..
jife
has permission to erect buildings on Foundation
.......................... .. .,� .....c ��.l-r,.� ....
Rough
to be occupied as Jaxtr...... 40...... ................................ Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in 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 M,ANTK I ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIO Rough
Service
................... .................................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building 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.
The Commonwealth of Massachusetts
F Department of Industrial Accidents
U 1 Congress Street,Suite 100
Boston,MA 02114-2017
www mass.gov/dia
VParkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/plumbers.
TO BE FILED WITH THE PERNHTTING AUTHORITY. please Print Le 'bl
A ' licant Information
Narne(Business/Organization/Individual):
�� �a m
Address: 773 CA) 5�°r'15-
City/State/Zip: r4k AneJaue/ PM ®d '`-''Phone#: I ZT" 3a- 77gLf.
Areyou an employer?Checkthe appropriate box: Type of project(required);
em to frill and/or part-time).* 7. ❑New'donstraotion
1.F1 I am a employer with P y ees(
2.Q I am a sole proprietor or partnership and have no employees working for me in 8. n Remodeling
an apacity.[No workers'comp.insurance required.] 9. El Demolition
3. !am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 RR<uilding addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole
11.❑Electrical repairs or additions
proprietors with no employees. 12.1 Plumbing repairs or additions
p
S.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.�Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t 14. Other
6.Q We are a corporation and its.officers have exercised their right of'exemption per MGL c.
152,§1(4),and we have no employees.[No workers'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 submitthis affidavit indicating they are doing all workand then hire outside contractors must submit anew affidavit indicating such
$Contractors that check this box must attached an additional sheet showing the name of the sub contractors and state whether or not fhose,.entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
site
e olic and 'ob sa
Below is th J
I am an employer that is providing workers'compensation insurance for my employees. B p Y
information.
Insurance Company Name:
Expiration Date:.
Policy#or Self-ins.Lic.#:
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 MGL c. 152,§25A is a criminal violation punishable by 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.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 ains and p nalties of perjury that the information provided above is true and.correct.
Date: �O
Si ature:
Phone#: '77 -X1+3 d- 77?d
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):
3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
1.Board of Health 2.Building Department
6.Other
Contact Person:
Phone#•
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another underany contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receivet'or trustee of an individual,partnership,association or other legal entity,employing employees.•However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub=contractor(s)name(s),address(es)and phone number(s)along with their certificates)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if are ou required to obtain a workers'
Y
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
thai must submit multiple pennit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston,MA 02114-2017
Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia
TOWN OF NORM ANDOVEP, -
b
t . t4*�pC R b , • , .
OFFICE OF
B- y■ l)lMTLLN y
•1600 D400
ry1te0t Buff&92%.y1it,2936 .r
7 °RaimoF4��5 •NofthAudovor Massachusett.,01845
9 '
Gerald A.Brown Tole.
$one(9 79)68 9-9:545
Ynspeetor ofBuildings _ Bax (978)689-9542,
MWOWNEE.'ZICENSE MMPTION
B"UNEP+{B1M'ii`APPLICATION
pleaseprint
DATE: 44 �Zl, -
OB LO CATION: 73 . . � °�oc, � O
•Number Map4,ot .
- IXOIVMOWMR cpme 17T-`I30- 7,;yLj
ame. orste 1'horte Worltl'houe
73
y4k MA -I
C y 7'ni State• - z p Gods
s ,
The current exemption.for"Ilomeowntere,Was extended ie?`ncIude ownex occupied diyelings to is o
fa aunio ts o�;$s,at-,llow suh homco mut-s to engage an.L-10Mdual•for hire-who does so possess a liceaise,pxovided that f oc s a
acts as supervisor). M 3u dkg (Code Seotion lt)5,3.5.�)
DEIi.INITION OF HOMEOWNER ,
Persons)wl�o awns aparcel of land on wbich'Lelslre resides or intends to reside,on which dere is,or is i afended fo
��,aoneoxtwo azailystnlctures. t personwtoconstructsmoretriatonehomeinatwoyearpertodsballnotbe
considered alaDMOowAer; ,
The mzderszgued"homeowner"'assumesresponszbi ity foz-compliances wifh tie StafeBuilding Codeand otlxer
.Applicable codes,by-law.;xules and-xegalagom.
Tbendrsigned".homeovm0e,cmffesbatbelsheunderstaudsMe,Town ofNbrhAadoverBuifdffigDefoat
mir kullm inspection procedures an l requirements and lhathels]ze will comply witb.;said pxacedures and
requirements, .
rA-
MAMOWMRS SIGNA.TM
APPROVAL OF BMDMG OFRCIAL
Revised 7.2009
F'om�FSomeownersBxemption -
30ARt3 0FAP,PEAM 688-9,541 OONSFA VAEON 689-9534
13EAL'1H6$8-9540 PLANNING 689-955i
Belt courses, fins, columns, leaders, sills,pilasters, lintels and ornamental features may project not
more than one foot, and cornices and gutters not more than two feet, over a required front yard.
47.32—Proiections into Side Yards
Uncovered porches, Balconies, open fire escapes, chimneys and flues all may project into a
required side yard not more than one-third of its width and not more than four feet in any case.
Belt courses, fins, columns lead a ff§:'=+ffental features may project not
more than one t . yes-and gutters not more than two feet, over d side yard.
Projections into Rear Yards
recovered porches, Balconies, open fire escapes, chimneys and flues all may project to a
required rear yard not more than one-third of its width and not more than four feet in any ase.
Belt courses, fins, columns, leaders, sills,pilasters, lintels and ornamental features may proj t not
more than one foot, and cornices and gutters not more than two feet, over a required rear d.
7.4 Building Heights
Maximum heights of buildings and structures shall be as set forth in Table 2. The foregoing
limitations of height in feet in the designated zoning districts shall not apply to:
1. Farm buildings on farms of not less than ten(10) acres.
2. Nor shall they apply to chimneys,ventilators, skylights,tanks,bulkheads,penthouses,processing
towers, and other accessory structural features usually erected at a height greater than the main
roofs of any buildings.
3. Nor to domes, bell towers, or spires of churches or other buildings,provided all features are in no
• way used for living purposes.
4. And further provided that no such structural feature of any non-manufacturing building shall
exceed a height of sixty five (65) feet from the ground.
5. Nor of a manufacturing building a height of eighty five (85)feet from the ground, or
pharmaceutical manufacturing silo having a height of one hundred-fifteen(115) feet from the
ground.
7.5 Lot Coverage
Maximum lot coverage by buildings shall be as forth in Table 2. Lot coverage shall mean the percent
of the lot covered by principal and accessory structures.
7.6 Floor Area Ratio
Maximum floor area ratio (FAR) shall be as set forth in Table 2. FAR is the ratio between the total
amount of building floor area on all usable floors and the area of the lot on which it is located.
7.7 Dwelling Unit Density
Maximum dwelling unit density(dwelling units per acre) shall be as set forth in Table 2
7.8 Exceptions
1. The residential lot areas and frontages above required and listed in Table 2 shall not apply in any
residence district to any lot of less area or less frontage than above required if such lot be not
adjoined by other land of the same owner, available for combination with or use in connection
with such lot,provided that the applicant for a building permit on any such lot shall show by
citations from the Essex County Registry of Deeds incorporated in or attached to such application
that such lot was lawfully laid out and duly recorded by plan or deed prior to January 9, 1957 and
84