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HomeMy WebLinkAboutBuilding Permit #Exception - 78 UNION STREET 5/1/2018 r BUILDING PERMIT o fAO or I"tio TOWN OF NORTH ANDOVER' a? '' APPLICATION FOR PLAN EXAMINATION �-� '' '° - 0 f � o Permit NO: Date Received (% v 1• �9SSACHUS Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION D (. p gdnt PROPERTY OWNER Pa 4 tl 1 q Print MAP NO: 1 PARCEL: ZONING DISTRICT: R HistoricDistrict yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential I New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: ihc� /0 t7�' lC� CN Z /7Dart �GGJp�c © Identification Please Type or Print Clearly) OWNER: Name: btf Phone: Address: 75 71 -4�0y) 44h eL !VO , .14✓Idcll-2G— CONTRACTOR Name: Phone:. Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER 10 I--e& 1 l hone: Address: 1600 d 5 t- Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 000, 0C7 FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature_Of Agent/Qwner Signature of contractor 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 DATE APPROVED PLANNING & DEVELOPMENT 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: 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 1 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 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— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 A Building Department i i 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 i ❑ Building Permit Application ❑ Workers Comp Affidavit 1 ❑ 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 i Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan i ❑ 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 Hydraulic Calculations (if Applicable) ❑ 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) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit i ❑ 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 ❑ 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 DEPARTMENTMFORM07 Revised 2.2008 pOR711 Zoning Bylaw Review Form 4.pE a�ao w 1 . °."o Town Of North Andover p Building Department 1600 Osgood Street, Building 20, Suite 2-36 North Andover, MA. 01845 SS�cnuse Phone 978-688-9545 Fax 978-688-9542 Street: 78-80 Union Street Ma /Lot: 9/39 Applicant: Paul and Robin Dubois Request: Add 3'dwelling unit to existing 2-family, 3 story building Date: 6-2-08 Please be advised that after review of your Application and Plans that your Application is DENIED for the following Zoning Bylaw reasons: Zoning District: R-4 Item Notes Item Notes A Lot Area F Frontage 1 Lot area Insufficient X 1 Frontage Insufficient 2 Lot Area Preexisting X 2 Frontage Complies X 3 Lot Area Complies 3 Preexisting frontage X 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage 1 Allowed G Contiguous Building Area 2 1 Not Allowed 1 Insufficient Area 3 Use Preexisting 2 Complies 4 Special Permit Required X 3 Preexisting CBA X 5 Insufficient Information 4 Insufficient Information C Setback H Building Height 1 All setbacks comply 1 Height Exceeds Maximum X 2 Front Insufficient X 2 Complies 3 Left Side Insufficient 3 Preexisting Height X 4 Right Side Insufficient X 4 Insufficient Information 5 Rear Insufficient X I Building Coverage 6 Preexisting setback(s) X 1 Coverage exceeds maximum 7 Insufficient Information 2 1 Coverage Complies D Watershed 3 Coverage Preexisting X 1 Not in Watershed X 4 Insufficient Information 2 In Watershed j Sign NA 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district I X 2 Parking Complies X 3 Insufficient Information Remedyfor the above is checked below. Item# Special Permits Planning Board Item# Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parking Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate Housing Special Permit Variance for Sign Continuing Care Retirement Special Permit Special Permits Zoning Board Independent Elderly Housing Special Permit Special Permit Non-Conforming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Development District Special Special Permit Use not Listed but Similar Permit Planned Residential Special Permit B-4 Special Permit for 3 Unit R-6 Density Special Permit Special Permit Pre-existing, Non- B-4Conformin Watershed Special Permit Supply Additional Information The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled'Plan Review Narrative"shall be attached her and incorporated herein by reference. The building department will retain all plans and documentation for the abov You must file a new building permit application form and begi the permitting process. Dom' Building Department Official Signature Application eceived Applic tion D nied Denial Sent: If Faxed Phone Number/Date: Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the building permit for the property indicated on the reverse side: eV �e ; o fi DW � &13-y* t o ear c Fr,r lt+ m Reference B-4 A Special Permit from the Zoning Board of Appeals is required for the conversion of an existing 2-family dwelling unit structure to a proposed 3- family dwelling unit structure per 4.122.14.0 of the Zoning Bylaw: "The conversion of an existing dwelling to accommodate not more than five (5) residential units,by special permit from the Zoning Board of Appeals in accordance with Sections 10.31 and 4.122.14.D of this Bylaw." B-4 A Special Permit from 9.2 of the Zoning Bylaw is required for the change, extension, or enlargement of a pre-existing, non-conforming structure is required from the Zoning Board of Appeals in order to allow the proposed conversion of an attic in a 2-family dwelling to a 3rd dwelling unit.. Note: The proposed 3rd dwelling unit shall require all 3 units to be sprinkled er North Andover Fire Department&Massachusetts building code. Referred To: Fire Health Police X Zoning Board of Appeals Conservation Department of Public Works Planning Historical Commission Other BUILDING DEPT ZoningBylawDenia12000 ✓lk (/ e. �= V2 �JeE k ti Am AGGREGATE INDUSTRIES METRO / NORTH READY MIX CONCRETE Plants:Everett,Dorchester,Saugus, Swampscott,Waltham,Wilmington Sales Tel: 978-535-8600 v Sales Fax: 781-941-7272 Dispatch: 800-CONCRETE TOWN OF NORTH ANDOVER Construction Control Affidavit Project Number: 0804045 (Architect's Job Number) Project Title: Paul Dubois - 78-80 Union St third floor plans Project Location: 78-80 Union St, North Andover Name of Building: Nature of Project: New emergency systems, third floor renovation In accordance with Section 116.0 Registered Architectural and Professional Engineering Services-Construction Control 9 9 9 of the Massachusetts State Building Code, I, Gregory Smith Registration No. 8688 being a Registered mal E flier/Architect, HEREBY CERTIFY that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural X XXXX Structural Mechanical Fire Protection Electrical Other(specify) j FOR THE ABOVE-NAMED PROJECT AND THAT SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE 780 CMR MASSACHUSETTS STATE BUILDING CODE. ALL ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the state of construction to become, generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. UNDER SECTION 116.4, I SHALL PERIODICALLY SUBMIT A PROGRESS REPORT, TOGETHER WITH PERTINENT COMMENTS, TO THE BUILDING INSPECTOR UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature and Stamp(no facsimile) \�tiRED ARCyIT �evV 'Iy P No.86b C) NORTH A?�v LINDA VANDEVOORDE Notary Public o New Hampshire My lromz;,.ission Expires March 10,2009 SUBS BES Air! WORN BEFORE ME THISI DAY OF 2008 MY COMMISSION EXPIRES "'N R\11 PUBLIC Residential Property Record Card PARCEL ID:210/009.0-0039-0000.0 MAP:009.0 BLOCK:0039 LOT:0000.0 PARCEL ADDRESS:78 UNION STREET FY:2008 PARCEL INFORMATION Use-Code: 104 . Sale Price:` 325;000 Book: 07163 Road Type: . T Inspect Date:, 08/08/2003 Tax Class: T Sale Date: 10/10/02 Page: 0284 Rd Condition: P Meas Date: 08/08/2003 Owner: Tot Fin Area: 2498 Sale Type: P Cert/Doc: Traffic: M Entrance: C DUBOIS, PAUL&ROBIN Tot Land Area: 0.13 Sale Valid: Y Water: Collect Id: RB Address: Grantor: FOUL09,MAURICE Sewer: Inspect Reas: S 57 SECOND STREET NORTH ANDOVER MA 01845 Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / RESIDENCE INFORMATION LAND INFORMATION Style: DK Tot Rooms: 10 Main Fn Area: 1249 Attic: Y NBHD CODE: 4 NBHD CLASS: 4 ZONE: R4 Story Height: 2.35 Bedrooms: 4 Up Fn Area: 1249 Bsmt Area: 1233 Seg Type Code Method' Sq-Ft Acres Influ-Y/N Value Class Roof: G '' Full Baths: . 2 Add Fn Area: Fn Bsmt Area: 1 P 104 S 5865 0.130 155,970 Ext Wall: AB Half Baths: Unfin Area: 450 Bsmt Grade: VALUATION INFORMATION Masonry Trim: Ext Bath Fix: 6 Tot Fin Area: 2498 Current Total: 357,000 Bldg: 201,000 Land: 156,000 MktLnd: 156,000 Foundation: ST Bath Qual: T RCNLD: 200989 Kitch Qual: T Eff Yr Built: 1962 Mkt Adj: prior Total: 380,500 Bldg: 216,500 Land: 164,000 MktLnd: 164,000 ` Heat Type: ST Ext Kitch: Year Built: 1900 Sound Value: Fuel Type: O Grade; A Cost Bldg: 201,000, Fireplace: 0 Bsmt Gar Cap: Condition: A Att Str Val 1: Central AC: N Bsmt Gar SF; Pct Complete: Att Str.Val2 Att Gar SF: %Good P/F/E/R: /100//73 Porch Tyne Porch Area Porch Grade Factor E 50 P 159 SKETCH PHOTO 4 25 14E%$Pxt NIj 0 P ctu irnr�+ 34 1288 SqA Availa b I 6 5 Parcel ID:210/009.0-0039-0000.0 as of 6/2/08 Page 1 of 1 The Commonwealth of Massachusetts 1 Department of Industrial Accidents ~�" l•„ Office of Investigations 600 Washington Street lilt, I 111111 Boston, MA 02111 ``Qk,••�A www mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Hanle(Business/Organization/Individual): Al t, /` D i Address: 2,� go W �.1-i City/State/Zip: eo ikel,- % `k Phone #: Z,/ D rp �cv Areou an employer?Check theappropriate box: YType of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 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• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in 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.E] Electrical repairs or additions 3.X 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.] t employees. [No workers' 131-1 Other comp. insurance required.] *Any applicant that checks box#I 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 1 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.qq#: / Expiration Date: Job Site Address: 7 U � t/l�l�J l� 5.,L City/State/Zip:fG- /�,"7c� 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. 1 do hereby certify un the pa' nd penalties of perjury that the information provided above is true and correct Si nature: /' Date: Phone#: ? /_73 -;-- f/ 20 - '3 2 G �) 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#: 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 under any 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 receiver 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 certificate(s)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 you are required to obtain a workers' 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 that must submit multiple permit/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 Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26-05. Fax#617-727-7749 www.mass.gov/dia tµoRTM I TOWN OFNORTHANDOVER OFFICE OF BUILDING DEPARTMENT i� 1600 Osgood Strut Building 20, Suite 2-36 North Andover,Massachusetts 01845 Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE-EXEMPTION Please print DATE: JOB LOCATION: 96 (/( j Num1ber Street Address Willa HOMEOWNER fq-q( �t4 1a6 !S 7� V.20 5 2 6 6 Name Home Phone Work Phone PRESENT MAILING ADDRESS O Ja V-ar- Cr V'l I City Town State 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 lienee,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 responsft*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 requiremmu. HOMEOWNERS SIGNATURE A APPROVAL OF BUILDING OFFICIAL Rid 10.2005 Form Honwwnm Fmmptkm BOARD OF U'PF:aI_S(M-9541 CO.NSERVNFION 688-9530 HEALTH 688-9540 PL.INNING 688-9535