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HomeMy WebLinkAboutBuilding Permit #203-2011 - 793 TURNPIKE STREET 9/8/2010 BUILDING-PERMIT of ""LIED TOWN OF NORTH ANDOVER o= APPLICATION FOR PLAN EXAMINATION '' Permit N0403 ` A0 Date Received �.95 RgTED Date Issued: r I ORTANT:Applicant must complete all items on this page �:.Yi'�.i;�;r_-�,:i'�`c=r'-'c?r,�3s':3t.: '•kt,?. :-:.cp� ..n�:i�frr,- __ _ _ _ �: ._: .�.,_-a.�r,- ..gin,.•. _ - :., ., .=•r.'�< ui. - - N.J-S - -.r-J•-• - .:- t -<, err .,I,+• - i'.r =>• 18 - tow: �',• - •moi,',,. :.'.:f;:'.<. rr - '•-� ��= .::rm..��> c Gd`; =-^-•y�:SSi�5'' = a ,.�..t.- +r -J'^., y:r.,_. _.y.Y'r.:;Srra':�,�sr'rr•'--•, ":`641 M; rte., j,i4'�--,,z,., ..F„':n;'• -,s: r .s.y �K'tn'-r:'s-,.-.'."•�_ ��;.. 7..;•. �q5[,y.�bie:. 3,r5_ "r �.'�..:.�r,:s:-�.�-'s° g ,7.<�u�-':-",•,-=' „l._..,,.r d.. :�F-•,.:_;%�-min}�rv:.;.,i. - _ � � _ .5. F'L�-. •, -e 2Y 'r�i:�:��''�•'_�•- - -�r�,,. �:,u�'i'=t,�..s..^4:x,.0 ,r r :;="�- �'I�•=� 1s;l �:.Y,�.�.Oi�:`.' t". 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Commercial Repair, replacement Assessory Bldg -Others: Demolition Other =N� r.l a,,..• ?.; ;ter:;.i:. =>x 5:. 'r�;' .'fit'. "' :c='°' _•n. _- u;. •L' ,. •r'.}'�c�,� J .,:.d:¢ ��I-„tY i rtl'� 'f_ ik,"tee ", wz 1 .yta . r?5;' tti='3ry::FY,S'4 ,. N ;•a,rs_ 'r.,,dr"' t .!3` J d l C ,•9�'�r �� •y�,� yT7 ) :he1�•- r�Y'-U�G:a4J�.r 'A2l' ':t" "M1� �•�-a'v'.w'+in�ret {. ��'��� '�' JY��III� d � L .•[.,--...wo tln f. L` 4J� "C,.,..•,c Ta=i' ...n «��•'i -' � ��"' y:t�`.''�`'� [�"��s•. ^"°��,��`7"""..'"-'.�•�'�. mss' .�:� z,. -�:.r`" •rw.�. "-' � 1` J�, �i�� m r n er ¢elk �h ,�s`e,ds rk ,:�:�J, ti �-a�,::e-r;a Y,..?,�:.•.-�• �._.'r�,A� {`3:^,.._ -i-u':�' II,�L�1 �h� �• 3'a.,f;��.�"� s .:k, I�'�! -,e -'..,e tF;$�o� �i-e•Z��.�. }i.aF, .�:'�`"aV,xtr�.r�,fd":.,t�YF����T�ss r- 5g1G�+i.7 Ydl,.•s`..J+"`�.,r` ?sC%�.�:rr�=;r',"> e1=1s.7,'af-t�u`"<-ti3. ,c,._ Y['rr ..'.:f`�.. �:�, � �Sr�k.,: >'j-.9 ✓tv:,:-.:r sdF •,:. 4'••; r r•• -.F:w:i"N,E d_a-;'.. .c,:, ,'•{_v{ .P+'!.r•-zF:ts.:i:: siet3:•v. '_yy,14".icc. scr,.e.�.`-�, v, ,fir.: Yr:%-x •,��_r�,. :Fr",Gj:-4,--.?��;�'i� - x.r ?; P..�ti-,'�'a1�F�-• Lhtj,,�. /,-�•'°'a�r�!-, ��.:;rr' :.......... .:.. �.. .¢•z:•.... .�. ._. .r57�C .n=�:+7 ..=3Y:..r.d:?t y;•a`_ ;=;di;.y,y. c-+�•.. �Mr -.,cJ1{�y -j' Sc- t'-[�- �,-,t� DESCRIPTION OF WORK TO BE PREFORMED: �. � r n t p Identification PIease Type or Print Clearly) OWNER: Name: Phone: Address: - :,. , sr„'t.:%,••z[,_ .;t ,: .s __,...w[g4a �7,s. ` �S-r��f .-* -•= :.,,s=�F1'r '�,-.<:ti,.rvi;;.+cia.� ;� •ue:.',,.n,,., - - - •vM1!',n ` ,;�C-�.�c"- 4,T;'�{x"J"_"�'��w,�•v'�srw^€��. ,r•T��F-^,-e'.� 1,..rr r7s--' �>;.._ar�rr.r+�rYe,.",•>�'c,. .,���[r"x�`�..''��?�'�+',s.�w`L••?t+�:,(ti�r�a^�",�•�t�_y'"r`-,�„_yc�;.�,.+,-r���r. 1.,,[��-+` ,;,`_1,,;A= �e�irou�-^J'1z;z�r,.c � �''�u�' :,= ''ivit ,, +,rrrh,,•e„g�`{u..-�,. i" `_'•S_ -rJ i'* '.F, M�''C,[.9 �,�5a•'' " �,t'.��i 05 L•=�+ ��' � � k>,r,� '.�`i�': •'"�"-r. ,,,';,•`m" �'�"ei'}or'-`^my[�r'•;y>,� +a�u�S�:. _�'�'tS�, e-•.�_- _ - v' `+v� r _ -t -'kz W � . ,. „' 'a ,,:tis_'.v`z': '�+�u 'r,... r •-•,. ,z. v L _- .. :�'-� as��p.,..,:..� � - ""-.; �;,F>�;:�d�* �'§'.��'Zr,u,�,..,;.SP�:tE'"�d'_'u��:,-� , rrx��•w,:•�:'� 'sv�_'� 'Ya-''� 'fit ..;�g�,�C,�-i .ems .,£�".Jt'� r.-'rc,,. ,�si' `Fh�:-1• �„'m,,.a$;:�:€; =��.r�- �� -x��::A�1-r-�S.:-,,._"-" �.-.,w�eL='"J;��' ;Si?�z >� '°"*2'Sy�"- u;i�-r'A;it �' �^+.;L.;� rr+:.. •:�, , y�., '};,:a.�._W'. - ., -�.,;r;=.OFFS .�- �.�k;l � .:e- y��••'�x,�'tsvJ'"`Tj-"N,s�'ti�3i�a'}�a �]�:1�7Ar���13J` �5L_. 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I ,t�.�.s+;, -- r'L`v,d. q.'-i1. r:.��,_... <�., .?�-`� _ _ .^•�'•�::;-.�. ,r-,-..'r^?ur}-: ,,,�da:czk�-�;r- s �' M•. � r'n.....�.;,-rr�'�G: .4,.`�',r uy ".7:1=i> ::,.J�.i34•t,�'..stl:s r,t �:.,,s u_:�.sYa_i_�,. ��`C•`!��-rr�-"•,r ?Fi�_ a'.��i,.. _•;'�?a�t"�: �`E .u.. r�r�[;�'�., 1'--,'y�.,_.�,��-,+�--'�',^y:f 4�a� �1�;{;.� •c.4S,'�r �"Iki;:....:E+.� I-,.2�t`T' '� +i J x�f5�N"'FSS:'`I.t,�4 r _ �T _ f,Y x .1 , r,�5 '''-hrsr�F..«'',. �i:cir 1 _�y -.:T;.�:;.-_N.� G gip'.• •z' �S c+,.d:�..;��'`-'-�.si"'^F,_."t:,a`-`,��r� _��r '�� 1 �. 6 [� ac.;�tha=, xt^+3_, r11'.-1:-•�.:rN'rt`•4rZ:�x�: ",.. ..� � .:..1•nJ,,¢f.�`'-,�.,-.-3er_a�, r�J^S� 7'a� '� �r ,.r�a�"Fr��.rJre^�",.J�tk•= -_;' .:F`: �4•••i'--r^,,:,�..' rr "x�e•-r,,:a _l?r' .::.fid..-:.s?-:r�-it�'^y4-:. :r.2°": �,' �.i�,4; .,rk• --rue�n� � �c_��'�:n= .� r.-,-;,,.- _ �i'rJ n,;s.�•;a�a .f3-',�'i. �9 �;D �:-T�I1'a '�_ Til i5'Es.;_�.�a...i>•z •� �-' .� �_, rr�:,�,I �ti:- - - .,+".. k.�:+•-,"':�=.�:. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 0 00 FEE' lLl � Check No.: Vic 5.-7°/ Receipt No.: NOTE: Persons contracting with unregistered contractors do not have a es uarantyfund -9natiaTeNZ or�:raor- :. �+ -- Plans Submitted Pians Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Swimmin Pools Tanning/Massage/Body Art g -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 ..O....�-•.t - - �.viviivicivTS _ HEALTH Reviewed on Signature COMMENTS I i Zoning Board of Appeals:Variance, Petition No: Zoning Decisionlreceipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature Date Driveway Permit DPW Town Engineer: Signatiire: ,}. Located 384 Osgood Street d aT�p;g� - 'K Y:�:":'.�e.,.,;•:` .�,�:l'Ft'.�^isf,_'e:.i.'L''-�._:=5: ti•�:_.::.'::.:.i... _�. .rias ; eat �f Ill 2 n-;tree .. .... .. .:�.r:?t—. ...r1w..._-;;,.c...--_^r•= __. :�..a:' .:__c: _}yi*.gni^::..�. - �'t�r I 7 y t - _- - - •t-rte -- _ - 'y'�S•,'.C'c... 'fie:_. 1"^`t+• ._ :•_i:. ._,o-:_�.:..:,.�ar:i - - - 1':i^..v 2 _y .>,:_ r;:=!'�, ,:-. r;.... .,.....:ga.:§-. .,.:_..__: ..,.,,..•,:•s.r+:r:�•..�:..�..,,:.'� - sn- - t - _.tF•. riX. a _ �'^ - :'tip:':'.':`..:,:,•y" it"+VJ :s � i 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) j I ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 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 M ❑ Building Permit Application ❑ Workers Camp 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 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 ❑ Workers Comp Affidavit ❑ 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) ❑ Mass check.Energy Compliance Report (If Applicable) a ❑ 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 Pp Permit Application � _UX! _j n n�_t L'! ❑ -el U111 11 r-rO..; i WL. i i�lri ❑ 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 ❑ 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.Building Permit Revised 2008 Location No. d// Date Np^Th TOWN OF NORTH ANDOVER 3j •. _ p F - w i �o Certificate of Occupancy $ scMusEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ k Check # k:P 3 y 234 : 6 uil ing Inspector 0 0 ?liassachusctfs - ©cpanwent of Public S:tfct} Board of Building Regulations-and Standards Construction Supervisor License License: CS 22988 Reltricted to; 00. JOHN GRASSO 865 TURNPIKE ST Nd ANDOVER, MA 01846 Expiration; 1=112011 <�ua�mi.ciriaer Tr#: ,7237 O - 9 O U? c BoerhfBuQ ff ung alioa'o�rds License or registration valid for individul use only re the expiration date 1f found return to: HOME IMPROVEMENT CONTRACTOR befo o I Board of Building Regulations and Standards 0 Registration., 113130 one Ashburton Place RM 1301 ra itloni'w16120ll Tr# 283129 mA Boston,i14a.02108 m " s '.'Type::Priva6e Corparafion co C GRASSO CONSTRUCTION_I.CO:,INC. -_ yq .JOHN GRASSO M� w 865 TURNPIKE ST' N .;: "" '_. Not id without signature N.ANDOVER,MA 01845 `='' Administrator •-i N O —4 0 N r— O O . i ORTFI Town of No. = A K E o dower, Mass., COCMICMEWICK %p ADRATE D P �C5 1`SS BOARD OF HEALTH PERMIT - T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........a/, ................................................... E.......................7.................................................................. Foundation has permission to erect........................................ buildings on ...//.....f......... ............... ..�.�................................:.............:..... Rough v E /UG .bfi%✓'�:`� ,.� �`�,Z, _ �r 6��v Chimney to be occupied as.................... ..... ......:.................. ..............:........... .................:............................ ::............ provided that the person accepting this permit shall in every respect comm 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 PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR II Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building, Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. The Commonwe¢Zth of Massach usetts Department o f.industrial_,accidents Office of rmestigations 600 Washineon Street Boston, Mq 02111 Workers' Av Com ennsarion asseov1&a ficantmInsurance Affidavit: BaUders /Contractors/Electricians/Plumbers Please Print Legibly Name (Business/Organizabon/individuai): ICY� Address: (oc� � n •< �r� � � City/State/Zip:_ � phone#: o -- �'O- Are You an employer? Check the appropriate boa: 1•❑ I am a employer with 4. ❑ 1 am a a 77R=odehng ect(required): ------- general contractor and I 2.❑ employees(full and/or part-time). have hired the sub-contractorsonstruction I am a sole proprietor or partner- listed on the attached sheet x delingship and have no employeesThese subcontractors havelitionworking forme in any capacity. workers c _[No workers'comp, insurance 5. ❑ We are a corporationandc itsg ade. ditionrequired.] officers have exercised their rcal repairs or additions myself. [No workers' romp. Ghon Per MGL 11.❑Plumbing P c. I52,§I C4),and we have no ��or additions insurance required-] t 12•7 Roof repairs employees. [No workers' comp.insurance required-1 13.0 Other `•`aS''Pa?icant that ch-k.:bor mi s?eso uu cec fhe sec a ceeot!•`^oY ..t 'r�oxneowners who submit this affidavit indica -"•e:r mor-=ets'cow•• ��.; �€tht-y are doing aL'wore and r- on Y.,hc;Y ca 'Contractors that heck this bo.*,must at a;,hed an additional sheet ahowiaP the ��hire outside cont<acto r i; submit a new affidavit indicating such. o same of the sub-contractors and their work=' I am an employer that is providing workers'compensation insurance or my e romp.Pow information information. f y mployees. Below is the policy and job site Insurance Company Name: -AQPJA JA) bnf� -S C-0 p 05) Policy 4 or Self-ins.11-1c.#. ' =� Q L Expiration Date: Sob Site Address-, QI City/State/Zip: Attach.a copy of the workers' compensation policy declaration pace(sho b ?i M4 Failure to secure coverage as required under Section 25A of M �vtng the Policy number"and expiration date). fine up to$1,500.00 and/or one-year imprisonment,as well as Glc. 152 can lead to the imposition of criminal en Of up to $250.00 a day against the violator. Be advised that a co Penalties m the form of a STOP Wop ORDERMies of a Investigations of the DIA for insurance coverage verification. Py of statement may be forwarded to the ref and a nae � Office of I Ido hereby c under the pains and penaWes of perjury thrzz the information f matian.provided eve is true and correct Signature: Phone#: I Official use only. Do not write in this area, to be completed by city or town official City or Town: Issuing Authority(circle one): 1 ermit/License# 1. Board of Health I Building" De b. partment 3. Cin/Town Clerk 4.Electrical Inspector S.Plumbin 6. Other Inspector Contact Person: "hone.P: Information an d Instructions Massachusetts General Laws chapter 152 requires all employs 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 t7Qe legalrepresentatives of a deceased emplover, 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 aparm3L ents and whoresides therein,or the occupant of the dwelling house of another who employs persons to do maintemiance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not be=cause of such employment be deemed to be an employer.,, MGL chapter 152; §25C(6)also states that"every state or 10.4cal licensing.agency shall withhold the issuance or renewal of a license or permit to operate a business or to c onstruct buildings in the commonwealth for any applicant who has not produced acceptable evidence of coimpliance 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 utZI:il 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-contractors)name(s), address(es) and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships W)with no employees other than the members or partners,are not required to carry workers' comp ensation 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 sig and date the affidavit. The affidavit should be rcra med to Lisle city or kTm tiha',.the applicauQn for the-ermuit Qr tic n is being''= est..ed, „ meet t^.A.Depart.of Industrial Accidents. Should you haveany questions mgardt�b the law or if you are required to Dentia a workers' compensation policy,please call the Deparmiecnt at the.numbe=r 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 Iegibly. 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 stampe=d 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 than 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 teI I ep ephoae and.,fiix.numbez.._... The Commonwealth of Massachusetts Department of Industria=l Accidents Office of Inrestigafioas 600 washiagtGn Street Boston,ISA 02111 Tel. 4 617-72.7-4900 e,)t 406 or 1-8 r.7-h!LkSS-.FE Revised 5-26-OS Fax i-, 617-72.7-7749 v'vrv7.mass- ¢ ._OV/Cha.