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HomeMy WebLinkAboutBuilding Permit #697 - 84 SECOND STREET 4/27/2007Permit NO: Date Issued:_ BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF IMPROVEMENT PROPOSED USE 2 N� ✓rt ' U 11� Residential Non- Residential ❑ New Building ❑One family 11 Addition W Two or more family ❑ Industrial ❑ Meration No. of units: ❑ Commercial EVftepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Se"yo d t=ptD - es�etlIlf7istln ; , �a Phcne: DE CRIPTION OF WORK TO BE PKEFUKMhU* sj Il 0.-J re.-rAble - e o Igo os e arl 2 N� ✓rt ' U 11� Gc_i 1 c- Iti e Nf © /1 ��� s► Identification Pleale Type or Print Clearly -- Il S �8 50� OWNER: Name: 0,,--/a-- t%ll uN �!v i�n� grrpo Phone:�7 Address: 0"J ,S re e -F �b CJITiCTfQE%rrtWr Phcne: .Address: Su e l vX C + t t��atl{ ei�.�i p Dat Flume Im rtsvemrtt I�ice�se: n'P� Dat. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. c� "moi Total Project Cost: $ 1-2�, 000 FEE: $ Q Check No.: & S—k Receipt No.: *a V NOTE: Persons contracting 'th unregistered contractors do not have access to the guaranty fund Signature of Ag6hf/Owner ^'` Signature of contractor /&Z 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 PLANNING & DEVELOPMENT ❑ COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street FINE DEPARTMENT, Temp DutiipSIt Oil Sit yes no Located at 124 Main Street ` Fir"® Departments si naturefdate COMMENTS. 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 Doc.Building Permit Revised 2007 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 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 ❑ 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 ❑ 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 DEPARTMENT:BPFORM07 Revised 2.2007 44 Location (�7 `eF6 IS7�0,iw S,7— No. �o % Date D �ORTM TOWN OF NORTH ANDOVER :. Certificate of Occupancy $ S' E Building/Frame Permit Fee $ s^GNUS ti Foundation Permit Fee $ Other Permit Fee $ > TOTAL $ Check # k/�4— 2 U ', 54 6::?-" k -0 -- Building Inspector E� �I W rA co w o H 3 W 0 t iI.1 g W J= F w x � p°G w w o H U w x � p°G w x U U w a°' cii w x '7►�' a�' w a w rA o cn �' cn rl i' r cl �r : N A O ,.., ti C.2� O * cm CD c E . N Is mm ` y z 3 = O c o .r > S N O W O H IC C N • �. CD :w Ca O I C3ti O C Z c d0CD c Q 4 m C •O a = m tp N r C#2 t • r=.. uj2c 0 Lu V .O O m �•� ~ y a 4D O � !� t a0.. Kim CD ? i 0 0 z O U O O Z O D COD CD a O Z c O CD ca h O V .a CIO c O u cc C C 0 0 y U) W W oc W U) c � o � c H O C a C3 d c 06 ...1 Ca t y E Q � o 0 d .i ♦+ y rl i' r cl �r : N A O ,.., ti C.2� O * cm CD c E . N Is mm ` y z 3 = O c o .r > S N O W O H IC C N • �. CD :w Ca O I C3ti O C Z c d0CD c Q 4 m C •O a = m tp N r C#2 t • r=.. uj2c 0 Lu V .O O m �•� ~ y a 4D O � !� t a0.. Kim CD ? i 0 0 z O U O O Z O D COD CD a O Z c O CD ca h O V .a CIO c O u cc C C 0 0 y U) W W oc W U) TOWN OF NORTH ANDOVER BUELDING DEPARTMENT 1600 OSGOOD ST BUILDING 20 SUITE 2-36 NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax Please print DATE .�I%s-/zooms T -T JOB LOCATION _ SI% ^ S (o Number Street Address Map/Lot Name Home Phone PRESENT MAILING ADDRESS O Y — �3 G 'Ze— L- 471ed City/Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1.) DEFINITION OF HOMEOWNER.- Person(s) OMEOWNER 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, one or two family dwelling, attached or detached structures attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shalt not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance 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 procedures and requu HOMEWOWNER'S APROVAL OF BUILDING OFFICIAL 220 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 1600 OSGOOD ST BUILDING 20 SUITE 2-36 NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE LUMPTION Please print DATE��,�(� JOB LOCATION HOMEOWNER '/ n�✓�" I�tu I Street Address 74 61 k&- 4505_ Map/Lot Name Home Phone Work Phone PRESENT MAILING ADDRESS _ Se Lo%v� S-�reeef A ANI,,vz r M A . 01 Y4- City/Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1.) DEFINITION OF HOMEOWNER Persons) who owns a parcel of land on which he/she resides or intends to reside, on which there is or is intended to be, one or two family dwelling, attached or detached strictures attached or detached structures accessory to such use and/or farm strictures. A person who constricts more than one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance 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 cements and that he/she will comply with said procedures and requirements. ' 0- HONEWOWNER'S SIGNATURE_ APROVAL OF BUILDING OFFICIAL a NORTH aAL Date..... ..............7:......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...............................`'{ f�............................................... has permission to perform ............:.. . �.:: ..:' "..". �.._r .... ................... ......... ........ wiring in the building of .X ..... ..,--...'-� at ......�'..... .................. ...................... . North Andover, Mass. l Fee .�/h.:. `�..... .... Lic. No. �! 1. :/.G . / ��.r .......................... . .............. ELECTRICAL INSPECTOR Check # '63' L: 0 A C /� nt0 C,omonweAd1 o/ Waseac1LaJelfe 2)eparintenl o13ire �ervicee BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Pcrmit No.. W, -?A Occupancy and Fee Checked /r/O [Rev. 11/99] ]cave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusens Electrical Code (h1EC), 527 CMR 12.00 (PLEASE PRIiVT LV INK OR TYPE- ALL iNf'OI MATION) Date: -� �/ 7 � Z�(33 City or Town of: A h d xzNZ R To the lirspector of Wires: By this application the undersigned gives notice of itis or her intention to perform the electrical work described below. Location (Street & Number) 5t=tar�� �� r1=r✓� e��g b85-316°7 Owner or Tenant Q�gg; t1 $�bo5 ,v Telephone No. Owner's Address _ ,sflvne A5 Aboy-e Is this permit in conjunction with a building permit? Yes ❑ No © (Check Appropriate Boz) Purpose of Building - �yy�r i� �UwmEQ 1� ) Utility Authorization No._ j Is l O 1 Existing Service �Og Amps 120 / 240 Volts Overhead ® Undgrd ❑ No. of Meters 2 - New New Service 300 Anips 12o /Zt{u Volts Overhead 0 Undgrd ❑ No. of iMeters:. Number of Feeders and Ampacity it) ;X'Amp Si%)xs 2o) 6Amp 2) 30Arv.a 2 -P. JF Location and Nature of Proposed Electrical Rork: -r -1) i,ioA L-PoIE No. of Recessed Fixtures - - No. of Ccil.-Susp. (Paddle) Fans -�.� ..••• �� .•u.vcu a)-utc 11 � ecroro/ nares. No. of Total Transformers KVA No. of Lighting Outlets No. of Hot "Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- ❑ ntd. rnd. o. o mergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating. Devices No. of Ranges 1; Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers en [ft Pump Number 'tons KW No. of Self -Contained Totals: Detection/Alerting. Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Connection Other No. of Dryers Healing Appliances KW SecuritySystenis: . No. of Devices or Equivalent No. of Water Heaters KW No. of No. of Ballasts Data �Viriug: Signs No. of Devices or Eq uivalent No. Hydromassage Bathtubs No. of Alolors Total I -IP l' clecommunications Wiring: No. of Devices or Equivalent OTHER: naac.r uuuntanu. uetau y aesrrea, oras required by the Inspector of {Vires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: j g�O (When required by municipal policy.) Work to Start: 772o03 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify,under the pains and penalties of perjury, that the information oft this application is Imre and complete. I� I RM N AN-M-d=1yN�l, i'/E c� cAl Co,4,,1-Ae t'nG 6-, LIC. NO.: Licensee: ,')Amrs Q 4,1, Signature LIC. NO.: S (If applicable, en�tcr "c.iaer11pr" in the �liccrsie number lift .) cBus. Tel. No.:_ S-7_3 Address: k-571 Al(.Tel. r`io.: !77T-9WZ7—/ 38 OWNER'S INSURANCE that the icensee does not have the liability insurance coVerage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ oxvner ❑ on'ner's agent. Oirr�cr/Agent Signature 1'cicphouc \u. I'LRA3IIT FEE: S `�J'• `rd V 2� A i a.. James L 1341 Pawtucl Unit 33 Lowell, LICENSEs SERIAL NO A18246 i7/ 1/2004 883089 COMMONWEALTH OF IVIASSACHUSETTS�` 'AS A REGOJOURNEYMANIELECTRICIA. t ISSUES THIS LICENSE TO JAMES R LYNYCH 1341 PAWTUCKET BOULEVAR NUNIT 33 0 O LOWELL -MA 01854-4.403 39389 E 07/31/p4 354231EXPI r • N AT TOJR�6 N OF ORTH ANDOVER mapFOR PLUMBING -� �'SSACNUS� � This certifies that ... ��.-.. ...... 1�.�""f........................ has permission to perform�-�+r� ................ .. . plumbing in the buildings of . .................... at �. rB ...�.-•-- - ° ........ � Nortb Andover, Mass. (/ PLUM8IN,,INSPECTOR Check # 7400 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location �7 4 .2 nd St New [:] Renovation L:J Replacement (Print or type) Installing Company Name 0+ Address C 7 /3-o d ,6,- FTXTITRFC oquer, PLQ,, C. I T oges' Date 1~V -D7 Permit # Amount ,Spy, &P Plans Submitted Yes [] No LTJ Check one: Certificate 0 Corp. ElPartner.' Firm/Co. Name of Licensed Plumber. �'H A v n1 Cr v G U E /u Insurance Coveta¢e• Indicate the a of msuiance coverage by checking the appropriate box Liability insurance policy L..1 Other type of indemnity ❑ Bond 11 Insurance Waiver L the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent 0 I hereby certify that all of the details and information I have submi best of my knowledge and that all plumbing work and installations tted (or entered) in above application are true and accurate to the performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa Sgt lumbing Code and Chapter 142 of the General Laws. Bylona �rn n urn r TitleType of Plumbing License City/Town APPROVED (OFFICE USE ONLY /S-�6 rcense Numer Master Journeyman ❑ Date....i; ,; n��..... . a� NORTH at T VIOF NORTH ANDOVER + s PE IT FOR GAS INSTALLATION Y s + This certifies that .. -* . ................ has permission for gas installation ....... in the buildings of ........................ . at -.. C .. t ...... �../ , North Andover, Mass. Fee4...:.. Lic. No. �f GAS INSPE7,OR Check # 6015 MASSACHUSETTS UNEFORM APPUCATON FOR PERMPT TO DO GAS FTTTING (Type or print) NORTH ANDOVER, MACSSACHU^SETTS Building Locations y� O J &C0-_7/ YX Owner's Name aro 0 /'cs" Date 46 ' Ll U Permit # Amount $ 6*5,," New Renovation Replacement Plans Submitted y G w C a �w x SUB -BASEMENT 3 a u a> c H o BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR STH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) 1 rr Name Address q C- 0r qe" arN w e k ;Asv�2e 1 J -91 Lo,,jeLL Mw t&5� Business Telephone 9-) 5_6 y 3/&7 Name of Licensed Plumber or Gas Fitter s h A0rJ L. Cr G & u tJ C k one: Certificate Installing Company Cff Corp. 0 Partner. FFirm/Co. INSURANCE COVERAGE Check on . 1 have a current liability Insurance pot' or it's substantial equivalent. YesNo� If you have checked des, please in 'ate the type coverage by checking the appropriate box. Liability insurance policy M OthL_jer type of indemnity Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work apd installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus s tate Gds Codg4nd Chapter 142 of the General Laws. grignature of Licensed Plumber Or Gas Fitter Sj63GPlumber IS -16,3 --- Pas as Fitter (cense Nurnber ROVED (OFFICE USE ONLY) I n Journeyman