Loading...
HomeMy WebLinkAboutBuilding Permit #541 - 91 BOSTON STREET 2/21/2006Ot .NORYN , o ° p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SSACHUSE4 Permit NO: Date Received:4".% Date Issueil: __,_0— 2 iimpoRTANT: AtiollCallt 11111St C0111pIttl all itCI11S llll tills LOCATION _0 PROPERTY OWNER Print ;,IAP NO.1_0 '� " &PARCEL:' �ZONING DISTRICT: mom; nr. ♦bill itCL' !1C 13119t nrN!` HIP.TnDid- MgTR1f T VFi rl TYPE OF IMPROVEMENT 1PROPOSEDUSE Residential Non- Residential New Building -i Addition _ Alteration - One family - Two or more family No. of units: Industrial Repair, replacement Demolition - Assessory Bldg Commercial (relocation) r' Other _, Others: _'.'-Moving _ Foundation only i DESCRIPTION OF WORKTO Bh PKhkUKMEU �M Identification Please Type or Print Clearly) nature i I / 4 inA.. /i 14 CONTRACTOR Nanle:1 0 /� % in SPhone: %� 4 l Address: A �t,�Y-���.�r.�.� � +�- Supervisor's Construction License: C, S� 6 �U? Exp. Date: © Home Ilnprovcnlcnt License: Exp. Date: \RCIIfTECT; FiNc11NF F'R Nc1n1�: Phone: Address: Reg. No F'EE SCHEDULE: BLLDLVG PER,IJIT: 510.00 PER 51000.00 OF THE TOTAL ESTIMATED COST BASED ON S/25.00PER S.F. /�0. a Total Project Cost :$ 0 x10.00 FEE:$ / Check No.:_ �% 7 Receipt No.: Location No. Date Check # TOWN OF NORTH ANDOVER D fa Certificate of Occupancy $ Building/Frame Permit Fee $ ., Foundation Permit Fee $ Other Permit Fee irA?,e- $� 4 TOTAL $ Building Inspector TYPE OF SE\kARGE DISPOSAL Public Sewer 1 (40 (41414 Private (septic tank, etc. Tanning/1vlassage Body Art Tobacco Sales Permanent Dempster on Site Swininlin" Pools - I - Food Packaging, Sales :VOTE: Persons contracting with unregistered contractors da not have access to the �;uarautj jlutd Signature of Agent,Owner Plans Submitted Plans Waived ❑ Signature of Contractor Certified Plot Plan D Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED ❑ ElWater Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE REJECTED DATE APPROVED % CONSERVATION ❑ L COMMENTS DATE REJECTED HEALTHEl COMMENTS Zoning Board of Appeals: Variance. Petition No: Zoning Decision, receipt submitted Plannllli-,, Board Dcclslon: Ci)Illlllelltti Conservation Decision: coninicilts Water & Scwer connection signature & date Tenlp Dempster on site yes___no__ Fire Department signature'date DATE APPROVED 131ailding Permit Approved and Issued by: r ri Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided RcqLlil-Cd Provides Required Provided DUNIENSION 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 :1 Building Permit Application ❑ Debris Removal Form 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 ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Fonn ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses a 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) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Form U 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 Hydrauli Calculations (If Applicable) • Copy of Contract ❑ Mass check Enerzy Compliance Report III all cases if .1 �'Iriance or special permit ivas required the Toy+n Clerks office must .,tamp 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 Dile: INSPECHONAL SEIt� K ES J)EPART,%IE-\T:BT'F0RM05 Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 Building Demolition Affidavit DATE 01 /a / &, PROPERTY LOCATION 2/ & S`(36)1 S±I-P-P_-� �/ f l�Uslr�-i St• /V d • 64h da�v, �i-h EXTERMINATOR A�3T 9r� J— nc . k, TER- BLDG. INSPECTOR DATE RECD 3a.-p� aUi4l� NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 91 Boston Street is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by NIGL .i1,S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 1 OA. The debris will be disposed of in: LL & S Wastewood, Salem, NH (Location of Facility) A" r'�Z� Signature of Permit Applicant Fire Department Sign off: "5�� Dumpster Permit /a I/O g- Date Site "�a��iiruyruaea` ��i G'L(�1dlGCfLiIJP.G BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 012428 Birthdate: 01/18/1934 Expires: 01/18/2008 Restricted: 00 DONALD F JOHNSTON 114 BOSTON ST N ANDOVER, MA 01845 M M Tr. no: 14148 x'-04, , '-'// , & a 17� Commissioner o a a u a W � � � w °o v o o G o G W o G o G w cn w w U c w" rs: w w w a w rA n cn O proh o C Q s: o CL:otv. ez ff { `' Y'�s�y E a ® C C 3 X CEm w C yt,,, u+ m yCa CL 0 .Q Z 7 4.1r ■� c v� m W tr Ii G0 c=m.. U It% CD M G3 G3 CL.CD W a hm H �, o o� W O c p O W � s c� o. W C. OC a := Cc 0 c o 0 CL rm :Erna w y Ca W ._ :mom �, u m-c� m Cf) eo La a CC J ,..O � c wCP O. O goc Q4rAmo r m O C. gym o U V V) coo o, O !O CL _ 4D 3 PQ C C W wiz d c c Z H yr ui 'E d, o_ ' v o c ~' 1� -1 y a m p m CLT A a G C F- .2 Rte. a=.. CO ::w I, Dona 1 d E- .Tohnsfan as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury ✓a k/12 / Pont Name i tore of ;Ager Date Item Estimated Cost (Dollars) to be 01 Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number ( I T > ��.. 14. UYih�. { '�.F. ''nM tr :G MIR J ft .✓'r 52: f.Gt£'1kif�'.YSF it ��Y S, �: l� >f-�f ; hP-'-P �1 j ;F 35S1ytk i - 5,{� '3'Y.t 4 ... xr{F/`f C,t;yi.t%r k�T�Ylx 'is ff '• gmi �f ^xrlt S,). e�.. .aJ{!-ra r4... fi` 3'''15 44 :D�.".�X.7 �..7,"'s_-� Sj S' '2 _ I z` r4 7 ' NO. OF STORIES SME TWO i 1 BASEMENT OR SLAB Full Basement SIZE OF FLOOR TIMBERS 1 ST 2ND 3 211XV 11 2"X10" SPAN 13' DEMENSIONS OF SILLS Two 2"X6" PT DEMENSIONS OF POSTS 4X6 DIMENSIONS OF GIRDERS $11X10" HEIGHT OF FOUNDATION THICKNESS 7'. 10;, 10" SIZE OF FOOTING X 10"X20" MATERIAL OF CHIMNEY Red Brick &Fire Btick, Brick Hearth &Block IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE No u , �1iv2 'rt'+t' "�C \iov.pn 'ems. +� �, "+�s.+ 2Gx'``y�Gc' s 7 X✓,i''{' 2. "7.`''- ` �3 t a New Construction k Existing Building ❑ Repair(s) IJ Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other [1 Specify Brief Description of Proposed Work: Going to remove existing house and replace with 34'X54' Four Bedroom House (Colonial) With a Kitchen, Dining, Family Rm & Living Rm, with 2 1/2 Baths. Wood Construction with Red Brick Front and Fire Brick Chimney & Fireplace, and two Car Garage. ❑ BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height (ft) Structural Structural Peer Review Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Donald F. Johnston Owner of the subject property Hereby authorize Donna L. Dupuis to act on My behalf, m all matters relative two work authorized by this building permit application Signature of Owner Date USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 0 A4 0 A-2 A-5 ❑ A-3 ❑ ❑ IA IB ❑ 0 B Business 0 2A 2B 2C ❑ ❑ ❑ C Educational 0 F Factory 0 F-1 ❑ F-2 0 H High Hazard ❑ 3A 3B ❑ ❑ IInstitutional 0 I-1 ❑ I-2 ❑ I-3 ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 0 R-2 R-3 ❑ 5A 5B ❑ ❑ S Storage ❑ S-1 ❑ S-2 ❑ U Utility M Mixed Use S Special Use ❑ 0 ❑ Specify: Specify: Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34: Proposed Use Group: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height (ft) Structural Structural Peer Review Yes ❑ No ❑ SECTION 10a Owner Authorization - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Donald F. Johnston Owner of the subject property Hereby authorize Donna L. Dupuis to act on My behalf, m all matters relative two work authorized by this building permit application Signature of Owner Date