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Home My WebLink AboutBuilding Permit #208-12 - 96 CHESTNUT STREET 9/13/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �O�r /77 Date Received Date Issued: IWORTANT::Applicant must complete all items on this page LOCATION Ces v 1 S� o R4-k AELDve.AMA. PROPERTY OWNER ` Print MAP NO:_(Q�/O PARCEL: ZONING DISTRICT: Historic District yes no lilt Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building e,6ne family addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other la ml®��Wellu, T ®}Flood ui p _� _ - _ Dist` -. � ..�. �Waterslied� �®IWater/Sewer•__- DE 1710 IV OF WORiC TO 3E t ilR-'i ORM1JD: it ilA N�iC_A4 Ce S,S 17l lit (Identification Please Type or Print Clearly) OWNER: Name: ver-) e l.�s Phone: Address: of L ��s�NU`�` �TNo(z T% Nct t) MA CONTRACTOR Name: 2eS1 C A C.cA Phone: Address: 1/A �2�s�� S� IVoEZ� At dov z MJa O) g� S Supervisor's Construction License: ��' 9� $' Exp. Date: Jc -/5 —ORO Home Improvement License: Exp. Date: j ARCHITECT/ENGINEER v v o c4i e Phone: 1� I 3 1/ M `T-i- lit Address: N-e- S�Ip� 'd �V� 1 /e �e c�/�'I�4 0;-155 Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F. Total Project Coat: $ � C Oo O FEE: Check No.: �2y Receipt No.: NOTE: Persons contracting with unregistered cont rac ha access to the guaranty fund ,_g_ Location r/ ,OyLt No. ate— .^4/2 Date N,Go TOWN. OF NORTH ANDOVER 3? •. '• O y 9 i s � ; ; Certificate of Occupancy $ CMUs<� Building/Frame Permit Fee $ /- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # '7 e, 2 B6ilding Inspector V f Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ I TYPE OF SEWERAGE DISPOSAL Public Sewer Tanningimassage/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 I 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/si nature&Date Driveway Permit cr v DPW Town Engineer: Signature: Located 384 Osgood Street I FIRE DEPARTMENT - Temp Dumpster on site yes no { Located at 124 Main Street j Fire Department signature/date COMMENTS Dimension �I Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. i.: _ ELECTRICAL: Movement of deter location, mast or service drop requires approval or 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 i i ® Notified for pickup - Date Doc:.Building Permit Revised 2008mi i 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 o 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 MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Per Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Comtraci: v Flo or/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 Pen- New Construction (Single and Two Family) a Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses .a Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (if Applicable) o 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 .Fern 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: Doc.Building Permit Revised 2008mi TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 1 Permit NO: Date Received l/ t Date Issued: IWORTAldT:Applicant must complete all items on this page LOCATTON Eint PROPERTY OWNER 1C' .A_vL,L� Pirnt MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no ff tMachine Shop Village yes no 111t f TYPE OF IMPROVEMENT PROPOSED USE c Residential Non- Residential ❑ New Building ❑ One family lid ition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial } ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other OJS pticj ®��WellpYFlo plain A® etl Wands; ® Wa she IDs r _ ct� i DES C.s. TION OF WORK TO BE iR�.i'ORMED: Or lit (Identscation PJease Type or Print Clearly) a1,9— 7/ F3 7 OWNER: Name: d3f Phone: Address: CONTRACTOR Name: one: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: 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. ITetal Project Cost: $ FEE: $ i 'peck No.: Receipt No.: TE: Persons contracting with unregistered contractors do not have access to the guaranty fund ure'ofi4gentiOwner< �_ :_ -�F�:,.�Signafure�of contractor��s� = "� �� ' ��-�l7 t Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOS Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ ` Well Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ElPermanent Dumpster on Site 7 I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED 3 Z PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS �tJc7 ' cc s�� r w,�1 S PCZ o,).+- 6 I h HEALTH Reviewed on Signature COMMENTS a / s Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board'Decision: Comments r Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street r FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Failure to possess a current edition of the Massachusetts State Building Code 1 is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS � I Z99LL :#Jl Gaut rssnuuu, £lOZ/9L/S :uoiiejidx3 SVOLO t/W 'H3AO(IMd N { j 1S 11OOS3W 8 L L ` OOVIOS a a3HdO1SINHO a 91'L69 SO :asuaDi- asua0l-1 10slnladnS uoljoni;s-uoZ I)urjS put: suoipeln7k.)H ;;uipl!ng to p.rco8 ?'tdnd.Irr lu3wi.ru( )d -�uasnil�rssal� (` Contractor: Christopher Sciacca 118 Prescott Street North Andover, MA 01845 978-314-6934 Homeowner: Steven Reynolds 96 Chestnut Ave. North Andover, MA 01845 Contract for Addition/Construction li Construct an Addition approximately 830 square feet per the plans submitted by Doug Shoop, architect. Connect addition to rear of house at family room with a 8'X 7'connection/hallway. Construct a 22'X 35'addition which will consist of an office area, closet/laundry areas, master bedroom, and full bathroom. Entire addition will be build to be handicap accessible. Bathroom will have handicap accessible shower,with tile walls throughout. Install a central air conditioning and a separate forced hot water boiler and hot water tank. Roof shingles will be 30 year architectural shingles to match existing house. Exterior siding will be vinyl with all trim wrapped in white,aluminum coil stock. i Specified casement windows can be substituted for double hung windows at owner's discretion. Windows will be Anderson, Harvey, or comparable.Owner's choice. Work will include tree removal(as needed for addition),excavation,foundation,framing, windows, siding, roofing, central a/c, and f.h.w. heat, insulation, blueboard and plastered walls, laminate flooring throughout, except tile in bathroom, interior trim, and paint. Contractor will construct a concrete walkway from the existing driveway to the new addition. Work NOT performed by contractor: Desks,desktops, cabinets in Office area. I will leave the site finish graded, but does NOT include any landscaping (loam, seed, shrubs, planting) Total cost for project: $105,000 Three payments of$33,000 and one final payment of$6,000 when occupancy permit is issued. Steven Reynpl o 'eowner Christopher Scia ,contractor I� I �70RTy T® ANDOVER TOWN 1'Y O1lAIy - ` OFFICE OF 1 J BUILDING DEPAP TMENT 1600 Osgood Street Building 20,-Suite 2-:3 6 y9sSa�yu5 �5 North Andover,Massachusetts 01845 Gerald A.Brown Inspector o;Buildings Telephone(97S)688-9545 HOMEOWNEKLICENSE EXEMPTION Fax (978)688-9542 PEPLWT APPLICATION Please print DATE: JOB LOCATION: V S Number Strejet Address EOMEOW`NF_R s P�e,�l ne. No(�l s Map/ pt Name " Home Phone Work Phone PRESENT MAILING ADDRESS o C4*V Town. State . Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to a1-low such homeov%ners 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 HOMED WNER Person(s)who gwns a parcel of land on which he/she resides or intends to reside,on which there is,oris intendd to be,a one or two family structures. A person who constructs more that one horn e e in a two-year period shall not e considered a homeowner. The undersigned"homeowner"assumes responsibility for Applicable codes,by-laws,rules and regulations. compliances with the State Building Code and other The under signed"homeowner"certifies that he/she understands the Town Of North Andover Building Department minimum inspection procedures and requirements and that lie/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 658-9541 C0NSEfil%A770N 688-9530 HEALTH 699-9540 PLANi`ING 685-9535 r• . r The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contiractors/FIectricians/Plumbers Applicant Information Please Print Legibly Na1M(Business/Organization/Individual): Address: City/State/Zip: Phone#: FEl you an employer?Check the appropriate box: Type of project(required): I am a employer with 4. ElI am a general contractor and I 6. ❑New construction.employees(full and/or part-time).* have hired the sub-contractorsI am a sole proprietor or partner- listed on the attached sheet.t �• Remodeling ship and have no employees These sub-contractors have 8. []Demolition working for me in any capacity. workers'comp.insurance. g• ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.ElPlumbing repairs or additions myself. [No workers'comp. c. 152,§ (4 1 ,and we have no ) 12.F1 Roof repairs insurance required.]7 employees.[No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. 1 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. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: P Y Policy#or Self-ins.Lic.#: Expiration Date: 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 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 ofthis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains and'penalfies ofperjury that the information provided above is true and correct. Signature: Date: Phone#: 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 CIerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Persoia: Phone#: NORTH Town of Andover . . Ilk No. p�- �,ol� -_ - _ 14 o 1* dover, Mass. O 't- LAKE \ 1 COCHICHE:.': �lgS0RArEo PP�� BOARD OF HEALTH Food/Kitchen P�ERMIT T U Septic System BUILDING INSPECTOR �� L✓�/v THIS CERTIFIES THAT............ . s.................................................................... ........................... ...... ............. Foundation has permission to erect........................................ buildings on ........................... Rough to be occupied as........./ !-' .:.../`�.. r(./.^ 10`y............ 3 U...J .....G.'. :............................................. Chimney provided that the person accepting this permit shall in every respect conform tope 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 ELECTRICAL INSPECTOR UNLESS CONSTR�ICTIO TARTS Rough ...................... .� .......L' -t...................... ................... BUILDING INSPECTOR Service Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det.