HomeMy WebLinkAboutMiscellaneous - 106 AUTRAN AVENUE 4/30/2018I
Location
No. �'p Date x
M0RTM TOWN OF NORTH ANDOVER
SOL
i - y
Certificate of Occupancy $
CMU sEt� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
14 4
i�
Building Inspector
i
I
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PER NUMBER: / DATE ISSUED: �_ X
SIGNATURE:
ic
Building Commissioner/I for of Buildings Date - OU
SECTION 1-SITE INFORMATION
1.1 Property Address: / 1.2 Assessors Map and Parcel Number: .
Map Number Parcel Number
��\
1.3 Zoning Information: 1.4 Property Dimensions:
ZoningDistrict Proposed Use Lot Area Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide ReqwrW Provided Repired Provided
1.7 Water Supply M.QL.C.40. 34) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT m
2.1 Owner of Record
Name(Print) Address for Service:
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
z
M
Si ature Telephone 90
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
6;0- 3
Licensed Construction Supervisor: L/ y'cj�
S7-7-- �/� GLicense Number
Address
/C ?/ p
S 6 ( Eapir h n Date
Signatu .Yep
— Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name 6 M
5/9lA''!�: Registration Number
Address
Expiration Dater Y®
Tele hone
SECTION 4-WORKERS COMPENSATION(MG.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes.......0 No.......0
SECTION 5 Description of Proposed Work chat a llcable
New Construction ❑ Existing Building V Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify i, . _
i \
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to beIM77
`" h
Completed by permit applicant
3
1. Building (0) (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3
Plumbing Building Permit fee(a)x(b)
4 Mechanical HVAC TV
5 Fire Protection
6 Total 1+2+3+4+5 Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, /Ud''e'4' ���� as Owner/Authorized Agent of subject property
Hereby authorize �lU !/�✓� /t� Q�"✓`zJ �/9)� to act on
My behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b O NER/AUTH ZED AGENT DECLARATION
,as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge `
and belief
Print Name
Si attue of O r/A ant Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1 2ND 3fw
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DR\AENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CH MNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
NORTii
Town . of over
00T O LA o dover, Mass.
'Q COCMICMEWICK ' '
V
A �
�d ORATED
S H �
BOARD OF HEALTH
PER I D Food/Kitchen
Septic System
AdIL BUILDING INSPECTOR
THISCERTIFIES THAT............. .................................... .......... ..........................
................. .......... .........
• •• Foundation
has permission to erect............. ' in s on..*AM..1.6........ ....... ..... . .... PRough
to be occupied as.. Chimney
�.
provided that the Orson accepting this perm lin every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Code nd 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 S;tR
ELECTRICAL INSPECTOR
Rough
.........................................:........................::.......................................... Service
BUILDING INSPECTOR
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.
a L SEE REVERSE SIDE Smoke Det.
•e+ - -- �/ze -�aavrreaizurea� �/�aaaaefiticoelYd
B
OARDF
O BUILDING REGULATIONS .
License: ,CONSTRUCTION SUPERVISOR
Number:-CS 034200
Birthdate j09/3011945
Expires:.09/30/2001 Tr.no: 5943
- - Restricted To: 00
NORMAN GAY _
70 JEFFERSON ST ,...,.v
N ANDOVER, M4,01845 Administrator
4
J
& Cominerci °of; • •
Sia
�e Licensed& Insured
V
• Roof Leak Experts •
(978) 794-3883 • 1-800-WAIT-4-US
Proposal submitted To Phone Date /
Street 6' ��
/� Job Name l
City,State&Zip Code [/f' Job Location Job Phone
We Propose hereby to furnish and labor in accordance with specifications below, for the sum of:
78a'a - fjrA -rv/A, t r
Dollars (S�"`_.`w�. -s-__ _-- • ��.� " -
' ars' �'/� �9�Pcyrrz�%ric,�vt -�- �/Si� =' ,q�,o,•;����
All material is guaranteed to be.as specified. All work to be completed in a workmanlike Authorized
manner according to standard practices.Any alteration or deviation from specifications be- " Signature: - -
low involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estimate.All agreements contingent upon strikes,accidents NOTE:"This proposal m y-be
or delays beyond our control, Owner to carry fire, tornado and other necessary insurance.
Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days.
d estimates for:
We hereby submit specifications an t
ca s u2 car ""fla,we /Cc
�r✓.lr� iGnnln X6-4 7—e 7- -edi,al*�4ss 92*440 ova
'.,.OGGi9 � 'i
5"%�G' �.-�.f" �il��''' /!i i ��1 � 5`.FfG�i•r- �'.�„9c£" SLG ,t�i.,a�S'�'
G�.��9r/ .Ci! t /Z�ff 4J ` JC'11.�..�i!�'�� �•�'....K-�*f.l��, `S�"r�rC. �QG.G �GA..f�/l.�/"�J'
r
LSU 3 e s 4o. c&&,ZA
c, w1�rs-� g s► ••
M1 I
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Acceptance of Proposal - The above prices, specifications
and conditions are satisfactory and are hereby accepted.
You are authorized to do the work as specified. Payment Signature:
will be made as outlined above.
Date of Acceptance: Signature:
.. s
(IV
Q
i
9
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING j
(Print or Type)
Mass. Date 3/6 1g,* Permit #
Building Location 0& d 1" z&.0— Owner's Name -s/17
Type of Occupancy
New ❑ Renovati n ❑ Replacement C� Plans Submitted: Yes❑ No ❑
Emergency: Mass Electric
W.H. Rental # / FIXTURES
/ 5 .0,:9,52419
P
Z N
N Q
2 Y
O Z Z W W
N Z N Q ¢ < ~ = O 2 H d
O _ ¢ = N
J N W N y = ~ < W N
¢ rp
a
¢ W O n ¢ Q N Q Q W y Q J ?
W ¢
W z Q 2 3 3 O = S Y a O ~ Q Y d W LL Y W
h- U > F- O = a 3 H r- = O O Vj = - W F- O (jT.
3 Y J m N C a J 3 = f- N U. a � O Z 3 O m O
SUB-BSMT.
BASEMENT
IST FLOOR
2NOFLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
Installing Company Name Welch Brothers C.c) _ T n r Check one: Certificate
Address $# �h e 1 is f e r—e? ;9 ® Corporation 1501—C
T.n w a 7 7 MA - 01 Q 51 ❑ Partnership
Business T elep'llone ("508) 4 5 3—210 v^ G Firm/Co.
Name of Licensed Plumber T h n m A c F. r a re y
INSURANCE COVERAGE:
I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes ® No ❑
If you have checked ye, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy ® Other 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:
Owner ❑ Agent❑
Signature of Owner or Owners Agent
I hereby certify that all of the details and information I have (or entere )in abo ap tion are true and accurate to the best of my
knowledge and that all plumbing work and installation orm riderthe it is d is pplication will be in compliance with all
pertinent provisions of the Massachusetts State Plu ing Cod d Cha oral S.
BY
Title gnature o cen Plumber MR o
City/Town
Type of License:Master J urneyt ZCF]
_ 8
APPROVED(OFFICE USE ONLY) License Number
r
i Date.
T0 2847
".ORT"
�+ TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
�,..,._.:a_.: s •
+.
SSs Ar„
I' ACH SES
This certifies that . ., -�'��. E...4.•. . � .• . . . . . . .
has permission to perform . . . w.fT. . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of .' 2c.c�f. . �.��L�/�tl. . . . . .
, North Andover, Mass,
Fee. No4-1-111Y A . . . . . . . . . . . . .
PLUMBING INSPECTOR
03/14/96 11:54 15.40 PAID
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File
Location
No. C%—� Date
"0RT" TOWN OF NORTH ANDOVER
F p Certificate of Occupancy $
41
n
# Building/Frame Permit Fee $
Foundation Permit Fee $
s CHU
R<A ° /•'
g aher Permit Fee $ yb.c>y
Sewer Connection Fee $
Water Connection Fee $
_
--- TOTAL $ \rS.00
JAN,"i 6
1990 Building Inspectbi
Div. Public Works
PER111T NO.\ �°!b � APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1
54AP 4-40. —) LOT NO. 2 RECORD OF OWNERSHIP ;DATE BOOK ;PAGE —
ZONE K SUB DIV. LOT NO. �—
LOCATION p !� URPOSE OF BUILDING / 1a .�
L' OWNER'S NAME AL1=/'��n � /"P�L/ R I/� NO. OF STORIES
OWNER'S ADDR SS BASEMENT OR SLAB J
ARCHITECT'S NAME `� � C p SIZE OF FLOOR TIMBERS IST 2ND 3RD
I,1 to J
IU1LDER'S NAME V /7 Al
5—A
SPAN ---
(/DISTANCE TO NEAREST BUILDING ,c "IG SPAN
OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES—SIDES REAR " " GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS 3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES EST. BLDG. COST � B
PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
PAGE 2 FILL OUT SECTIONS 1 - 12
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLLANS MUST BE FILED/AND APPROVEDBYBUILDING INSPECTOR
DA FILED
BOARD OF HEALTH
SI 1V U OF OWNER OR AUTH RI DGT
F E E
PLANNING BOARD
PERMIT GRANTED
19 P
BOARD OF SELECTMEN
BUILDING INSPECTOR
WHITE: Building Dept. CREAM: Assessors CANARY: Treasurer
BUILDING RECORD
1 OCCUPANCY 12 ,
SINGLE FAMILY s�oR1Es THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY IFFICEs LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE _ d 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDWD
PIERS PLASTER _
DRY VJALL _
UNFIN.
3 BASEMENT
AR&A FULL FIN. B M AREA _
FIN. ATTIC AREA _
NO BMT FIRE PLACES _
EFS AD ROOM _ MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3 _
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDVJ'D _
ASBESTOS SIDING COMMON
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY _
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR I_
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME
SUPERIOR POOR
ADEQUATE
ADEQUATE NONE
rj ROOF 10 PLUMBING
GABLE I HIP BATH (3 FIX.)
GAMBREL MANSARD TOILET RM. (2 FIX.) _
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK _
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. _ STEAM
STEEL BMS. & COLS. HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G -
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC
1st 13rd NO HEATING
'WGGD STOVE INSTALLAI-iON CHECKLIST I- "l'' (I�,:�<SS - / 22
Permit
A building permit is required for the installation of any Solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and not to the stove construction.
Stove
�•.._.�` A. New v... Used
B. Type/radiant Circulating j
C. Manufa _Lab. No.
Nam /Model No. C��Ilar size ✓ (��
Dlmens eight �o�r 1' 64 L Length Width ti
Chimney
A. New __..Existing
B. Size(flue area) � x
C. Other appliances attached to flue(Number arid flue size) N4�s p
D. -Prefab(Manufacture ame and type)
E. Masonry/Lined 1r d
, Flue liner
Unlined stype d manufacturer)
F. Height(refer to diagrams) cap
OVER, ICI
2t Mlht. Z � 11t1. � �
3'MIN to
12" �
MIN.
HEARTH
I/V
CHIMNEY HEIGHT
Hearth(non-combustible) o�
A. Materials
B. Sub-floor construction
C. Minimum dimensions(refer to diagram)
Clearances and Wall Protection(see stove i stat tion clearanc-s chart)
A. Type of wall protection provided 11162.z
B. Clearances(refer to diagrams)
3•i
FIREPLACE conNER WALUCENTER
NORM
OFFICES OF: 3: "� Town of'
I:?1) ,11E 111) titwcl
I
BUILDING NORTH ANDOVER �c
Tiii11 AI1(1()\cl,
CONSERVATION *; fJ �IE)� r)t htE�( illi OIts-4S
F-IEALTF-I 'J: Say DIVISION OI
PLANNING
PLANNING & COMMUNI'11' DEV ELOI'M EN'1'
KAREN ILP. NELSON, I)IItI:C"Ic)IZ
i
To:
From: North Andover, Building Department
Re: Wood Stove Installation
This is to certify that I have inspected and approved the
installation of a woodburning stave at your residence, located at
the above address. The installation meets all the requirements.
of the State Building Code.
Yours trul
Ys
Assistant Building Inspector
MJG: gb
I