The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 125 GRAY STREET 4/30/2018 / 125 GRAY STREET 210/107.D-0056-0000.0 -"" PERJiIT NOy too (z APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP NO. I LOT NO. 1 2 RECORD OF OWNERSHIP IDATE I BOOK PAGE ZONE SUB DIV. LOT NO. I - LOCATION PURPOSE OF BUILDING 'motwrp 1nse f i OWNER'S NAME y� �%1' NC1 V:. � • NO. OF STORIES SIZE �C' OWNER'S ADDRESS BASEMENT OR SLAB - 12_SG cad �• - ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS 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 w ®A 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 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PIER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 72 ' EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED % Z$' -7 (ftj BOARD OF HEALTH SIGNA RE OF NER OR AUTHORIZED AGENT F E E PLANNING BOARD PERMIT GRANTED +� 19 1 ARD OF BELE N fU1LDIN<i INfPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ SiOkIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES 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 HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL IN. B M AREA _ '/ 1/2 3/1IN. ATTIC AREA _ NO B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARD\'J D _ ASBESTOS SIDING COMMON _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY - STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR ADEQUATE NONE rj ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLATJ�l 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 I 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 3rd NO HEATING L N WOOD STOVE INSTALLATION CHECKLIST P111MIT No: 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. NewUsed B. Type/radiant Circulating C. Manufacturer Lab.No. t)L 1182 Y)Ai )) lef£S_S . Name/Model No.'QlSaC Collar size Dimensions/Height` Length " Width Chimney A. New ,�� Existing S. Size(flue area) C. Other appliances attached to flue(Number and flue size) D. Prefab(Manufacturer—name and type) E. Masonry/Lined Flue liner Unlined (type&manufacturer) F. Height(refer to diagrams) cap 3' yuity OVER. Ic I 3 . I2" I$I f 12 MIN. 2 MI. 1C' -MIN .o MIN. MIN.R. ` ; ' FU ELASf"i AL =5591P HEARTH CHIMNEY HEIGHT Hearth•(non-combustible) A. Materials B. Sub-floor construction C. Minimum dimensions(refer to diagram) Clearances and Walt Protection(see stove installation clearances chart) A. Type of wall protection provided B. Clearances(refer to diagrams) 79 i AP . I � FIREPLACE CORNER WALUCENTER 13 cap factory built chimney C r roof support support bracket B connector pipe non-combustible wall protection A connector overlap i 1 A A woodburning stove ,tenon-combustible floor protection 12" • t'h" 18" 12". Figure 2109.4 Figure 2109.4 STOVE INSTALLATION CLEARANCES Combustible '/z"Asbestos Millboar Concrete:Masonry Spaced Out 1" Stove Components Material Spaced Out t '' 2. . 'Foundation Wall 4 Brick Veneer Radiant Stove1. 36' -- - -Front Circu Wing Stov<0 24" — - -Front A. Radiant Stove 3. 36" 18" 6" 18" —Side!BackiTop A. Circulating Stove 12" 6" 6" 6" —Side!BackiToo B. Single Wall 18" 12" 6" 8" Connector Pipe S. Insulated 2" 2" 2" 2" Connector Pipe C. Chimney Height Three(3)feet above adjacent roof and (Metal or Masonry) two(2)feet above any roof ridge within 10 feet.. 0. Gamper If a damper is not included in the stove construction, it must be installed.in the connector pipe. 1. 6ront:Fuel or ash access side. 2. Non•comoustible spacers required. 3. Clearances on each side of a radiant stove with a heat shield shall be measured as if a circulating type. ' Note:Clearances shall be measured perpendicular to stove body. Laboratory verified test clearances permitted. I . 4. Thimble required for passage through combustible construction. 12 T 40 Location y QG. No. `' ' Date NORT" TOWN OF NORTH ANDOVER F w A + r Certificate of Occupancy $ ��s'•"°'tt�' cMBuilding/Frame Permit Fee $ ti s� us Foundation Permit Fee $ Other Permit Fee $ e� TOTAL $ � Check # �, a 7897 / Building Inspector v N TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPRENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING se BUII.,DING PERMIT NUMBER DATE ISSUED: ic SOUND SIGNATURE: Building Commissioner/I for_Buildings Date z SECTION 1-SITE INFORMATION 1 O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: a )10//o 7 D &4 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide Regaired Provided ReqWred Provided —+ v 1.7 Water Supply M.G.L.C.40.11 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 'ictrict: Yes P,lo m 2.1 Owner of Record ew, Name(Prin Address for Service ew - :Tina re Telephone I 2.2 Owner of Record: Name Print Address for Service: z M Signature Tele hone go SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: 0 Is License Number ,on Address r Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number '"' r Address z Expiration Date Signature Telephone G) �A SECTION 4-WORKERS COMPENSATION(M.G.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 check sII a Neable New Construction ❑ Existing Building.0 Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant . 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC a� 5 Fire Protection 6 Total 1+2+3+4+5 O d a d.Oo Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AG OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property ip n Hereby authoU/mama to act on Mybel�all',,m-til nia rs ivrk authorized by this building permit application Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,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 r Si ture of Owner/Agent Date L NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIy1BERS l' 2' 3 RD SPAN DIMENSIONS OF SI1,LS DIMENSIONS OF POSTS DRyIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE NORTH c Town of O No. All dover, Mass., T Q - LAKE /k. C OG KIC KE WICK V SRATED PPS` �y BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.................... Foundation ..................... .............................................. ................................... ....................... buildings on has permission to erect................ g .............. .... .... ..................................... Rough tobe occupied as.. ..... .... .......... ... .. �... ............................................................... Chimney provided that the person accept this permit shall in every respect conform o the terms of the application on file in Final this office, and to the provision f 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 CONSTRUCTION STal )PT 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. sumer Street No. SEE REVERSE SIDE Smoke Det. i pORTN TOWN OF NORTH ANDOVER OFFICE OF p BUILDING DEPARTMENT x * 400 Osgood Street 41-ro- .c�* North Andover, Massachusetts 01845 �SS�cHuS D.Robert Nicetta, Telephone(978)688-95454 Building Commissioner Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: �l��,y �j'�• ��. i Number Street Address Map/Lot HOMEOWNERAla .% 5F70-'f7i`-- Name Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less P g 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)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The iundersigned"homeowner"assumes responsibility for compliances 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 and requ• ents and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL I i i I BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 r r� North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM 54 a condition of Building Permit the provision of MGL c 40 S 9 In accordance with p Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: �I (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this prothrough the Office of the Building Inspector project 9