HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (18) �v
N
S.
Location
No. Date
M0RTh TOWN OF NORTH ANDOVER
3?o�tt`•o I•,��
f w
9
i
}�o Certificate of Occupancy $
ITS^CMOS Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
' TOTAL $ �S
Check #. ir
Building Inspector
TOWN OF NORTH ANDOVER
• BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONS.OR TWO FAMILY DWELLING
IN7
BUILDING PERNUT NUMBER: DATE ISSUED: 1
0V
7V y X
SIGNATURE: AN�
Building CommissioneEig)4ctor of Buildings Date --la-7
SECTION I-SITE INFORMATION z
1.1 Property Address: 1.2 Assessors Map and Parcel Number:Map 0
M-A
Nu Parcel'N"unt er
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Areas Frontage(ft)
1.6 BUILDING SETBACKS(ft)
Front Yard Side Yard Rear Yard
Required Provide Required Provided Re 'red Provided
1.7 Water Supply M.G.LCA0. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System D >
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M
2.1 Owner of Record
0,
I&A
Name(Punt) Address for Service
5m
Signature Telephone
Owner of Record:
Name Print Address for Service: 0
z
Signature Telephone M
SECTION 3-CONSTRUCTION SERVICES 90
3.1 Licensed Construction Supervisor: Not Applicable 0
Licensed Construction Supervisor:
License Number
Address "n
>
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable 0
Company Name
Registration Number M
Address
Expiration Date z
I Signature Telephone G)
Y
SECTION 4-WORKERS COMPENSATION(RG.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.......❑ No.......❑ �~
SECTION 5 Description of Proposed Work check all a licahle
i New Construction ❑ Existipg Building Q Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
• SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be {}moi Com,USE Q ,
Completed by permit applicant
1. Building (a) Building Permit Fee
7
Multiplier
2 Electrical > d� (b) Estimated Total Cost of
Construction
3 Plumbing Building Permit fee(a)X (b)
4 Mechanical HVAC
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
as Owner/Authorized Agent of subject property
r
Hereby authorize ��.�.may to act on
My behalf,in all,matters relative to work authorized by this building pennit application.
Si nature of Owner Date
SECTION 7b OWNER/AUTHORIZED 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 (�
C`JL �/<_E m a r s �Gl✓�1f v n , �J��T1 Grp PC t\ C,
Sip-nature of Owner/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS iST2ND 3
SPAN
DIMENSIONS OF SII LS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING x
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
& ,,_. •r7
t J_
Building Department
27 Charles Street
North Andover, Massachusetts 01845
(978) 688-9545 Fax (978) 688-9542
A Hose
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 s 54, and.a condition of
Building permit-# the debris resulting from the work shall,be disposed
of in a properly licensed solid waste disposal facility as defined by MGL cl I, s250a.
The debris will be disposed of in/at:
Facility location � �.��'
signature of
Applicant
Date
t
NOTE.- A demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
,r •
Building Department
27 Charles Street
North Andover, MA. 01.845 ".
D. Robert Nicetta
Building Commissioner
(978) 688-9545
978 688-9542 Fax
HOMEOWNER LICENSE EXEMPTION
Please print
DATE
JOB LOCATION
Number
Street Address
Map/lot
"HOMEOWNER 77 �{
Name Home Phone 7
Work Phone
PRESENT MAILING ADDRESS
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 HOMEWOWNER:':
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which
there is, oris intended to be, a one or two family dwelling, attached or detached structures ac-
cessory.to such use and/or fart structures. A person who constructs more than one home in a
Mo-year period shall not be'considered a homeowner.
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
Applicable codes, bylaws, rules and regulations,
The undersigned"homeowner"certifies that he/she understands the Town of No_Andover
Building Department minimum inspection procedures and requirements.and that he/she will
comply with said procedures and requirements.
c
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL 7
SUTTON POND
MEMORANDUM
DATE: August 14, 2001
TO: To whom it may concern.
FROM: Matt Dykeman, Agent
Sutton Pond Condominium.
RE: INTERIOR RENOVATIONS
I MATTHEW DYKEMAN AS THE MANAGING AGENT FOR SUTTON POND
CONDOMINIUM, GRANT PERMISSION.TO THE HOMEOWNER OF B332 TO
CONDUCT INTERIOR RENOVATIONS.
ALL WORK MUST BE DONE BY LICENSED CONTRACTORS AS REQUIRED
BY LAW. ANY APPLICABLE PERMITS MUST BE PULLED AND COPIES
PRESENTED TO THE SUTTON POND MANAGEMENT OFFICE.
SINCERELY,
MATTHEW DYKEMAN
Condominium
Homes
148 Main Street,
North Andover,
MA 01845
(508)681-4567
NORTH
E
Town ® Andover
o „. _,�W.. r ' z
0
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0 �oC„,� � dover, Mass.,
AORATE D
'9S H
BOARD OF HEALTH
PERMI ., D Food/Kitchen
Septic System
• * ;j� 4 4 BUILDING INSPECTOR
THIS CERTIFIES THAT........................................... Foundation
�� .... ��✓has permission to erect........................................ buildings on .. .. ........,. ... Z Rough
tobe occupied a ... .......................................................................................... Chimney
.... . . . . . .. . . .. .. . .
provided that the person accepting this permit shall in every respect-conform to the 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
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTIO ST TS ELECTRICAL INSPECTOR
Rough
............. .. Service
c� 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.
SEE REVERSE SIDE Smoke Det.
Date.................................
3 . 79
N2
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
'I CHUS
Thiscertifies that ..... ............... .............................................
has permission to perform ........................ .....................................
wiring in the building of.............. ..........................................
at.... ........
........................ ................................. .North Andover,Mass.
Fee..;.:................ Lic.No. . .............................
ELECTRICAL INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
J // /
(f1mmonweahk of�addachweifd Official Use Only
2 �7 Permit No.
o`Jiro Serviced
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] tleaveblank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 0%1R 12.00
(PLEASE PRINT IN INK OR TYP -;ILL INI-0 L•ITIOiV) Date:
City or Town of: /,�iT� w ll To the Ins ectot of JVii•es:
By this application the undersigned gives notice of his or her tntentiot to pe. r i the electricalwork described be ow.
Location (Street & Number)
Owner or Tenant Telephone No.
Owner's Address
Is this permit in conjunction with a building,permit? Yes No ❑ (Check Appropriate Box)
I'urliose of Buildingle i-/6/ Utility Authorization No.
- Existing Service Amps /-?Q / Q Volts Overhead ❑ Und�rd N
b LTJ No.of Meters . '
New Service Anips / Volts Overhead ❑ Undgrd ❑ No.of Meters.
Number of Feeders and Ampacity /
Location and Nature of Proposed Electrical Work:
Completion of t/ttable stay be waived by the hts'cctor of Wires.
No.of Recessed Fixtures No.of Ccil.-Susp.(Paddle)Fans No. of Total
I'ransforiucrs KVA
No.of Lighting OutletsNo.of llot Tubs Generators KVA
No.of Lighting Fixtures Swimming Pool Above ❑ !n- ❑ o.o mergency tg ttntg 1
rnd. rnd. Batte Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARt\•IS No.of Zoites
No.of Switches No.of Gas Burners . No.of Detection and
Initiating Devices
No.of Ran-ges No.of Air Cond. TonTots No . of Alerting Devices
Heat Pump I Number Tons K\V _ No. of Self-Contained
No.of Waste Disposers Totals: Detection/Alertina Devices
No.of Dishwashers Space/Area Heating KW Local E] Municipal El Other
Connection
No.of Dryers Heating Appliances K\\; Security Systems:
No.of water No.of No.of No.of Devices or Equivalent
Heaters K\V rata`r'✓firing:
Siatts Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total I-IP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
.lttach additional detail if desired, or as required by the Inspector of Wires.
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 permitissuing office.
CHECK ONE: INSURANCE [�]'BOND ❑ OTHER ❑ (Specify:)
(Expir ion te)
Estimated Value of Electrical Work:' J DU.O[J (When required by municipal p)licy.)
Work to Start: Q Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I cet7if•, under !rep its and penalties of petjury,that the information on this application is trite acrd complete.
FI1;U\I NAME:: /// �G�TIC LIC.NO.:
Licensee: J/ y� •v �� !J Signature LIC.NO.,
OF
--f
(ljapplicable, enter/,"ercnr !"in the licence nr�u`ben fin ) /J Bus.Tel.\o.•
Address• fJ l jyi/ f%/ /�/6/ � Alt.Tel.No.: -.d
O\VNER'S INSURANCE \VAINER: I am aw re that the Licensee docs not have the liability insurance coy erase normally
required by law. I3� my signature below, I hereby waive this requiremcut. I am the(check one) ❑ owner ❑ owner's agent.
Otiyncr/Abent
Signature "Telephone No. P1:RJ11T FEE: S