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Home My WebLink AboutMiscellaneous - 30 MARBLEHEAD STREET 4/30/2018 (2)A Ct Location 30 - -7 No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ C.. Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ x, Building lnspecfo—r" 3305 08/10/99 14:35 25-00 PAiD Div. Public Works 7 Vj C) Z Z m m 0 0 0 z 2 rn z m Z m z m r2 M Ll. Al ORT411 0 =1 TZ _.� I a 0 1 >11 AIN City/Town ___�-State .Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six units or less and to allow such homeowners to en -a e, n individual for hire who does 0. 0 not possess a lic6nse, provided that the o-,vner acts as s upervisor.� (State Building Code Sec- tion 109.1.1) DEFINITION OF HOIMEOWNER: Person(s) who owns a parcel of land an which he/she resides or intends to reside, on which there is, or is intended to be, a one to six familv dwelling, attached or' detached structures ac- cessory to such use and/or farm structures. A person who co- nstructs more than one home in a two-year period shall not be considered a homeow-ner .'-S uch- .:"homeowner" shall submit to the Building Official, on a form acceptable to the Building� Official that he/she shall be responsible for all such work performed under the,building permit. (Section 109.1.1) The undersianed "homeowner" assumes responsibility for comnliance with the State Buildin- Code and other applicable codes, by-laws, rules ajad regulations. The undersi-ned "homeowner" certifies that he/she understands the To 0 wn of tNo Andover Building Department inspection procedures and requirements and that he/she will comply withsaid procedures and requirements. HOMEOVV`NIER:S SIGNATURE APPROVAL OF BUILDING OFFICLAL Note: Th-ree familv dwellinas 35,000 cubic feet, or larger, will be required to comply with State Buildin- Code Section 127.0, Construction Control. BOARD OFAPPEALS 688-9541 BUILDING 688-9545 CONSERVA70N 683-9530 HEALTH 688-9540 PLANNING 682-95135 Cl) m m m m m m C/) m Cl) 0 m C= CD 2. 'm co) CD 0 "o. = r— C') IW IW CL CA >Cc -0 C-) co CD CL Cr cm CD CD CD CD CD CA CD C42 CZ) .CA 10 CD C-) CD CD to n 0 z cn 0 On CD co r*4 CD CD C17 C= CD C= W CD CD CL 0 CD n C) CL Co CD CD CD CD CA CD cz C3 z — CD p CD CA co C, CD CD CO) cm CD r -L c c c co CAO3 CAO) M CD CD CM CO) -0 CEO to CD CD CD CA CD Q co) co CD C-) C-) CA cz c') CD CA CA a7 0 csj:: cn C-) m M m col I ,."k r I Location,30 No. -�� 8 3 Date 15—(Q�-CY TOWN OF NORTH ANDOVER 0 M Certificate of Occupancy $ CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check# lef K) 1420/9 $ c:,2 za Buildingi-Inspector y 10 N M 0 z M 90 0 M G) TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING �4, BUILDING PERM[IT NUMBER: DATE ISSUED: SIGNATURE: Building Commi!�nerflnts'pector of Buildings Date SECTION I- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: .6 — Map Number Parcel Number --� 1.3 Zoning Information: Zoning Di�tr ict Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage (R) 1.6 BUHDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Reqwred Provided 1.7 Water Supply M.G.L.C.40. 54) Public 0 Private 0 1.5. Flood Zone Information: Zone — Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal n On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIENAUTHORIZED AGENT T 2.1 Owner of Record M— � K& AP*, Name(Print) & 1;?4,6� 9t Kddress- for Se�vije 2 - 'Signature Telephone 2.2 Owner 4 Record: Name Print Address for Service: Signature Telephone SECTION 34- CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supe�� Address Z--� Signature Telephone Not Applicab�� License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicahl Company Name Registration Number Address Expiration Date Signature Telephone 10 N M 0 z M 90 0 M G) SECTION 4 - WORKERS COMPENSATION (MLG-L C 152 � 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit willresult in the denial of the issuance of the building permit. Signed affidavit Attached Yes ....... 0 No ....... 0 SECTION 5 Description o Proposed Work (check applicable) New Construction 0 Existing Building 0 Repair(s) 0 T7J�terations(s) 0 Addition 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: ?�u c4-�__ ne vi�- 0a.0 SECTION 6 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant I Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (.) 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 Hereby authorize to act on O/Mhalf in all matte e to work authorized by this building permit application. 72-10-W Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 knowl6dgp and belief Print Name Signature of 0 er/A ent Date "''I oil '10 111 1 NO. OF STORIES SIZE BASENENT OR SLAB SIZE OF FLOOR TDvIBERS iST 2 ND 3RD SPAN DINIENSIONS OF SILLS DINIENSIONS OF POSTS DRvIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUI1,DING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 1p,b FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to venify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT L0 ( �HON( I --- ASSESSORS MAP NUMBER &OTNUMBER SUBDIVISION NUMBER STREET t",Y\ oqqf iL— ft -!62 STREET NUMBER So OFFICIAL USE ONLY INNEMMOMMEG RECONMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR TOWN PLANNER COMMENTS DATE REJECTED k/N CY3 DATE APPROVED DATE REJECTED DATE APPROVED FOOD INSPECTOR - HEALTI-I DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - BEALTH DATE REJECTED CON54ENTS PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DA D. Robert Nicetta Building Commissioner (978) 688-9545 ..:(978) 688-9542 Fax Please print DATE 1—\k— 0k) JOB LOCATION 3k) Number Town of North Andover to Building Department 27 Charles Street North Andover, MA. 01845 R Ac HOMEOWNER UCENSE EXEMPTION Address Map / lot (Ic ..HOMEOWNER Nlk )(4P(KS -1 f -( - q-5 7;7 (2 1� I - '�d V 11 - Name Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for "homeowners" was extended to include owner-<=upied 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, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by4aws, 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. HOMEOWNER's APPROVAL OF BUILDING OFFICIAL Cl) m m m m m m Cl) m Cl) 0 m C#) CD Ro D CL CO) CD —1 C.) 0 CD CD CL CD CD 0 CD Go W -3. a CD Vi CD CL Cl col) CD cn CD CD CD 0 n 0 z I =r S. .0 CA CL 0 0 Cl) CD 0 to 0 CL C.) C*' CD _. = a. = =r -O CO) w ca — (A. = -* CD — =r CL �* CL 0 =r CD =r SU W CD CD -0 0 --4 CD :E =!R -% CD R C2 CD co C3 Co CD CO) ,to ro L RL to < CD CA CD C-)= to 0 CD lu CD CA CL w=r d< cx CL Cc, :E CD W) CO) -V CD C�D CD a j CD Wilt F—r' i� = Cc) C3 ': C, CD C, ti C" C=' C3 CD cn 3 0 77- (D C/) q 2 - z o co a RL '0 b r_ :p eL �n m Ix FL ;)� 0 r- �x n el) JQ :7, 5 CL 0 w rl cn cn (D "a 5 CD al 0 a. C) > omi 0 41i 1>, MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 9 0fi--i (4ND6L)e-A-- , Mass. Date 3,9 Permit Building Location 'Owner's Name 0 Type of Occupancy IM New 0 Renovation 0 Replacement o,'*-- . Plans Submitted: Yes[] No [] Installing Company Name —94 Check one: Certificate # Address I LI -7 Piutfot— P�-,( 0 Corporation -PW-1�0 d elL— ViA P�- C] Partnership Business Telephone L RG 2-s-9(, 0 Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0 No 0 If you have checked yes, please Indicate the type coverage by checking the appropriate box A liability Insurance policy 0 . Other type of Indemnity 0 Bond 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Ch�jpr,142 of the Mass. �eneral Laws. and that my signature on this permit application waives this requirement. Check one: OwnerO Agent SigrfWre of owner or owner's Acent' I hereby certify that all of the details and information I have submitted (or entered) In above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. T I U nse: Z_— �� y Pl"- olumlicee r Signature of Ucensed PlumEer or Gas Fitter Title HGasfitter Master License Number City/Town LiJoufneyman APPf`k-YW-D—T0-rrFCMF 0-FIFYF— MEN MEN BEENEENEMENEENNINE ARE NEENEEN ILI 16112 Kole]; NEMENEENEEMENE MEN won Installing Company Name —94 Check one: Certificate # Address I LI -7 Piutfot— P�-,( 0 Corporation -PW-1�0 d elL— ViA P�- C] Partnership Business Telephone L RG 2-s-9(, 0 Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 0 No 0 If you have checked yes, please Indicate the type coverage by checking the appropriate box A liability Insurance policy 0 . Other type of Indemnity 0 Bond 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Ch�jpr,142 of the Mass. �eneral Laws. and that my signature on this permit application waives this requirement. Check one: OwnerO Agent SigrfWre of owner or owner's Acent' I hereby certify that all of the details and information I have submitted (or entered) In above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit Issued for this application will be In compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. T I U nse: Z_— �� y Pl"- olumlicee r Signature of Ucensed PlumEer or Gas Fitter Title HGasfitter Master License Number City/Town LiJoufneyman APPf`k-YW-D—T0-rrFCMF 0-FIFYF— Date.. � ........... I ...... TOWN OF NORTH ANDOVER x - - 0 I- PERMIT FOR GAS INSTALLATION CH This certifies that .1 ...... ...... ....................... has permission for gas installation ......................... in the buildings of ? .................. I ............... at ....... ................... I North Andover, Mass. Fee. . / ...... Lic. No.. . ; /. �— . . GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File