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HomeMy WebLinkAboutMiscellaneous - 33 MORNINGSIDE LANE 4/30/2018N O w O z z N � V � O m o z o m Location 33 Mork) (N cps i J -c- �N 81 �c No. % a Is Date ,. TOWN OF NORTH ANDOVER Check # a a / D v ___- M 'i 756 Building Inspector 9 Certificate of Occupancy $ �� s'•n°' E<�' �cNus Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # a a / D v ___- M 'i 756 Building Inspector TOWN OF NORTH ANDOVER ` BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner AW or of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: h ay\,C 1.2 Assessors Map and Parcel C n Map Number Number: Parcel Number 1.3 zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area Frorrta ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ftqlfired Provided J54) 1.7 Water Supply M.G.L.C.40. 1.5. Flood Zone Information: 1.8 Public Private " ❑ Zone Outside Flood Zone ❑ Municipal oL�nT7nwT 7 TTIATTATT\) A Sewerage Disposal System: On Site Disposal System ❑ .---����.�-�.���.���� v.. a...+awa•ewalav- n.L AViL1\1 21Owner of Record �1 2.2 Owner of Record: Address for Service : 70 9S Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1Llc tsed Construction Supervisor. Not Applicable 0 Licensed Construction Supervisor: t 14 -- `[ License Number Address aor. Sign �T�elJI.n7e _S �� Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 `.� Company Name \ O -1 \ (� I !_1 S ; �` p Registration Number A d ss l /l. D , ., \ �uc� t �t Sf Expiration De, \ - oa . r L 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 F^f�j Isult in the denial of the issuance of the building permit.� Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check an a ble New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) 7Fdditi on 0 Accessory Bldg. 0 Demolition 0 Other ❑ Specify Brief Description of Proposed Work: P o c C U SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building p (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) I D� 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 I, , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work 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 Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERSR X iST 2 ND 3Ew SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING 1 D % \ o X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a co f Page No. of Pages DESCRIPTION OF JOB PROPOSAL SUBMITTED'TO' 1 �, ' 1 `7 0 7 `7 \A V ARCHITECT DATE OF PIANS JOB ADDRESS CITY STATE ZIP PHONE DATE CA �{. n ol, Gt t' V,< to ('AA 0.�,iQ 1 C-aVj��' � 1C:c"L� C'lV�(5C �'T��E Cc F r3i- r c C;,4%A i �C l" ('inn. r Oaf\ c';-Aou UJI -X Oc "-Us UNUM "'46-61ft We hereby propose to furnish material and labor, complete in accordance with above specifications, for the sum of . ! i res: n r 1 :1 -- c h, f 1C\ dollars /. s: G) P y with payment to be made as follown� '3' "--'—j-..4r.\---------` All material is guaranteed to be as specified. All work is to be completed ifyla` J �� manner according to standard practices. Any alteration or deviation fro sp cificincations Authorized involving extra costs will be executed upon written orders, and will b + ecome an extra Signature charge over and above the estimate. All .agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary Note: This proposal may be withdrawn by us if not accepted insurance. Our workers are fully c8vered by Worker's Compensation !nsuranSe. within days. Acceptance of Proposal - The above prices, specifications and condi- tions are satisfactory and are hereby accepted. You are authorized to do r ) the work as specified. Payment will be made as outlined above. Signature' t Date of Acceptance:. — Signature _ • e . .4 r� *art[` Cgin (978) .255-2 3D HC S j'R a 5,317 f PROPOSAL SUBMITTED'TO-E`C kt# '7 o 719 I P -Q-4- 0 Z_/ S 6r, _q'VF1 6o '91 (9,W PI /X -O, oa. 0 663 Page No. � 7$ EFS S3Fs� \."6- 33 140RNWGSID2zQ. N o p+A l�.�� va, M -X 'a b,\\A \a a\�acNve-A 9\c>,,&. r0u Nae-9eVvNA'NA7S C Gn L., c-�10 Y\ Q v\. S M olc�e i\ '� c`\ S DESCRIPTION OF JOB ARCHITECT - - DATE OF PLANS JOB ADDRESS CITY STATE ZIP PHONE DATE cs pe C S up? l e d aJ \\ti2I 4O&W )1 1"c.\ C"& ckc.a Coae ,S 'ort C" v i:.' v> = �ttc� y CO(),e S o e v\ -(S? cl i� y C'Ae5 'mac=t5o�u�te '� N0�.k We hereby propose to furnish material and labor, complete in accordance with above specifications, for the n OL sum of .))SF -D�]_S�ov��t i t,c—�� _ fir dolaI rs (S�- OAS 9C r 00 with payment to be made as foll c Ovv.% V jr A i v\ All material is guaranteed to be as specified. All work is to be completed iOcifiations lik ' manner according to standard practices. Any alteration or deviation fr sp involving extra costs will be executed upon`written orders, and will become an extra charge over and above the estimate. All agreernents contingent upon strikes, accidents or delays beyond,',our control. �ner tQ carry firs- tornado and othernecessary insurance. Our wotP�sl ire(tlly Mered by W6rkerlcC�omp0nfation 4,jsUfaftQ0. �j Acceptance of Proposal - The above prices, specifications and condi- tions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: 8 ! 4,A — Authorized t /1/D Z/ Signrure J Note: This proposal may be withdrawn by us if not accepted � ba SignatuFe� Signature �ApF VA w ofA-_ �G�yS -�o r. - C 04klpV--1rL0A o -`P Oaf\ as .6DU) 0q aou 'mac=t5o�u�te '� N0�.k We hereby propose to furnish material and labor, complete in accordance with above specifications, for the n OL sum of .))SF -D�]_S�ov��t i t,c—�� _ fir dolaI rs (S�- OAS 9C r 00 with payment to be made as foll c Ovv.% V jr A i v\ All material is guaranteed to be as specified. All work is to be completed iOcifiations lik ' manner according to standard practices. Any alteration or deviation fr sp involving extra costs will be executed upon`written orders, and will become an extra charge over and above the estimate. All agreernents contingent upon strikes, accidents or delays beyond,',our control. �ner tQ carry firs- tornado and othernecessary insurance. Our wotP�sl ire(tlly Mered by W6rkerlcC�omp0nfation 4,jsUfaftQ0. �j Acceptance of Proposal - The above prices, specifications and condi- tions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: 8 ! 4,A — Authorized t /1/D Z/ Signrure J Note: This proposal may be withdrawn by us if not accepted � ba SignatuFe� Signature BUILDING CERTIFICATION - I LOT 22 Z41 90 46,956±SF. EXISTING DECK / TO BE RAZED. EX HSE 49' J---- 52.8' PLAN NEW 12'x 12' SUNROOM ON NEW 12'x 20' DECK. ffORNINCSIIJF.' IN SETBACKS ON THIS PLAN ARE FOR THE DETERMINATION OF ZONING REQUIREMENTS ONLY. I CERTIFY THAT THE BUILDINGS AND/ REFERENCE HQF�.S� OR STRUCTURES ARE LOCATED AS SHOWN. DEED: BOOK PLAN: No: 5145 �© JAMES PAGE: 'AAb,. "� X3389 e STREET 33 MORNINGSIDE LN CITY NORTH ANDOVER, MA. sv APPLICANT BRIAN & SANDRA DONAHUE. n� DATE 4/18/2003 SCALE 1"=40' JOB# 4336 62 CRICKET LANE P.L.S. 14i�I0 LS'URTIZYING DRACUT, MA. 01826 la' G i q.\"St'\Ab, uowAE , �n`►s-�n� slid-ep -- Lt`Ix xo", 'Beo^ F1oo(" C04)SVruc:k-:o,N Co , 1 -.z Or Gra-4c�e tOo 'A ice (J L1 aaGie XS P Jo tis�s l D•G XFs So�'bc� i�\dc.�,�n� @ Geo- eo. �Oec-ww Lkx 1 C)" 3 P1, 06 s� N-jbi 12 �]IY I,tLI X--�4 3 m0.J- ,� 1fix 9 M,036 "' o/ xl,% tj — /o.v,3F "o/ X $ jj - - �.� ��•�a7�q �-t J� 9b �A r j - ' fj j-,e4T -� oo/� n,cv z-rz oc/ :%rq V a X i°' 3�o Aw.a9d 3fv,->f Qn/a S t, 4i�\eiocj�a-t3 99 �a/ U�C-,Ms , (�cbve \v\eaAel's pVev- CL %9 ao;aU9/3 afot2 742 S�d,e � 1, e � cc� o�N 4ftoET)G9i3 912 eat �Le- D 60 �J. v; Pi fink _ JI �3 a x 8 �, \j,�-- , 9.'� A&e-, a X 8 q\ -f,s \ co. o .c u ►��cX v c r i �.Ct��l e5 U:)C)os \.0cc�c L4 x NS Oyu e/PIO�< C: �' 'M � G� C� eA,, G- P N e- �La 1 v eu�*1 `47 rv-7�x 2 Nu v �1 ,3ju; L hzj a x 0 .C,4 06 C/ 5)j l-)3:f�p V�s1�� 3 ivY oY 07` 2�/� -` �'�� �7 �j'J7.vT ;J � r ���-r _ : r. � 1 ,L -� �;� }'� �� ! �✓��/ /�f yNY _'7 .di�iT� � uA I ivl S� Vi z° A I Au- BUILDING CERTIFICATION S I LOT 22 7,9D 46,956±SF. EXISTING DECK / TO BE RAZED. EX HSE 49' ----- A 52.8' :11 PLAN NEW 12'x 12' SUNROOM ON NEW 12'x 20' DECK. ffoRil�cslDz I j v SETBACKS ON THIS PLAN ARE FOR THE DETERMINATION OF ZONING REQUIREMENTS ONLY. OE Ri'«S 1 CERTIFY THAT THE BUILDINGS AND/ REFERENCE .r OR STRUCTURES ARE LOCATED !� JAME9 As s►+owN. DEED: BOOK PLAN: NO: 5145 D, r+ PAGE: AHO y �st353f tv STREET 33 MORNINGSIDE LN CITY NORTH ANDOVER, MA. APPLICANT BRIAN & SANDRA DONAHUE. DATE 4/18/2003 SCALE1"=_JOB## 4336 AW .S'URVZ-rlNG 62 CRICKET LANE P.L.S. DRACUT, MA. 01826 m M M m YI M N M° y .0 - - d CA 10 0 CD .%Z y =6 n� � O C = y n� � o m 0 0 v CD Cl CL� d CD cD o CD C O CCDO) CL v CO) CD S v CO) O CD z o � 0 CD FJ 0 W O cn 6W 1010 o =r-4 s c Go900 no S.m y 4 a�mc m C-)���c z CL .. a o m �a m y C y v S m m = :w 0MO: C ?yip: c A m o CD H ;+ 0 CD m 3 O � y COD am. O CL CA ��.c�y r o � m � . 0 o� cc C-3 p . Z '*CCF m az c CD VJ O m N cCD Z CD m am C/) R n C/) :4�� o G7 R7 "' p �'- p r zn 7y 171 a ?; W cn 'r1 a x py O � 7d 7d z vz 05 V �12 0 c FORM ULOT RELEASE FORM L11a,31o3 INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*****`**************** APPLICANTI:: 0&� Cmem^(.4���PHONE Sst)1 LOCATION: Assessor's Map NumberPARCEL OURS SUBDIVISION LOT (S) STREET -1.3 ST NUMBER 3 ************************************OFFICIAL USE ONLY*********************************** /REECO -ENDATIONS OF„TOWN AGENTS: CONSERVATION ADMINIST/RIATOR DATE APPROVED DATE REJECTED COMMENTS � 49 REI TO ANNER DATE APPROV D D E EJECTED p NOOVER PLANNING DEPARTMENT COM E S L� 1 v zJ FOOD INSPECTOR -HEALTH V DTE PPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMME PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm . ✓/ae i�anr�no,auleulC/ a�✓l/laaaac%uaella BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 082357 Birthdate: 09/01/1956 Expires: 09/01/2006 Tr. no: 11173 Restricted: 00 'ETER M BLANCHETTE � t5 GREENFIELD ST .AWRENCE, MA 01843 Administrator Z4 T T% �drzmauuea/,l� � .�aaaac/ucaeka Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 140719 `. Expiration: 11/17/2005 Type: DBA PETER BLANCHETTE HOMEWORK PETER BLANCHETTE 45 GREENFIELD ST.� LAWRENCE, MA 01843 Administrator The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. 0 I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name Address a 9 L Company name: t 'i C A G,r \ 1f\C Cc Address City: Phone #• Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to $1,500.00 and/or one years' imprisonment•asmell_as_civil_penaltiessinthefnrmofa.STOP WORK_ORDER..and..a fine of ($10100), day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensin El Building Dept []Check if immediate response is required ❑ Licensing Board E] Selectman's Office Contact person: Phone A ❑ Health Department ❑ Other Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 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 Name PRESENT MAILING ADDRESS City Town Home Phone State Work Phone 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, 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, by-laws, 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 SIGNATURE APPROVAL OF BUILDING OFFIC Zip Code ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID CDATE(MWDD/YYYY) NSR KDCONnl 08/16/04 PRODUCER CHARLES J COUGHLIN THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION POLICY EXPIRATION DATE MM/DD/YY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 14 DINLEY ST. P . O. BOX 10 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DRACUT MA 01826-0010 Phone:978-957-3588 Fax:978-957-6612 INSURERS AFFORDING COVERAGE NAIC# INSURED X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [:] OCCUR INSURER A: National Grange Ins Cc 14788 INSURER B: Misc. Insurance Company K & D Contractors PREMISES (Ea occurence) $ INSURER C: Kenneth Dimmock 1 Jeffrey Street INSURER D: Methuen, MA 01844 INSURER E: nw0e A^— THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENAWGE-TO _REMCE $ A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [:] OCCUR NEW APPLICATION 0 8 / 16 / 04 0 8 / 16 / 0 5 PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT p LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR F—I CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NEW APPLICATION 08/16/04 08/16/05 TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below OTHER E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CFRTIFICATF=wni nro Town of North Andover Building Inspector 146 Main Street North Andover, MA 01845 ACORD 25 (2001/08) NORTHAN I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ©ACORD CORPORATION 1QAA FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT Jr(A'y\ �OVXA�u� PHON ? T` LOCATION: Assessor's Map Number /D PARCEL 4 O SUBDIVISION nn / LOT (S) STREET -3-3. hor ra kVIGi!S(a �� ST. NUMBER I************************ ********OFFICIAL USE ONLY* *** * **** * , *** * ►* -Pla FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS =- DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPE Revised 9\97 im DATE