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Home My WebLink AboutMiscellaneous - 405 CHESTNUT STREET 4/30/2018 405 CHESTNUT STREET 2101O98.C-0081-0000.0 Location `�0,5- No. Date N°R7" TOWN OF NORTH ANDOVER � ; a Certificate of Occupancy $ sA�MUs Building/Frame Permit Fee $ �' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �a Check # r� 15Sb7 �-Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLIIySHH•A ONE OR TWO FAMILY DWELLING to `�E`'VI�I� 'V.IG,� BUILDING PERMIT NUMBER. '24/ DATE ISSUED- 0 A � � SIGNATURE: 4944W Building CommissioneMEtor of Buildings Date 67 - /-o'✓ SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O �aS G1at-7" ST Ile,G` /J j �� 'Map Number Parcel Number /` 1.3 ZoningInformation- 1.4 Property Dimensions: Zonin District Proposed Use Lot Areas Frontage fl 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide Regired Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record 4h7 ��Yt !9iy 'I SS Cir s�,tic,� S Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: dSe O License Number Address' /l C l Expiration Date 7 ic ic ignature Telephone r 3.2 Registered/Home Improvement Conttractor Not Applicable ❑ Company Name V /To M Q Z ` Registration Number r Addres Expiration Date ^ . nature Telephone G/ 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.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify r. n Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFIIAL' SE ONLY' Completed by permit applicant 1. Building (a) Building Permit Fee �j Multiplier 2 Electrical (b) Estimated Total Cost of }� Construction 3 Plumbing Building Permit fee(8)X fbl 4 Mechanical HVAC q 5 Fire Protection O 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 t 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 Na c�vGe! Si attire of Owner/A ent Date NO,OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2ND 3RD SPAN DIIVIENSIONS OF SILLS DIIVIENSIO.NS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS 13UILDING CONNECTED TO NATURAL GAS LINE Jlae�'rvmmco.a.�alt�x a�✓��,aaur�..�i�caelle BOARD OF BUILDING REGULATIONS ti License: CONSTRUCTION SUPERVISOR Number: CS 058241 Birthdate: 01/08/1955 a Expires:01/08/2004 Tr.no: 16095 Restricted: 00 RONALD S HEBERT 102 ADAMS AVEC N ANDOVER, MA 01845 Administrator North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit 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: ( �/ni�I✓1'J 7//S/9aS�l �� (Location of Facility) G Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building Inspector Norc ray Town of Andover I..I........ No. AX � = AL A * dover, Mass., ADRATED P'P�\�� S H b BOARD OF HEALTH PER IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....,...... .....1......... .... ......................................................... Foundation has permission to erect........................................ buildings on��................. ......... ..........,............... :...... Rough tobe occupied a .. .............. ...... ' ....... ....... ........................................................................................... Chimney.:.. provided that the person acce ng this permit shall in ev respect conform to the terms of the application on file in Final this office, and to the provisi s of the Codes and By-La s 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 CONSTRUCTION S T 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. SEE REVERSE SIDE Smoke Det. Date...................... . .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING '7SACHUS This certifies that ..................d.... .............. has permission to perform ..........Y&/' .. . ....... ...... .... ... .......... wiring in the building of........ at... ..... ............. ...... ...... .North Andover,Mass. Fee......Z�....7:�'"Lic.N04 ...... .... ..... .. .... ELECTRICAL.............................................................ECTR ICAL INSP EC TOR 03/021-W 09:21 20-00 PAID WHITE:Applicant CANARY:Building Dept. PINK:Treasurer GOLD: File a _ office Use only u�1: Tmumnm Permit No. �tRariatrni of Public *afid g 0=paney A Fee Checked J� l .ug BOARD OF FIRE PREMMON REGULATIONS 527 CMR 12.00 4 peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work_ to be performed in accordance with the Massachusetts Electrical Code. 527 74&L— OM (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. \Location (Street & Number) S"OJ CFE' 'ov1/ S r Owner or Tenant Owner's Address �� C �,-T�y y� S✓ w Is this permit in conjunction with a building permit: Yes No [�_C (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps ---/ Voits Overhead '—I Uncgrnd r No. of Meters New Service Amps _J Volts Overneac 77 Uncgrnd C No. of Meters Numcer of Feeders and Ampacity, Location and Nature of Proposed Eiectricaf Work Total No. of Lignting Outlets No_of Ho[Tucs No. of Transformers KVA Acove— In- No. of Ugnttng Fxtures I Swimming '=°�' gme. — cmc. _ I Generators ln/A No. of Emergency Lignting No. of Receptacle Cutlets I No. of Cil turners - ( Battery Units No. of Switch Outlets No. of Gas Sumers I FIRE ALARMS No. of Zones Total Nd. of Cetection and I. No. of Ranges No. of Air Conc. tons I !ntaaung Devices Heat Total Total No. of Disposals N°.af Pumas Tons Kw No. of Sounding Devices No. of Serf Contained I No. of Dishwashers ScaceiArea Heating iCVV Detec[:eniSoun g Dev ces unicigai '—Other No. of Dryers Heating Devices �� Local Connect:on No. of No.at I Low V age I No. of Water Heaters KW Sicns Ballasts Wv:n 5�: 6 No. Hycro Massage Tubs No. -of Slaters Total HP OTHER: INSURANCE COVERAGE: Pursuant to the reeuwrements of Massacnusetts general Laws I have a current Liapliity Insurance Policy including CJnc:eteC Operations Coverage or its sucstantlal ecuivaient. YES _ NO _ ! have suomittec valid proof of same to the Office.YES = ,NO _ If you nave checxeq YES. Tease Inglcale the tyre of coverage cy cnecxtng the approcrlate Cox. INSURANCE = BONO = OTHER = (Please Spec:fy) (Excitation Date) �,�P00. Estimated Value �r E'ec• cat world 5 work to Start J Inscec^cn Date Recueste¢ Rough Final Signed under the Penalties of perjury: r FIRM NAME LIC. NO. �+ �7p(�/ctf� j Signature LIC. NO. /1112— Licensee I 75-AK Bus.TelNo. Tel.. Address �� f`�G�ZSa/C" L.{' (/j2�Inc _ Alt. No. CWNER•S INSURANCE WAIVER:1 am aware that the Licensee Coes not have the insurance coverage or its sucstanual equivalent as to gtureo t)y Massachusetts General laws. and that my signature on flus permit application wanes this requirement. Owner Agent (Please check one' - Teleonone No. PERMIT FE=S tctnnamrn of Owner or Agentl