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Home My WebLink AboutMiscellaneous - 43 STONECLEAVE ROAD 4/30/2018 / 43 STONECLEAVE ROAD J 210/104.B-0144-0000.0 r I Location No. > �/ 5 Date • - TOWN OF NORTH ANDOVER, . fl r Vis' Certificate of Occupancy $ Building/Frame Permit Fee $363 Foundation Permit Fee $ Other Permit Fee $ f-kATED TOTAL $ J Check# 3 Building Inspector BUILDING PERMIT o`"°DT bgti TOWN OF NORTH ANDOVER �L� ''- :` :° o APPLICATION FOR PLAN EXAMINATION * yy H T Permit No#: 500,00, Date Received / gSSACH�1`��y Date Issued: 1 IMPOR ANT: Applicant must complete all items on this page LOCATION 3 ` Print PROPERTY OWNER Print 100 Year Structure yes, no MAP .1.0 - PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop.Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial >CRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WrK TO BE PERFORMED: rr Q L '-Q_ - �T Identification- Please Type or Print Clearly , OWNER: Name: S, nnn L Y1apok:A Phone: j�8 -683 Z7-6( Address: 3 'f>IC�004�xWlb_ 4Ydc 62A Contractor Name: 13u-6 mcry,Phone: 2�s.- 42n --2,010 Address: Supervisor's Construction License: �xQ' Date: VIT Exp.' C Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $_ ,� FEE: $ Check No.: L Receipt No.: ay� NOTE: Persons contracting with registered contractors do not have access to the guaranty fund Signature of Agent/Owner - ture of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools*` ` ❑ Well ❑ Tobacco Sales ❑ Food Packa in Saleg El❑ g � Private(septic tank,etc. permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORK , ,. PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS j CONSERVATION Reviewed on Signature I I I l COMMENTS 1 HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Con nection/Siqnature& Date Driveway Permit DPW Town Engineer: Signature: Located '384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date i COMMENTS I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10o-$1000 fine NOTES and DATA - (For department use) ❑ Notified for pickup Call Email Date Time Contact Name I Doe.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 NORTH Town of No. h h ver, Mass, T O IANE �. COC.41 CNE W'CN V X1,9 A°R�reo �P��S S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System l �,VI BUILDING INSPECTOR THISCERTIFIES THAT .....................�.T.�`-.........................1:.•••.•`........................................... .. Foundation has permission to erect .......................... buildings on .........�.3.....4�.'�4!Rz:..C.It...4.'!�'�:............' Rough to be occupied as .............. ...r.'L....C:1A;S ...... .K ....�?. l.10_.......................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR (3) • UNLESS CONSTRUCTIOST TS Rough Service .............. ............................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. Smoke Det. NORTH own of ndover o - ..�. No. *� h ver, Mass, SQA COC NICHt WICu X1„9 °RwrEo �Pa`� c� S � U BOARD OF HEALTH PERM T D Food/Kitchen IT Septic System THIS CERTIFIES THAT BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on ......... ..... !nZ..<.I.C.!q.'!�'�-............' Rough to be occupied as .............. r.—e.... � ...... Y�.�..... ..!.....l �s................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR �� • UNLESS CONSTRUCT IO ST TS Rough Service .............. ............................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. y The Commonwealth of tL1'assachasetts - - Depariment o,flndifst.>igl,4ccldats Office o,fInves igafeons ' 6114 Wasftgion Street Boston,MA 02111 www.massgov/clza Workers,Compensation bsurance.Affidavit:]3aders/ContractorsfFIect czansli'! berg A. heant hformation Please.Prim Ue bZy Name(Bus uossiorganizationftdivldud): C V0• 1. Address P0AU.-P . Rcac City/statelzip: .Ase pout an employer?Check the appropriate Yoox: Type of project(required): 1.El z am a employe x with 4. ❑1 am a general contractor and 1 6. ❑New construction employees(fall aad(oxpart-time).* have Dkedthe sub-contractors 2.[� I am a sale proprietor or partner listed on the attached sheet; 7. []Remodeling Alp and`lave,no•employe,es These sub-contractors have S. Demolition working forme in any capacity, workers'comp.insurance. g, $ g addition [No workers'comp.insurance 5. E]We are a corporation and its 1011 Electricalrepairs or additions requixed.� off 1cers have exercisad.their 3. am a homeowner doing all work right of exemption per MGL 1111 Plumbingxepairs or additions myself:[No workers'comp. c.152,§1(4),andwehaveno 12,x]Roofrepairs msrancereqaired. employees.[No workers' �� 13.�.Otlier /fZ..PJ�Q/� comp.insurance required.] —7 ny applicautthat checks box#I mustalso m dutthe section bemw showingtheir workers'compensationpollcy information. A Ai Homeowners who submitth9s affidavit indicatingthey fire doing allwork and then no outside contractors must submit a new affidavit indicating such. TContractors that cheok this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. �Man empl'oyefthatispr-ovidirigworkeys'compe�asationirzs�trancefor•�nyernployees Be iv stheyotieyandjhsVe in farmadon. insurance CompanyName;. Policy#or Selz ins.UG.#: ExpixationAate: I&Bite Address: City/State/Zip: A Each a copy oftDaworkers'cowpensationpolley declaration page(showing-the policynumber and expiration.date). Failure to secure coverage as requiradimder Section 25A ofMGL o.152 can lead to th.e imposition of eriminalpenalffes of fine up to$1,5000 and/or one-year imprisonment,as well as cKpenalties in the form of STOP WORK ORDER,and a fne ofup to$250.00 a day against the violator. Be advised that a copy of 615 statem.entmay be forwaxdedto the Office-of- investigations £investigations of the DfA.for insurance coverage verification. Xdo 116reby certf under�tlieiiains andpena7ties o perjury mat Me ire,formation•provided above is true ancicorxect, Si afore: Data: G 2 f Thone# 0M- 68 3--' Oieial use oply. Do not write in 61s area,to be eorrtpleted by city or town o lei I City or Town: Perm!-Mceuse f 1'ssuingAuthor4(circle one): 1.Board of Health 2.BuildluglDepartment 3.CitylTowa Clerk 4.Electrical Impactor 5.PXumbinghspector f.Other OF j!g0RM QE�ICE OF •AI�TDO'tE1� a m "'UD'NG J)E1P.ARTWNT ° • ' ��Rb��.�,� :'I60D Qsgo ad Street Building 20,•Suite 2-3 6 CKus� N'orthAn.dover,Massachusetts 01945 Gerald A.Drown. - Inspectorof$iTildings Telephcne(978)688-95445 a7c (978)688-9542 aij�RWMT APPLICATION . - �OMEOW.NEI..Z.•EICENSE EXEMPTION please�rint ', - DATE: r QB LocATIoN; 43 Number SrreetAddress DOME � IVIap/I,ot . ��R Name. V Home Phone - WorklPhone PRESENT MfAILiNGADDRESS Ion (pr��f„P zip Coda The current exemp5on for"homeowners" was extended to-wilo de ownez-occupied divelli gs to tvo units•or'3ess and %o allo�,v such hompo;�ers to engage an�dividual.forbire w:ho does n.otpossess a license,provided that owner acts as supelvisor). gtate3uilding (Code Section I08.3.5.1) DEFMITION OFROMEOWNER- Person(s)Who QWns aparcel of land on Which he/she resides or intends to reside,on which there is,oris intended fo be,a one or two family stmotares. -A.p erson.who constructs more that one considered a hoaneowner, home in a twe yearperio d shall not be The undersigned"homeowner"assumesresponsibilityforcbmpliances with the StateBuzIdin .Applicable codes,by-laws,xules and-regalations, g Code and other ' The undersigned"homeowner"cerfi es that he/she understands the Town of I\7orih,AadoverBuitding Deka ,,t Minimum Inspection procedures and raquirements, requirements and that he/she Will comply Withtsaid procedures and req - .HOMEOWNERS SIGNATURE APPROVAL OF BUMUNG OFFICIAL Revised 7.2009 -Vorm Homeowners Exemption - 13OART]OFA.PPEALS 688-9541 Ir r CONSBRVA•,t�ON 686-9530 BEALTH 688-9540 PUNNING 689-9555 • Location No. Date v NORTITOWN OF NORTH ANDOVER O? ° - • OR k F J 9 " • Certificate of Occupancy $ E<�' Building/Frame Permit Fee $ AGMus Foundation Permit Fee $ Other Permit Fee $ ,I TOTAL $ � az) i Check # d/7 r 8458 —Building Ins6,e6tor i TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ,.-��• �>;�.�^rte. t , � �� ;z BUILDING PERMIT NUMBER: DATE ISSUED: D C X SIGNATURE: ic Building Commissioner/I for of Buildings Date SECTION 1-S TE INFORMATION O 1.1 Pr erty Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Diarict Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re(pired Provided 1.7 Water Supply M.G.L.C.40. 54)` 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT HistoricDistrict: Yes No M 2.1 Owmr of Record j Name(Print) Address for Service: Signature r Telephone 0 2.2 Owner of Record: Name Print Address for Service: Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: �i License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number r Address r Expiration Date �z Signature Telephone V I 4 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.......❑ No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. X Demolition ❑ Other ❑ Specify Brief Description of Proposed Work! qI SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be (}FFICIATI USE QNL:Y Completed bypermit 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 5 Fire Protection 6 Total 1+2+3+4+5 / !fir Check Number SECTION 7a OWNER AUTHORIYATION 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 .._ Hereby declare'tTiV-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/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEMBERS IST 2 NO 3RD SPAN DEVIENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE C NORTH '9 Town of : Andover 0 No. fie Y - C% _ =_- o dover Mass. 8.. —0?00 S� COCHICHEWICK V 7 ORATED PPa` iC5 BOARD OF HEALTH j Food/Kitchen Septic System PERMIT T D ♦4 Z''m 04 *4 BUILDING INSPECTOR THIS CERTIFIES THAT .....�..........................�............................. ....�................................. .........��..... ........ Foundation f ' a 1 W3 S f,rNc has permission to erect.. ............................. buildi s on ..... .............................P'014 ................ ............................... .... Rough r � ha Chimney s . ............................ ,,c A .. to be occupied as....... ..................... . ....................................................... ................ ........ provided that the person accepting thi ermit shall in every respect conform to the terms of the applicati on file in Final this office, and to the provisions of the Codes and By-Laws relating to theIpspection, Alteration and Construction of Buildings in the Town of North Andover. /v �� y� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTIO ST TS ELECTRICAL INSPECTOR � Rough ., 40.' Service BUIL ING INSPECTOR Final Occupancy Permit Required to Ow cpy 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. NORTq Ot,t�ao a,M f } TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE �ZG�1/ 9 � 5 JOB LOCATION 1I3 7 ?1O�104�P Number Street Address Map/Lot HOMEOWNER Sq6l7 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 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 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,one or two family dwelling,attached or detached structures attached or detached structures accessory 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 North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEWOWNER'S SIGNATURE APROVAL OF BUILDING OFFICIAL 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 54ce" �) ,f'YI!may r-"1- PHONE 2 8 3 -279 t LOCATION: Assessor's Map Number 1048 PARCEL SUBDIVISION LOT (S) STREET 7uJ(Wty— .p_Q,V,? ST. NUMBER ******************" ***OFFICIAL USE ONLY********�************ M*EqA F TOW A ENTS: NSERVATION ADMINISTRATOR DATE APPROVED ` DATE REJECTED COMMENTS o-h tL �� o TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS 40D ECTOR-HEALTH DATE APPROVED DATE REJECTED PECTO EA DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm i ,a rTn�mA ANDOVER BOARD OF HEALTH ,,.are a x -c::-:�m.__....'':�.E..w.`�.!,.,..,,,_ "` M ._. ,. ". �. -w�.+..��.. j 61^• q r � x i i 'n r+ s .r t cn��. k ��c-.a re Tier✓,Y � ��,'� � <r� aV , Ap,*A()X ' ..r,(�`�„7 •t.,� �- ��"._%e��%t'�`:t5,.. � 5�.3:.' � t�, ...L�''".�'•'�'.�. � <W--'�� r 'fie�`_ �"`�"f�,__-�'�:`'r';�� i i s ^v+.)s ,. .G y "(/�ry • .arrJLM.W.wytiw�Y�.4.W""'.r'W�w._...+ • 2 T LOT B MSC Order # B 16888 3 120-43'-08" E 150.00 ' MORTGAGE INSPECTION PLAN This is a mortgage loan inpection for mortgage purposes only LOCATION NORTH ANDOVER MA City or Town State DATE: JANUARY 3. 1991 SCALE: I inch=40 feet LOT 3 Certification is hereby made to EAST/NEST MORTGAGE CO. that the existing structures shown on this plan are situated on the lot desiggnateppd in compliance with the 2 a oftthekmuhicipalityswhentconsthuctedle zoning bylaws This ins ection was prepared in accordance with the � p ti ti i technical standards for Mortgage Loan Inspections as ti adopted by the Commonwealth of Massachusetts. i ti deck ca i bye�W N LOT 4 LOT 2g stered Surveyor `` wodfs 4 ni � ,d�reJJin 1 y � 31� 43 9 e. DEED AND PLAN REFERENCE ESSEX NORTH DISTRICT Registry of Deeds �L SH OF Mgss��y Deed Book __J573 Page_52 JEAN ��, Plan number--7636 NMTDI = Certification is hereby made that the structure shown on No.26099 this plan IS NOT located within a Special Flood Hazard Area as delineated on the map of GIST Q� Qi L^nNOcommunity No. 250098 OOiOB Effective Date: June 15. 083 By the U.S. Department of Housing 6 Urban Development. Federal Insurance Administration. 150.00'L i INCH 40 FEET N 12'-36'-J2" W 40 0 40 eo 120 sso STONECLEA VE ROAD MORTGAGE SURVEY CONSULTANTS, INC . 126A PLEASANT VALLEY ST. —SUITE 7 METHUEN. MA 01844 TEL. (508) 975-2700