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Home My WebLink AboutMiscellaneous - 47 CLARENDON STREET 4/30/2018 47 CLARENDON STREET 210/069.0-0006-0000.0 ` I I Location r No. / Date �a U N0RT1y TOWN OF NORTH ANDOVER f i # Certificate of Occupancy $ �'�s'^• Eta' Building/Frame Permit Fee $ s�cwus Foundation Permit Fee $ Other Permit Fee $ tTOTAL $ �� Check #� r 17412 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1W Secilm for liipP6� BUILDING PERMIT NUMBER: DATE ISSUED: 6� O� SIGNATURE: Building Commissioner/1for of Buildings Date to v 28—U q Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: K 4/7 (s l efia d 2y) ST Opo 0 p Number Parcel Number A1W 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 ReqWred Provided Required Provided v 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 5 rn 2.1 Owner of Record f 2d&ewe A 97 e/OffNWA/ 07 /If® AA]WAt, Name(Print) Address for Service: D Signal� Telephone 9.7 9 t b 2.2 Owner of Record: Name Print Address for Service: O 1 Z r m Signature Telephone SEOTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: O License Number a" Address Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration Number M Address _r Expiration Date ^z Signature Tel hone V 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. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: }' +"" IV+a'•+ s N V/AI I SI D D1611 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit 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 ° 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 My behalf,in all matters relative to work authorized by this building permit application. !e Z 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 knowledge and belief 1 Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIvMERS 1ST 2 ND 3 SPAN DIMENSIONS OF SILLS 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 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: (Location of Facility) 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 4 ttORTit 01 Town of North Andover Y`Y� ` Building Department ° .. 27 Charles Street North Andover, MA. 01845 .a,rn ;, D. Robert Nicetta +ct�u= Building Commissioner (978) 688-9545 (978) 688-9542.Fax HOMEOWNER LICENSE EXEMPTION Please print. DATE GwE 96, jg07 JOB LOCATION T 10OP—Albo N S? /us &Wyme 45 Number Street Address Map/lot "HOMEOWNER A040 E/2/ ft - 4 Pr 7,X T2 /7S ocW dc?16 Name Home Phone Work Phone s PRESENT MAILING ADDRESS } City Town State Zip Code The current exemption for"homedwners"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 Pam( d av�/L- APPROVAL OF BUILDING OFFICIAL NORTH Town of Andover No. 8 0 LAK dover, Mass, COCHICHEWICK 0):?A T E D BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... Z.............7W... ..01 tod 0 '04% . .. ..... ...........'01.01 .................... .................................................j......74M Foundation '208 04 & - has permission to erect........................................ buildings on ......14.11........... .... .... ... Rough to be occupied as.. 4 Po I -.J*1 A, ... Ad, . . ........................ . . ......... . .. . IChimney provided that the person accoog'this peirmrsfiii—1 in respect conform to the terms of the application on file in Final re this office, and to the provisidWs of the Codes and By- 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 UNLESS CONSTRUCTIONS w ELECTRICAL INSPECTOR Rough 4aJV� Service ................................................................................................................. BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough 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. Location No. f Date NORTH TOWN OF NORTH ANDOVER p Certificate of Occupancy $ # Building/Frame Permit Fee $ s i � Foundation Permit Fee $ JACHUSE Other Permit Fee $ - Sewer Connection Fee $ • Water Connection Fee $ TOTAL $ o 4- 2� l Building Inspector l/ l I Div. 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I I. -- ----------- . dllx;.Cl>5I I'tRltlaAl _-- ----------- ElI(,IHIt'NII:IERSMIIS113L NJ(N11-SIDEO 13LIllDING M ICI'LNNHI NO. �- — At IA(-IIEI)(;ARA(;LSNIIISI (-()III()VIA 1OSIA]f---I E RLt;11I AIRNJS 11'I'l(()\'FI)UV: (31111 I11N(:INSI'F.(-1 OR I'1 ANS KII ISI Hf=III ED AND AI'I'RO VEI)IIY lit III.I IIN(;INSPECI(Nt G /� OWtJL:RS tL3.H I)AII11111) C�// � - ---- - -- ✓---- -- ------ /'1 NJIH I I/ N SIf.N 1111121 t 11 11\\'IJI K t Al l l l It Ntl/ )At;l IJ I / V t-lit , ------------ Location /—/ /) No. Date �oRTM TOWN OF NORTH ANDOVER 3: O0L � 9 ' Certificate of Occupancy $ ;7$►cNu�E�A Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # -� Building Inspector i TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: � DATE ISSUED. o �j A SIGNATURE: Building Commissionerls=for of Buildings Date z SECTION 1-SITE INFORMATION LI Property Address: / 1.2 Assessors Map and Parcel Number: q7 CLa/r.ePj0n 5 i ,v t� /7 h Gy!r M e r r Map umber Parcel Number 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 Required Provided 1.7 Water Sapply-MG.L.C.40.1-34) . . 000nenormaton: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Ed/PRA Cf�R P�N�fiI� �� C lfor?n4-7 Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Mg 11H�w C4R stf--1,1 Licensed Construction Supervisor: / /� D Fj T r�7 /1 n ,-!e 0 a / /J$ rh T�Utp/ A,f �.• G��J License Number Address L .JL &,,j r G� aid J Expiration Ddte ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name /o g d 3 J SRegistration Number Air%e lid (4,1^ r.fj �1Q sr o«� y re Address / �a Q Y �61 18-0 0& Expiration Date z Si nature Telephone Q �. _. The Commorlrvea�l . i o '1Glassd� uet{s �- Department o P f InIdustrial Accidents ' off/to of/HNSI/je ions 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit pill 52 Ansie Road Chelmsford Mass Q I am a homeowner performing all work myself. 1063 C] 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. 52 ltis3 e :1aat CheYmsfdr`d Ma s 7": 20 00 63 Liberty. Mutua'1 Gtou insurance co P rt. . :. r i. 0 I am a sole proprietor,general contractor,or homeowner(circle ane}and have hired the contractors listed below who have the following workers' compensation polices: ... 77777777777 addual city:. Failure to secure coverage as required under Section 25A of NIG L 152 can I e a d to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a 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--- A4 � oferjury that the Information provided above is true and correct Signature pate __L12/2001 Print name Matthew G Carstens hone# 978-250-0063 pill CC3he.k nly do not write in this area to be completed by city or town afficlai permittlicense# Building Department mmediate response is required pl.lcensing Board (❑Selectmen's Office on: phone#; ❑Health Department Other (resit«!3/95 PIA) JN r SECTION 4-WORKERS COMPENSATION(NLG.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. t Signed affidavit Attached Yes...... No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ . Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition Other ❑ Specify Brief Description of Proposed Work: /4 XI64 0 ;17 #11 Ipd fu ' P f (a P'P 104,A-1 800' /174 4/1// ko -"M&rd (In 3UG VAit d fir r'no, Uh �,w ft&a h'-e/4 C---d SECTION 6-ESTIMATED CONSTRUCTION COSTS Item J Estimated Cost(Dollar)to be '" ' , , ) mGj & 'Y m ll j Com leted by permit applicant 1. Building (a) Building Permit Fee p < Multiplier `S 2 Electrical (b) Estimated Total Cost of / Construction �r 3 Plumbing Building Permit fee(a) X (b) 4 Mechanical(HVAC) r-- 5 Fire Protection cbl/ 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN 1 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, tr #1'741, Co-r��Ph7" as Owner/Authorized Agent of subject property Hereby authorize to act on 1My behalf;inallatt s re tive to work authorized by this building permit application. ..Signalure of(honer 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 knowledge and belief Print Name Signature of Owner/Agent Date r' NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIvMERS 1ST2 ND 3 RD SPAN DM ENSIONS OF SILLS D1IvIENSIONS OF POSTS M ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHNINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE • w �1�e Po„r�,eoouaeal!/� o�✓�aaacrdeuaelta BOARD OF BUILDING REGULATIONS ; Ucense: t<ONSTRUCTION SUPERVISOR Number-CS 062489 itlh�ate: 03/16/1966 EXpies;03/16/2002 Tr.no: 19668 Restricted MATTHEW G CAAftENS 52 ANSIE RD "" : CHELSFORD, MA 01824 Administrator �'/ze i�anr�no�.uuea`C/ a�✓�craacae/uae(,�a ` Board o;Bul!dine Regulations and Standards License or registration valid fo•r individul use only HOME IMPROVEMENT CONTRACTOR before the exl)iration date. If found return to: Registration: 109031 Board o;'_tuilding Regulations an Standards qwl is?;--a:ic•►• U9I01/2�Tu2 One Ashburton Place Rm 130t iv�1e: DBA Bostoo,Ma.02108 A.C. CARPENTRY N.attnew Camtens ..ti:,,i Gam........-��..✓ Chelrnsiord. ,W,012-24 Adteinisdsator -Not Valid wit:fout sirnrtu. Town of North Andover �� %AORTfl .� y �ta�Ei Pk'.lt �O Building Department 27 Charles Street North Andover, Massachusetts 01845 ?, (978) 688-9545 Fax(978) 688-9542 42 cwus�� 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 1, s150a. The debris will be disposed of in/at: MSI are di t til Facility location Signature of Applicant 41 t Ivo Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. NORTH E Town of And No. _ - 05 " � / � A o� CoC�,� dower, Mass., x,95 RA 7 E D PP ON e- . H BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System *Ao * BUILDING INSPECTOR THISCERTIFIES THAT...C .j/ ............................................................................................................................... Foundation haspermission to mW. ...1.5. ......... buildings on ............................................................................:................. Rough �� 3 �S 0 �� r�� 0 i��t Chimney to be occupied as ..............N i 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. 30 fir, �,®, w 1#j** 1% Ce It^ 0S*0W. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. M `Of P( 41301 t sm ' Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough ...... ............................................................... Service BUILDING INSPECTOR . Final Occupancy Permit Required Occupy p ��PiRid tOu q � Bildin g GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final T No Lathing or Dry Wall 1 o Be Done FIRE DEPARTMENT 41 Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE