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HomeMy WebLinkAboutMiscellaneous - 47 MILTON STREET 4/30/2018 (2) 1 �� d. A)."o --Location � S-/ t No. Date - U� �ORTM TOWN OF NORTH ANDOVER Citt. c :�,ti0 �? •. • Ow 9 i Certificate of Occupancy $ "'°''<� cMust Building/Frame Permit Fee $ s� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �y Check # Z, / Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING 4, BUILDING PERMIT NUMBER. © � DATE ISSUED: 3 SIGNATURE: /tet Building Commissioner/Insbector of Buildings Date SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning DisUtid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided ReqWred Provided v 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 ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes NO PTI 2.1 Owner of Record 0/11/id Svc 1 <a b r�,GL y ? i STi� Name(Pnnt) Address for Service {j � I Sig ture Telephone U Q 2.2 Owner of Record: Name Print Address for Service: O Z r PTI Si ature Tel hone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration Number r Address r y Expiration Date z^ Signature Telephone 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: In .Stv// v d or ����� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be• OFFICIAI:USE�6 X Completed by permit applicant 1. Building (a) Building Permit Fee d l 000- 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 0210 0 0. Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT T_ 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 property as Owner/Authorized Agent of subject pd 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 NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMBERS 1sr2ND 3 SPAN DRvIENSIONS OF SILLS DIN ENSIONS OF POSTS DIN ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X q MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Y • +• O`tticof NORTij 6..;r O O _ Town of North Andover * i Building Department '` �-•-•� 27 Charles Street � CHUSES�y North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE --1 - -3 ` b 3 JOB LOCATION �I M ►J s"I— 3 I l 3 -z- Number ZNumber Street Address Section of Town "HOMEOWNER Number Home Phone Work Phone PRESENT MAILING ADDRESS S `^-_ •C- 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 engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) 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 to six family dwelling,attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official, 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 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 OFFICIAL Note: Three family dwelling 35,000 cubic feet, or larger,will be required to comply with State Building Code Section 127.0 Construction Control. jeo; ORTIy Town ofAndover No. D Q $ r o �o� . W,�� dover, Mass., � _43,.. AORATE0 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System �ABUILDING INSPECTOR THISCERTIFIES THAT......................................................................................................... .................................................... Foundation 4 has permission to erect.....i� 4.44L..1111011111...... on .. ...... .�.. ........... .. Rough to be occupied as �0 00V 7to ^a Chimney 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 By7sth s relating to the Insp ction, Alteration and Construction of Buildings in the Town of North Andover. ? / 3 Z 3 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Volis Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS 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 t BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner ' Street No. SEE REVERSE SIDE Smoke Det. Date. .. ... . ,4ORTF, pf 4�.io 41 o? TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION ,Sg HU5' . . This certifies that . . . + . . .�. / ::'.`.!°.'. .! . .r< has permission for gas installation . . . . . . . . . . . . . . . . . in the buildings of at . . �/. ? ,: 1.% �. : . . .? ./. . . . . . . ., North Andover, Mass. Fee. b . .'. . . Lic. No.. . .'. .'. .'. . . . . . . . .. . . . . . .... . . . . . . . GAS INSPECTOR Check# L �, 3 {' 7 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING k6-41" (Print or Type) - rn Iy • ,/7'n14b Mass. Dates 7 P? I 2co/,.I _ Permit # CS Building Location 7 ! i hZ ' S Owner's Name_ Alr (41.,f, ±i1 ype�of Occupancy_ I�e-51 irC N 7 r� New ❑ Renovation ❑ Replacement.(.g� Plans Submitted: Yes❑ No ❑ y CC _ y W y Y Z ¢ of y y V y Q y ¢ O y = W W y Q O Z O W Z ; O 1- W < m y H y W O W < r.. y 4 W X W = Z O W Z41C ¢ pC W ~ Ul ~ = h ¢ L7 F' Z J < _ ~ �W.. 0 Z O z W O to = � SUB-8SMT. BASEMENT 1ST FLOOR r• 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name iE Le T A . :AM M A T r.)1 Q Check one: Certificate Address %> 0-n H/h,4 r0 i til ❑ Corporation �1 - 7'H UE 0 r11 is 0 ( �q ❑ Partnership Business Telephone /d Z —(7 ()-7 ( 2- F-i rm/Co Name of Licensed Plumber or Gas Fitter - o AE P.T A A M r}1 r9 Tiq r""� INSURANCE COVERAGE: I have a curre,_nt H bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Lid" No ❑ If you have checked Les, please Indicate the type coverage by checking the appropriate box A liability insurance policy Other type of indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent C3 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 pe i ed for this application . be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of net Laws. T of License: Ud4 �Z3 Plumber k4kjhAlure ofcen u or atter Title tter er License Number 9,333 City/Town Journeyman APPPDVEffT0-FF1UCUSr5N­L'?1- BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME A TYPE OF BUILDING LOCATION OF BUILDING - PLUMBER OR GASFITTER LIC. NO, PERMIT GRANTED DATE x_..._19 GAS INSPECTOR