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Home My WebLink AboutMiscellaneous - 501 BOXFORD STREET 4/30/2018 (2)/ 1 O STREET ` 210/0/105.C-005.0-00 09-0000.0 \` I I I I I r Location No. �T� Date 40"TM TOWN OF NORTH ANDOVER F 9 Certificate of Occupancy $ MUEta Building/Frame Permit Fee $ ACS Foundation Permit Fee $ Other Permit Fee $ ti TOTAL $ /l Check 11 41 9,7l, 1 Q ( 68 f Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI&RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. ( DATE ISSUED: SIGNATURE: . Building Commissioner for of Buildings Date SECTION 1-SITE INFORMATION I 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Numbbr 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronto R 1.6 BUILDING SETBACKS R Front Yard Side Yard Rear Yard Required Provide Required Provided red Provided 1.7 Water Supply M.GL.C.40. 34) 1.3. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ ��. +:ur1c i / . rlo 171 SECTION 2-PROPERTY OWNERSI~IIP/AUTHORIZED AGENT i. t�,Ct; n; 2.1 Owner of Record Name(Print) Address for Service Signature Telephone f _ 12.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: 0 t License Number Address t Expiration Date Signature Telephone a. r 3.2 Registered Home Improvement Contractor Not Applicable o v Company Name M Registration Number r Address r Expiration Date z Signature Telephone G) r SECTION 4-WORKERS COMPENSATION(KG.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 aH a ble New Construction ❑ Existing Building 0 Repair(s) 0 Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition 0 Other 0 Specify Brief Description of Proposed Work: _J SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant I. 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 Crel' 5 Fire Protection 6 Total 1+2+3+4+5 (J 1 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 41M J1K , as Owner/Amtharixed„4gent of subject property I Hereby authorize to act on My beha f,in all matters jAative to w rk au ed by this building permit application. �. Signature of Own 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 r Si ture of Owner/Agent Date NO. OF STORIES SIZE S° BASEMENT OR SLAB SIZE OF FLOOR TMIBF.RS OT 2' 3Ku SPAN DM ENSIONS OF SILLS DM ENSIONS OF POSTS DMENSIONS 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 5 D►tit 1�'� �-- �-�-� (,c�1� � �I`� ju CZCt U "tin t-71 p 2 [,c I-V t l � C AJA t At Luc.LL -�3rAic.-,r c6 (214-7-1 �'.. �. t 1 ,r. i __ ---�- -- -�-- 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 Fa(cility) ' Signature of Permit Applicant Date NOTE: Demolition pee it from the Town of North Office of the Building nspecto over must be obtained for this project through th f &ORTH TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT " 400 Osgood Street }3'•�;,;,;��`h� North Andover, Massachusetts 01845 �SSAG►N►5�1 Telephone(978)688-95454 D. Robert Nicetta, Building Commissioner Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: l� ,Q, l�2lS�s JOB LOCATION: T Number Street Address Map/Lot HOMEOWNER "/_AZL/i/0q//lS' Name Home Phone Work Phone PRESENT MAILING ADDRESS JO/ ity Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to 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,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances 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 requirement -and that he/she will coin with said procedures and requirements. HOMEOWNERS SIGNATURE C� APPROVAL OF BUILDING OFFICIAL I I(MRD OF,W11FAI,S IM-95-11 CI)NSIiR%r,kTION 688-9530 IIFiALTI I68X!)540 PLANNIM;689-9535 I 2622 j - 464 43 1734 WA24 W2136L iLBSBJW 'Q34941 �� 1 W3036 3612 BC ;'R �,636/ 63D15 DISH. 24" 1312R! I R1PRO �---j i q424 I 994 W3 `� I 18 1364 1363 W22 E22 3612 ,3424L. .......... .......... . I i 37 - - --_i�'� 33L REFRIG T309018 C W331824 I 139 - 36 872 ------ - --- 262'2 - - • -- r Dwg no. harry scale: Design: 02/03/05 ,. All dimensions size designations This is an original design and must Date 03/01/05 given are subject to verification on not be released or copied unless job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. Designer I i / � � � 1364' .�-------- 3834 22 30 ------- -- 22 24 ----7/ \ \ 18 | | � 55� 18 � | SG QU 0] 54 — \ 342' /�------ 37 ----'---44' —' 22 30 10 36 ------�� harry All dimensions&size designations This is an original design and must Scale: 1/2 1' Dwg no given are subject to verification on not be released or copied unless F---D-&si9-n6(--- job site and adjustment to fit job applicable fee has been paid or job I — conditions. order placed. Wall/C Line# 1 w---- 2622 24 21 4521 30 142 6 36 521 01 El El 54 coo DI 4-12 91 P 11-J 464 43 1734 36 15 332 12 142 nations This is an original design and must harry F:S�cale:�1/2 Dwg no.. given are subject to verification on not be released or copied unless uesigner All dimensions&size designations job site and adjustment to fit job applicable fee has been paid or job • conditions. I order placed. Wall/C Line# 2 00 IF 0 0 Note:This drawing is an artistic interpretation of the general harry Dwg no. appearance of the floor plan. It is not meant to be an exact rendition. 26232- 33' 86 143 2 11 Fi C,011 196 901 0! 36 18 --12 33 30 5412 All dimensions&size designations I This is an original design and must harry Scale: 1/2 1' Dwg no. • given are subject to verification on not be released or copied unless Designerl job site and adjustment to fit job applicable fee has been paid or job rninrlitinnq nrd,,r nh(-.rA NORTH Town of Andover No. SY 9 C% over, Mass., 19, COCH K ADRATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... Foundation ..... .............7 7 W..—r7:............... ........... ........... has permission to erel....................................... buildings on. ....... .... ... ... .. Rough AW— , �A Chimney to be occupied a .... .... ..... ................................................................................... 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR CONSTRUCn0%gWj VL;L.A4� 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. IFSEE REVERSE SIDE Smoke Det.