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HomeMy WebLinkAboutMiscellaneous - 582 TURNPIKE STREET 4/30/2018NORTH ANDOVER. BUMDING DEPARTMENT .1600 Osgood Street North Andover Tel: 975-688-9545 Fax: 978-688-9542 DATE: ADDRESS: �7 -ew/? "t ZONING DISTRICT:_ .BUSINESS F0J?MF01? TOWN CLERK hb"`w, lie �r °lLp ( 'D )012 f�2 TYPE OF BUSINESS.: / / 05r -g � 116 BUILDING LAYOUT PROVIDED: YES (N�? AVAILABLE P ARi4WG SPACES: ZONWG BY LAW USAGE: YES) NO BUSINESS FORM FOP TOWN CLERK R_ SIGNATURE 2,40 Home Occupation (1989132) .An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary to the use. of the building. for living purposes. Home occupations shall 'include, "but not 'limited to the following uses; personal services such as finished by an artist or instructor, but not occupation involved with motor vehicle repairs, beauty parlors, animal kennels, or the conduct of retail business, or the manufacturing of goods, which impacts the residential nature of the neighborhood, 4. For use of a dwelling in any residential district or multi fairuly district for a home occupation, the follovhng conditions shall apply. a. Not more than a total of three (3) people may be employed in the home occupation, one of whom shall be the otvlier of the home occupation and residing ift said divelling; b. The use is carried on strictly within the principal building; c. More shall be no exlerior alterations, accessory buildings, or display which are not customary with residential buildings; - d. Not more thm twenty five (25) percent of the existing gross floor area of :the dwelling unit. so used, not to exceed one thousand (1000) square feet, is devoted to'such use. In connection with such use, there is to be kept no stock in trade, commodities or products which occupsr space beyond these limits; e. There will be no display of goods or wares visible from the street; f. The building or premises occupied shall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other way become objectionable or detrimental to any residential use within the neighborhood, g: An j buil g shall include no features of design not customary in buildings for residential I Sig4a/tur,6 /" Date Date..................... TOWN OF NORTH ANDOVER sz� 0-4 PERMIT FOR GAS INSTALLATION This certifies that ..........: Y: `:..::. :. khas permission for gas installation ` :::..:.. ............. in the buildings of ....... c!` ........................ . gat... !� `' .. , North Andover, Mass. Fee ..... Lic. No./. �: f `�.. % ' �?- ,,� .> ........... GAS INSPECTOR Check J 30'44 MASSACHUSETTS UNIFORM APPLICATON FOR PERIVITT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations Date 2 —2 g- 0 _-,✓'" Pennit # �7 Amount $ 6-0-, Owner's Name New ❑ Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) one: Certificate Installing Company Name ��� ��� S�'! �rS/r.' Corp. Address /�O, ❑ Partner. - 96;0 -. 5107 Name of Licensed Plumber or Gas Fitter .;, -C,/;Q I c S/ ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes [D No❑ If you have checked M, please indicate the type coverage by checking the appropriate box. Liability insurance policy P 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 ofthe 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 ❑ 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 Permit Issued for this application will be in compliance with all pertinent provisions of the MassachuWls State Gas Code,4ndnCh,f442 of the General Laws. ICity/Town (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber ❑ Gas Fitter License Number ❑ Master Journeyman • (Print or type) one: Certificate Installing Company Name ��� ��� S�'! �rS/r.' Corp. Address /�O, ❑ Partner. - 96;0 -. 5107 Name of Licensed Plumber or Gas Fitter .;, -C,/;Q I c S/ ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes [D No❑ If you have checked M, please indicate the type coverage by checking the appropriate box. Liability insurance policy P 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 ofthe 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 ❑ 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 Permit Issued for this application will be in compliance with all pertinent provisions of the MassachuWls State Gas Code,4ndnCh,f442 of the General Laws. ICity/Town (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber ❑ Gas Fitter License Number ❑ Master Journeyman Location L 9 �V /�0% �1 r No. !h Date O ! opNORT„ TOWN OF NORTH ANDOVER ?t...° ,�0 F 9 ' Certificate of Occupancy $ �'� s''•' Eta' Building/Frame Permit Fee $ / J\ +cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ?f a Check # /y i ti 17429 rc-r,�2�- 1 Building Inspector APPLICATION TO CONSTRUCT REP BUILDING PERMIT NUMBER: TOWN OF NORTH ANDOVER BUILDING DEPARTMENT R, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING T�us,SectiOb1 U#iiCiBlUse'OHI _. . DATE ISSUED: SIGNATURE: Building Coi missioner/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property .Address: 1.2 Assessors Map and Parcel Number: %� tV .4 /r - A- „ Klap Number Parcel Number 1.3 Zoning Information: - t 1.4 Property Dimensions: ZoningDistrict Proposed Use Lot Areas Frontage (ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 34) 1.3. Flood Zone Information: - 1.8 Sewerage Disposal System: Public 0 Private 0 Zone . Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Own r of Record Name rift) Address for Service 1 Al Signature Telephone I 2.3 Owner of Record: Mame Print Address for Service:. Signature Tele SECTION 3 - CONSTRUCTION SERVICES 1 4 3.1 Licensed Construction Supervisor: Not Applicable P Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.1 Registered Home Improvement Contractor Not Applicable 0 �Apany Name Registration Number %ddress Expiration Date ianature Telephone I r- -/ ir^%T A rur%nircDc f1nX4D1VNQATTnN lM (_ T. 0 152 S 25c(6) rWorkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result n the denial of the issuance of the building permit. signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Work check all a licable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑. Specify RT;ef Desc:rintion of Proposed Work: 6 Total (1+2+3+4+5) 1 Check Number SECTION 7a OWNER AU ORIZATION TO BE COMPLETED WHEN OWNERS AGENT RTAKCTOR APPLIES FOR BUILDING PERMIT 1 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. Si nature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I as Owner/Authorized Agent of subject property Hereby declare that the statements and infonnation on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Aent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS DINIENSIONS OF POSTS DUvfENSIONS 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 a k'Y-1� 7/ SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed b permit applicant �O. , I' O 1. Building4�� - 7 7 S (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) 1 Check Number SECTION 7a OWNER AU ORIZATION TO BE COMPLETED WHEN OWNERS AGENT RTAKCTOR APPLIES FOR BUILDING PERMIT 1 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. Si nature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I as Owner/Authorized Agent of subject property Hereby declare that the statements and infonnation on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Aent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS DINIENSIONS OF POSTS DUvfENSIONS 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 Ov �-I\M cQ ✓, X42 n `t� FORM - U - LOT RELEASE FORM INSTRUCTIONS:. This form is used to verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. a.S.Sm.....5■ $....SmSS.Sa.uS.S....sun.assummaa.S.S.....SSS■■SSSSaSS.S.....S. APPLICANT tn%� A/orG���,c/ PHONE �9 T a l� 7 S 6 ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER STREET STREET NUMBER, a s ........ . .. . . mama.. . masa. .......Suss............. . . ■.ssma. OFFICIAL USE ONLY .................................................................sons...... CO �m�NDATIONS OF TOWN AGENTS 57 DATE APPROVED I 6 CO SERVATION ADMINISTRA . DATE REJECTED --> /V®'. DATE APPROVED TOWN PLANNER DATE REJECTED CONDAENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR - HEALTH COMMENTS PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED RECEIVED BY BUILDING INSPECTOR DATE e " Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta""- Building Commissioner (978) 688-9545 (978) 688-9542. Fax HOMEOWNER LICENSE EXEMPTION Please print. DAZE L- 7—o JOB LOCATION , , umber "HOMEOWNER Narge PRESENT MAILING ADDRESS �43 e7— Y11 City Town Address 7s S Home Phone f21/1.,7/ lam! State F,6 _. oap Map / lot Work Phone 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 e. 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. 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M ar� Z y Z C -7 Q 0 o aJ C zz H s .c, dim 5 d rX ' X The Commonwealth of Massachusens Deparbnent of Industrial Accidents �+Iffilma ifmYeS&ANNIM A 600 Washington Street Boston, ,class. 02111 Workers' Compensation Insurance Affidavit ii��1111�111 III Cj 1 am a sole proprietor, ;eneral contractor, or homeowner (circle one) and have hired the contractors listed below who have the followingworkers' compensation polices: comoanv name: Failure to secure coverage as required under Section 25A of.NiGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years' imprisonment as well as civil penalties io the form of a STOP WORK ORDER and a fine of SI00.00 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 herebv certify rend the pains and allies of perjury that the inforrstmion provided above is true and �correct , Signature Date8/` Print name Phone # oftld2l use only do not write in this area to be completed by city or tows. official ciry or town: permit/ticease r—, Building Department C:Lieensing Board cheek if immediate response is required QSelectmen's Office C3Health Department contact person: phone it; r'10ther (rc,amW 1/95 PIA) Date ..7/Z/ ,: NORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING /),:Z/s I `le /� �-/ � �- ii?( c CI'd - T, �' C - Thiscertifies that ....... .. ....... ......................................................................... has permission to perform ..... ..... wiring in the building . of ........ "--7 .......... - ......... e at .... North And S. 13 Fee ......... Lic. No . ...4...... 7 ...... �� 4�1/ , ��CAL INSPECTOR Check # 5324 TBECOWO WE4LTHOf,ALIMCRUSMSLPerrmitNo. OfficceUse only DEPARTALENTOFPUBLICSAFETY BOARD OFFIREPREVEN770NRF.CMTIONS527C11R12-00 Checked VA PPLICATIONFOR PERMIT TO PERFORMELECTRCAL WORK - ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACI-IUSSTS ELECTRICAL CODE, 527 CMR 12:00 / sO (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ' (� Town of North Andover To the Inspector of Wires The undersigned applies for a permit to perform the electrical work: described below. Location (Street &:dumber) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Purpose of Building Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Yes M No = Appropriate Box) Utility Authorization No. No. of Meters Lgcation and Nature of Proposed Electrical Worktke— %ao ve— AcG, ro U nW A01 No. of Lighting Outlets No. of Hot Tabs No. of Transformers Total KVA N6. of Lighting Fixtures Swimming Pool Alr^ve. Below Generators KVA ground round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners _ No. of Ranges No. of Air Cond. Total FIRE ALARMS No. of Zones Tons No. of Disposals No. of Heat Total Total No. of Detection and Pumps Tons KW Initiating Devices No. of Dishwashers Space Area Heating KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices No. of f)ryers Heating Devices KW Local Municipal® Other a Connections No. of Water Heaters KW No. of No. of Signs Sailasis No. Hy�ro Massage Tubs No. of Motors Total HP I a rmwComage Ptastlatttiathetagt>itanetltsotll n Galeal Laws �j Iha�eaaarat[i blitybm m=Pobc.ymlxrtgCm#AkOp '�'ag� Co►aorabsurtiMaT ivalart YES rM NO ItmeabinkedvatidpwofofsmmlotheOlfioe YES U NO r If}cuha,,edmdodYES pimem&*the4Wof=emybydaiangthe MIRANCEQ BOND 0 OTf-&R 0 (Plea9espeafy) ",r Y 5 U � r�1e7 ins Co Expaatia D* WorkioStrt /� �0 7_�_© VahreofEkchicalWade$ � �_Fmal 0 c%Jec4r f c_ Go - c LioffseNa W/5a«3 Lxersm lad Pa f"-IJiMnselsb BusirmTdNa 9�' Ad�,�,2 444 //e,, Al®, M l -P/' /470 r d/87'/� X08'.3'(�SCY� Alt Td Na OWNER'SINSURANCEWANFR;Ianawa dxttheLi msedoesnothawthei ba=mmnWartabsm lepvalatasm4madbyNb%xdasezCjcmdiaws andtl�mystaernttrispantiteppfic�a'Iwaitiest� tec}tta. (Please check one) Owner M Agent M Telephone No. PERMIT FEE $ �K