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Miscellaneous - 650 FOREST STREET 4/30/2018 (2)
650 FOREST STREET 210/105.D-0024-0000.0 l S Date....���.`-.... . .... . NOR7M °`<�``° '•�"a TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that .........4 ..............................Q............ ..t-..:...... has permission to perform ....... ........................................................... wiring in the building of......r�..v rr"...�- ......................................... at...1 S U.......... .a... ......!\..................North Andover,Mass. (r.... Lic.No. '4�.�k+. ......... : ............... "aEcrmcAL INspEmR Check # 4483 THE COMMONWEALMOFMASS4CHUSEM Office Use only DEPAR7A1EW0FPUX1CS4FM Permit No. /_7 �?3 BOARD OFFIREPREVEVHONRBGUL47YONSR7CM 12 VO i Occupancy&Fees Checked APPLICA71ONFOR PERMIT TO PERFORM ELECMCAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat_ 'J 0 — O Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant &, Owner's Address 511 G Is this permit in conjunction with a building permit: Yes©No M (Check Appropriate Box) Purpose of Building / j`�M Utility Authorization No. _ Existing Service 7_00 Amps >2V/ 'LW Vol Overhead 0--underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work T% u No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground 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 Po.of Dryers Heating Devices KW LocalMunicipal Other �.Connections No.of Water Heaters KW No.of No.of Signs Bailasis 1Vo.Hydro Massage Tubs No.of Motors - Total HP OTIIER- NL(.,J 1-C bLT)—Lc 11 T 0 R 1 er kt i�-v DQ}_' Po<.1) u_ Q_;) hmaanceCovfraW_FUtsuaY>3ottteregtmartat��t,,a>er-alLaws �� YES 1:3 NOIbatieaoerttLiabkylrn�na=PbbcyitriAgCori4*e Wa Co�aits Ih=AbrAodvaaliddploofofsameiodrOfce YES FT F)Doha%edtedWYES,pl=m&aetltetypeofeDmxWby drddngthe bo .INSURANCE BOND 0111Ix ftasespe* G � L-ro UJ T� EVimfmDate Hstn xMdVahteofFJetii a1Work$ wbdmstart lrgVfiMD&RetPested Ratgh Final stgnedunderTr, i� FIRMNANIE C-Q R L Lioensel% 13 ©G 19 Lice VAt`C `— 1. - fl sigoahue f L;oaseNo t BusissTei]%. — 3a y Ccs rAIS S 7 — .TeL �' �0� OWNER'SINSURANCEWANER;Iamaw&e l_xmsedoesnothavedeirmnanceoovaaworitsa*stalAlec}uvalaYasiegmedbyNb%adlusetlsGmrallam and that mysignature on ttrispemutapplication waives this regzennert[ (Please check one) Owner Agent F-1 Telephone No. PERMIT FEE I Signature ot Uwner or Agent z w The Commonwealth of Massachusetts b Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. 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. Company name- Address City- Phone#: Insurance.Co. Policy# Company name- Address City Phone#. Insurance Co. Policy,# Failure to secure coverage as required.under Section 2M or MGL 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 and/or one years'imprisonment-as welLas_c nd,penalties-o.thelomniofA-ST9P]MVW Rand_afioe-d_(,E1D0-m)-arlayagainstme. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. l do hereby catty under the pains and penalties of perjury that the inforimbw povided above is true and correct_ Signature Date Print name Pbsme. Official use ony do not write in this'area to be completed by city or town dficiar t City or Town Pen*Ajcensin-q Building Dept t E]Check if immediate response is required p Licensing Board p Selectman's Office Contact person: Phone#. Health Department Other 11; 3 ,,9 7 6 Date....v. / ...d.LZ t HpRTM 1 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSAcMusE�� This certifies that ....... :.. ..........J. .` ..................................................... has permission to perform j { ( ]�..........�UJc , .................................. ............................... wtnng in the building of..... Z t- a ..............'..J..U..........c1.....r... ........... ..........&orth)kndover, Fee.... Lic.No. .. ...(.%V..... ........ .... .............. / ECMICAL INSP CTOR Check # �/// (..ornnsoniusallh o`///adeatliula�l For Office Use Only (Rev.11199) Permit Number. ..UsParfmsnf o`�i++��arvicu Occupancy&Fee BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (ALL wORK TO BE PERFORMED WITH THE MASSACHUSETTS ELECTRICAL CODE 527 CMR 1200) tl PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: City or Town of: y, vr,I :,�:t To the Inspector of Wires: By this application the undersigned gives notice of his or her Intention to perform the electrical work described below. Location:(Street&Number) ��— Owner or Tenpnt: Owner's Address: S/A-"• Is this permit in conjunction with a Building Permit? Yes o No Check Appropriate Box) 7 Purpose of Building: iH -C 1i,, X Utility Authorization#: Existing Service: Z r,a Amps�v/ 2 �Volts Overhead Underground.❑ #of Meters r New Service: Amps If Volts Overhead ❑ Underground.❑ #of Meters: Number of Feeders and Am aci J� ~f �"9 t f'X a��� I"er, P ty: v Location and Nature of Proposed Electrical Work: U A` No.of Recessed Fixtures No.of Cell.-Susp.(Paddle)Fans No. of Transformers Total KVA No.Of Lighting Outlets No. of Hot Tubs Generators KVA its No. of Lighting Fixtures Swimming Pool: Above ground o In Ground o *of Emergency Lighting Battery Units No.of Receptacle Outlets No. of Oil Burners Fire Alarms #of Zones ; #of Detection&Initiating Devices No.of Gas Bumers #of Sounding Devices: No.of Switches #of Self Contained DetectioniSounding Devices No.of Ranges No. of Air Conditioners TOTAL TONS: Local n. Municioai Connection c Othe; c� Ng. of Waste Disposals i Heat Pump Totals: Security Systems: Number: 1'DNS: KW:--. No.of De xes.q,,Eq;,iva1' No.of Dishwashers Space/Area Heating: KW Data Wiring,No.of Devices or Equivalent: No.of Dryers Heating Appliances KW Telecommunications Wiring:No of Devices or Equivalent: No. of Water Heaters KW No. of Signs: #of Ballasts: OTHER; > of Hydro Massage Tubs No. of Motors Total HP INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or Its substantial egwvale . he undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ Please specify: r Estimated Value of Electrical Work S (When required by municipal policy) Work to Start: —� Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the Information on this application is true and complete. J �+ Firm NamC`e: / LIC.t Jo 3 Licensee' l/!/ GG / Signature' LIC.tl AT�/ 3 Jr q (I1 applicable,enter axe in the license num er line) Adaress l�/ ��G/G3 B'� 6�-�-z��y AI:.Tel.t✓ OWNER'S INSURANCE WAIVER:I am aware the:the Licensee does not have the liability insurance coverage normally reou,red oy lav,. By my signature beiow.I hereoy waive this reeuirement. I am the(check.one) Owner D OR Agent c r-- Location 1"Y T� No. 3 Date NORTH TOWN OF NORTH ANDOVER � p ' Certificate of Occupancy $ res'•^°.•��n 9 Buildin /Frame Permit Fee $ s�cNusf Foundation Permit Fee $ Other Permit Fee $ 3 °� TOTAL $ ` Check # `7 �n Ilaf l i 5360 Building Inspector F ; t TOWN OF NORTH ANDOVER a ;.BUILDING DEPARTMENT f APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH ONE OIi"TWO FAMILY DWELLING i BUILDING PERMIT NUMBER: - DATE ISSUED:. SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1:2 Assessors Map and Parcel Number: Number Pat cel Number 1.3 Zoning Information: 1.4 Property'Dimensiom- Zonin I>istriii` Use LoYArea Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear.Yard Required Provide Provided ReTfired Provided t.y water sepply M 04 .sal l.s:' Flood zone!ofoimat en , t.s'. setiverage Disposal system Public ❑ P&-&& zone Outside-FtoodZone ❑ M' i.. ❑ On,$iOe.D�sposaI system ❑ SECTION 2-,PROPERTY OWNERSEEMAUTHORIZED AGENT 1 Owner of Record _ 14 i Com A) ,>� ��-,� Nanle Print) Address for Service 7 Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable. ❑ Licensed Construction Supervisor. License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ a Company Name Registration Number Address Expiration Date Sign ature Telephone F i SECTION 4-WORKERS COMPENSATION(NLG L.C 152 § 25c(6) . ` Workers Compensation Insurance affidavii must be completed and submitted with this application. Failure to provide this affidavit will result in the denial 6f the issuance of the building permit. t Signed affidavit Attached Yes:......0 No.......C `w ` SECTION 5 Descri tion of Pro sed Work check all applicable) New Construction D Existing Building ❑ Repair(s) ❑. Alterations(s) 0 Addition 0 r Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: WIN SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed by 't.a licant 1 Building (a) Building Permit Fee 2z"O 0� multiplier 2 Electrical (b) 'Estimated Total Cost of Constmctibn 3 Plumbin Building Permit fee•(.)x(b) 4 Mechanical AC 7� 5 Fire Protection 6. _.Totals„ 1+2+3+4+5. ,..., .: .Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I r-� i LE(� (fit f� ► as Owner/A orized Agent of subject property Hereby authorize to act on My behalf,in allRrffrelative to autho by this building permit application. 3- 7- �� Si tune of Owner Date SECTION 7b OWNER/AUTHORIZED' GENT DECLARATION I, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurte,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 TIMBERS 1sT 2ND 3 RD SPAN j DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIIVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE NORTH Town of �/E over 0__ No. 4 C% _ o�A COCHIC I ,., dover, Mass., 3 DRATED S H � BOARD OF HEALTH PERM : IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....� (/r .. .so.... N.............. Foundation r'has permission to ore c .................... buildings on �� its Rough ... .. .. ... . .. .... ...... to be occupied as........ ... V ..1A.0 f s............................ Chimney �.......r..................... ........ 0 w...... provided that the person acc ting 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 tot Ins ection, Alteratio and Construction of Buildings in the Town of North Andover. / 0000 INSPECTOR OP h5 o� Y /y3 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ......................... ...... ..... . Service BUILDING INSPECTOR 1, Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Display in .a Conspicuous Place on the Premises — Do Not Remove RoughFina, No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by-.the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Town of North Andover .;,t � :Y� Building Department 27 Charles-Street North Andover, MA. 01845 .4 D. Robert Nicetta �sc►ri,�t�{ Building Commissioner ' (978) 688-9545 .,..:(978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE 3Z7 Z- JOB LOCATION •�S� z Number Street Address Ma /lot 7 L ..HOMEOWNER t &77-1 Ci(,l N 0I `?17 k— 925-- J"z/1/- -7 -6 Name. Home Phone Work Phone PRESENT LING ADDRESS 5 awl 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 Budding 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, oris 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 t comply with said procedures and requirements. HOMEOWNER'S SIGNATURE Z Z APPROVAL OF BUILDING OFFICIAL Oro - A Location No. O Date '00 / TOWN OF NORTH ANDOVER Certificate of Occupancy $ j �s'••° Eta' Building/Frame Permit Fee $ 1,3 S CHUB Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �(O 1 15674 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: (a DATE ISSUED. -� ' i SIGNATURE: Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 05-0 -Ft-e.--.� SdreeP /OS Map � Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zomrij District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Repired Provided 1.7 Water Supply M.G.L.C.40.§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record L PQY)� Ap ei PA�1 1 G(G. oy t K &543 f Oreo 1.444- "p1 Name(Prin) !� Address for Service Signature Telephone c 0 O 2.2 Owner of Record: Name Print Address for Service: rn Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 'K 7f' �: Lne -�4" g nLo-',A •'. Licensedstrut' n Supervisor: License Number Mn Address Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable 0 71�4 *4jG W11L Alr AI&O. Company Name7— rn Registration Number ru Address r Z Expiration Date Q Signature Telephone Y� 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.......0 No.......❑ SECTION 5 Description of Proposed Workcheck au applicable) New Construction ❑ Existing Building Y Repair(s) 77le—rations(s) ❑ Addition 1$ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: T> ,w of /5o f sA 4or J't raiv Add �r.'CrK a ��s t er a ooraI4 Aak - 4=G y ,40vt_ 01244 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be '. OFCIAL DISE C11+IL Y Completed by 2ermit a licant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 PlumbinE 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 1, 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 1> ,as Owner/Authorized Agent of subject property i 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 f Si tune of Owner/A ent Date Si. �. NO.OF STORIES SIZE G, Q�✓� o l4' ' o' BASEMENT OR SLAB /t/E„ ,• w �c; ;,,� f Q)tt wA SIZE OF FLOOR TIMBERS v 1 s _ / 2 NUF 3 KU SPAN /.� DIivIENSIONS OF SILLS 4)( DIN ENSIONS OF POSTS - 2 y 3_2 DIMENSIONS OF GIRDERS _ 1 X _ ZX IU HEIGHT OF FOUNDATION THICKNESS Keg SIZE OF FOOTING /2" X " MATERIAL OF CHININEY Al,a, IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE g 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 S �� � ��14) PHONE ' LOCATION: Assessor's Map Number lO5 PARCEL a.,Z SUBDIVISION LOT(S) 'STREET �� � ;�cK1� ,� ST. NUMBER b b USE . ONLY*********************************** 4REMMENDATIONS OF TOWN AGENTS: RVATION ADMI STRATOR . DATE APPROVED Ga DATE REJECTED -- COMMENTS b -E- - ,,, W J L., wth J o-.,4ibn me_4;TOWN PLANNER PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED \16�' DATE REJECTED LI, jS.�� SE TIC INSPECTOR-HEALTH DATE APPROVED fof W1 Q L DATE REJECTED �' COMMENTS-JI PUBLIC WORKS - SEWER/WATER CONNECTIONS 1V DRIVEWAY PERMIT FIRE DEPARTMENT �� RECEIVED BY BUILDING INSPECTOR DATE ' Revised 9\97 jm MA CONSERVATION COMMISSION DATE: 6 / 21 / 02 SITE: 650 Forest Street MA DEP # 242 -1130 North Andover, MA 01845 OWNER: Pat and Bob Gohn SUBJECT: CONCRETE TRUCK SHOOT CLEANING We propose to afford a sand containment area,including hay bales to contain the shoot wash down of any given truck of concrete for this project. This area will be a minimum of 50 feet from said wetlands areas described on R.F.Kaminski&Associates plan dated January 10,2002,titled "Notice of Intent".The actual location would be in the area of the proposed pool location,some 65 feet from point#2 in the wetlands area. Containment sketch follows: i Co west RQ E, Regards, The Commonwealth of Massachusetts • q Department of Industrial Accidents Office or Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit . Please Print T Name: tah. Location: CiPhone am a homeowner performing all work myself. 01 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. company name: Address Com' Phone# Itsure_Co _ P€tlicy.# Cs�r�panv trams: . Address City: Phone#' tnsurae+r :.Co. Polio► Failure to stcura coverage as rr Wred under section 25A or W.,,.1,52 can read to the Neon of crkr* l pans,of a fine up to 61.500.oo and/or one years'imprisonment as'WOO as dvO penalties in the.form of a STOP WORK OMM and a fine of($1oD 00)a day against rne. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage veriflicatim. I do herby certify under the pains and atles of pedury Mat the lntamatADn provided above is true anis-correct Signature �f � Date G Print name Phone# `?'i� S� Official use only do not write in this area to be completed by city or town official' E) Building wept j DCheck if immediate response is required building Dept 0 Licensing Board 0 Selectman's �c6 Contact person: Phone# 0 Hlealth Department 0 othec M4 WORKMAN'S CopIpENsArioN 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 t . t s+ai�Tk Town of North Andover Building Department M 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta S�e►rusEt. Building Commissioner (978) 688-9545 i .... 978 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE �/b2-- J08 LOCATION CPLS r I"GA Number Street Address Map/lot ..HOMEOWNER �J�y �1 �t'/1� 17� �7�5'tj�� �7� 7? " 2-3`90 Name Home Phone Work Phone PRESENT MAILING ADDRESS S�y�+� City Town Stade Zip Code The current exemption for"homeowners"was extended to include owner-0ccupied 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 tie'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 SIG j NATURE APPROVAL OF BUILDING OFFICIAL 4- NORTH Town of over 0 T C over, -aS'-d © DL O COCHIC W1 V ADRATE D PPS\ '9S H �� BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System � BUILDING INSPECTOR THIS CERTIFIES THAT..... ... ..Q........eie.7...............°t'� �'� N Foundation ................................................................................................. Vf has permission to erect..../..41� ..................... buildings on .......�.�..�........ ^c s�..................................... ^ Rough to be occupied as.L.S.CPe.r. l OPO Oaa aS`� oP{ti vIC C K UI `L /B��O�y /QD V e �/�v�/3tj Chimney ..........,r........................ . .. ............................................................................. 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. /0 X72 �( #43 40 . PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit.` Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR C 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. SEE REVERSE SIDE Smoke Det. MA CONSERVATION COMMISSION DATE: 6 / 21 / 02 SITE: 650 Forest Street MA DEP # 242 -1130 North Andover, MA 01845 OWNER: Pat and Bob Gohn SUBJECT: CONSTRUCTION SCHEDULE ♦ Issuance of Construction Permit. ♦ Temporary shoring of the existing structure. ♦ Embellishment of existing floor beams. ♦ Project Layout [surveyor]. ♦ Initial excavation for partial foundation. ♦ Setting of formwork and concrete placement of foundation of existing structure and deck piers. ♦ Installation of stick framing, bracing, LVL girders and exterior sheathing. 9 ♦ Installation of exterior deck work. ♦ Completion of all trim. ♦ Pool Installation ♦ Grading repairs and seeding I 11 -7�`_r - _,'TVrl wi.-7�-,',X-1-'-_--.;-i�r-- v., -7� ,�,-��;e"ii!,-,-"",17-l-'�T-�-.-""f,--r''l�, - — - - —__ -__________ - ___ __ __;_ ,I I .1-11 I= "�T. I— ._.1 ,_1._ --I I - I—- -6-w- ` 11111_�, - I I . ._ 1. ,,, I ___— — _-1._--_ "iW _7jqF7��',�_11 - -� - -�, ,���.� . I. �, . I . . . � I . -�- . I - . 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