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HomeMy WebLinkAboutMiscellaneous - 70 FRENCH FARM ROAD 4/30/2018 70 FRENCH FARM ROAD 210/035.0-0073-0000.0 i Location ' No. Date ,.ORTM TOWN OF NORTH ANDOVER O?O��t`•o ••,�OO�' „ Certificate of Occupancy $ # Building/Frame Permit Fee $ cHus CH Foundation Permit Fee $ � s� t Other Permit Fee $ Sewer Connection Fee $ RECEIVEDRlon Fee $ TOTAL $ a MAY 1 1pog Building Inspector a No.Andover Collector Div. Public Works PER-,trr NO. 17V _ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. /PAGE 1 AP KVO. I LOT NO. 2 RECORD OF OWNERSHIP !DATE (BOOK ;PAGE — ZONE SUB DIV. LOT NO. LOCATION -�O ✓_r)���L ���n e' _!! PURPOSE OF BUILDING OWNER'S NAME '' AAi1.(e k bIstuICF K ^��(�tGll -r5 NO. OF STORIES SIZE OWNER'S ADDRESS .,4p C t?P we,4 FA �f R �Q BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMESPAN N ,iAIFr-t ,, DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR "' GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS /� u IS BUILDING NEW tPo SIZE OF FOOTING , ( X IS BUILDING ADDITION p© MATERIAL OF CHIMNEY ]�e(C(l IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND J �l SCJLI U WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �E S IS BUILDING CONNECTED TO TOWN WATER y ES BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER 7,-5 IS BUILDING CONNECTED TO NATURAL GAS LINE D INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST 97 o-0 d� PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS e PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED Ir1/1 4,1,i2 �;l BOARD OF HEALTH SIG ATURE OF OWNER OR AUTHORIZ D NT F E E �53 ,&�O OWNER TEL.#--2 PERMIT GRAN o CONTR.TEL.# A �`��2 PLANNING BOARD CONTR.LIC.# 19 _ BOARD OF SELECTMEN 1 BUILDINGIN R K BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY SToRtEs THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE _ a 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA _ 14 1/7 1/ FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI-j POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH 13 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.) _ FLAT I I SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING f pORTN ' OFFICES OF: �r �� Town of 120 htai►t Street 7 � � a AI 1 EALS ��` NORTH ANDOVER North Andover. BUILDING s;•. -:,=` .e M;iSS,1C111JSC1150184 i CON E-IWATION rs""" '` IMTSION OF (61 7)685-4775 HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN 1-1.13. NELSON, DIIIEC-1.011 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number / 2 S - is that the debris resulting from this work shall be disposed of in a properly licens 150A ed solid waste disposal facility as defined by MGL c III, S ' The debris will be disposed of in: Pe, t7 (Location of Facility) F Signature of Permit Applica t / Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. DEPARTMENT OF PUBLIC SAFETY COMMONWEALTH 1010 COMMONWEALTH AVE. �, OF BOSTON,MASS.02215 �e ' �► �- �Y MASSACHUSETTS LICENSE CHECK OR MONEY ORDER LII-EPJ E FOR REQUIRED FEE, 0:]:./31/1995CONSTR. SUPERVISOR EXPIRATION DATE MADE PAYABLE TO EFFECTIVE DATE LIC-NO. 6 RESTRICTIONS i� _.�� 7i) "COMMISSIONER OF PUBLIC SAFETY" li ?: FAMILY HOME'. � 04/01/1' 92 m (DO NOT SEND CASH). BART HC iLOMEW M GRIFFIN - #k 2:34-40-6546 1 i.i i W I LUWI i0D AVE PHOTO(BLASTING OWI ONLY) FEE: BRAINTREE MA ��-�1:3 A NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED -OR SIGNATURE OF THE COMMISSIONER DOB:.._ Q?Ulm V SIGN NAME IN FULL-ABOVE SIGNATURE LINE THIS DOCUMENT MUST BE Ig;� ATY E OF CEN CARRIED ON THE PERSON OFTHE HOLDER WHEN ENGAG- yOTHERS-RIGHT THUMB PRINT ED IN THISOCCUPATION. /�200M•2-87-81429AI I TH. CONSLHVAMOVA-------FINAL E E /ri � _ o - _FI�flAL PLAi��41MG_ _F6�`�AL w r � \_ Town ofndover � , 6 N0. 174 0 `14•`!r ��~ r(% DRIVEWAY ENTRE PERMITEw , Kms" er, Mass 19rt A �V oR Pa SSQ � BOARD OF HEALTH PER ILM THISCERTIFIES THAT.. .. .. .. ................1�. ........ ;red...................,...... -_ BUILDING INSPECTOR haspermission to erect ......................... buildings on �.. ...... ...... .. ... ........ O Rough Chimney to be occupied as......SIDI/06...bLw ..�PA�OW. .............. Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Perm' PERMIT EXPIRES IN NTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTR CT S TS Service Final .. . ...... . . .. . ... .. .. BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector Location f7D FA 9 1Pf j No. Z" J Date 17'/o'D 1 NORTIy TOWN OF NORTH ANDOVER f ; p • ; ; Certificate of Occupancy $ 0 ,ssACNUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ j Other Permit Fee $ TOTAL $ 30 r Check # © tf y IoltI37 S!Lf 7 6 building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ft►rUs�e BUILDING PERMIT NUMBER. DATE ISSUED: rn P7 -o SIGNATURE: /` (C -- Building Commissioner/InEeEtor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: `/,f S_S Map Number Parcel Number 1.3 Zoning/' 'InfInformation: 1.4 Property Dimensions: Zoning Distrid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required— Provided Requir=ed Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone In tion: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 J1 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 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 ❑ A Licensed Construction Supervisor: Z C� p_ L��L��s o 8 ✓'—' License Number Address Expiration Date Signature Telephone �W4 3.2 Registe Home Improvement Contractor Not Applicable ❑ /]CL clnQc-'�2 GAIL moa �/ �� C Company Name M /�7 L) �'/ ��( S �l�1Qa(j I LJf,1 Registration Number Address Expiration Date Si na re Telephone G) 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.......❑ 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: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed b permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X tbl 4 Mechanical HVAC if 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 lereby 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/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 tRD 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS 1IEIGIIT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CIMVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE AfC7xy 1i3, 'sb 7n�FN r, * �K y^'dT9 S L0 �tiy'e s 1J M 13 ✓ ®(Z)F Chimne=ys Residential & Commercial Roofing All Types Of Siding CHIMNEYS POINTED-REBUILT-CAPPED Expert Masonry Work Mass Toll Free * Roof Leaks Experts * Licensed & Insured Locally Owned Bc Operated Since 1976 ='"' 1-800-WAIT-4-US _�I License#034200 (924-8487) IKO C'ZAV Wcww oe o'90Aff We Work Year Round .o.',_ .• ,..IVV �m� SSG Proposal Submitted To Phone Date Street lob Name �� ✓ �� � U CL( ' ' City,State&Zip Code Job Locatio Job Phone 35 rl 3 We Propose hereby to furnish and labor in accordance with specifications below, for the sum of- / 2r Dollars �'` , j' .v w %- '/,Ei �.U!' 1 i,l •._.' (.e-f.j,.i 1 7'i' .J`. '1!C +, ..1 All material is guaranteed to be as specified. All work to be completed in a workmanlike Authorized manner according to standard practices.Any alteration or deviation from specifications be- Signature: low involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents NOTE:This proposal may be or delays-beyond our control, Owner to carry fire,tornado and other necessary insurance. Our,workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. r We hereby submit specifications and estimates for: ; • A�\ -f\V .`s Q] Install 3 feet of special "Eave Seal" ice and water barrier protection_along all bottom edges of roof and top to bottom in each valley. If roof is stripped, we will apply conventional ice and water shield ( )ft. high in the same locations prpviously,d`escribed and tar paper will cover the 7 wo o VC S� 2 � (VA g�2 � 5 t—. I �D�attme,-��`lndstsi7ial�d�s . . �v_ � Q�Ce�l?TU°St,Zg6tID11S 600 wasittagron.5'treet . Bosun, WA 02111 • 'V%srrkers'Compensai;on Insurance Asidavit ,4PPLICAN7 Lr-4FQMkTION Please PRINT Legibly City' lV d�0 LVZ- 4y�I�.S Telephone='• D i am ahameawlz��pformmg aIl workmyseli, D i am sol a proprietor and have no ane wor=g in my capacity p I am an crnployer providin._worker' compensanan for my:;kployces waning on this job Company Name: `n Address: Ciry: /`�''�`✓ �� ! / d-S Teleenane'—'. 3ns=ance Campany: policy p I am(cireie one) sole propnetar,seneral contractor or homeownc and have hired the contractors listod below who have the followinD. 1. workers, compensanonpolicies: Company Name: Address• Citgo: Te!cphom f: insu=re Company: Policy T: Company Name: Address: Telwphone t City: iusumnce Company' -Y't A,=ch additi=2d sheet if necessary railuse to secure coverage as required under Secdan^3A of MGL 1dB can Icad m the imposition❑f cripiina penalties of a fine up m �i,50 O.OU and/or one years' i=risontntnt as well as civil penalties in the rozm of a STOP WORK ORD:R and a fine of 5100.OD a bay against m.. I undersand that.e. copv of tnis sLTCment may be iomarded io the Ofnce of!nvesnganons o_the DIA for coverage vm=canon. 1 do hereby certify under tt'K pains and penalties of periury that the information above is true and correct Si=aTtire: Date: Phone — Orucial Gse ONLY-Do no,write in thus area o Building Deoartm enY PermitlLicensa t e Licensing Board Ciry or i owr-1: r,Seiectmen's Oioee ID Health Deoarimsnt ID Other M Check 11 immediate response is required LNTFORIMAEON &IISMU ONS Massachusetts General Laws chapter 152 section 25 requires all employers to provide workars' compensation for their employees. As quoted from the"lain' an employee is defined as every person in the service-of another under any contract of hire, express or implied, oral or written. An employer•is defined as an individual, partnership, association, corporation or other fetal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees- However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the-dwelling house of another who employs persons to do maintenance, Donstr=r1on or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of . such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renevral of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage Additionally,dditionally, neither the commonwealth nor any ofits political subdivisions shall enter into 0 any contract for the performance of public work until acceptable evidence of com_plianee with-the insurance requiremnts of this chapter have been presented to,the contracting authority. ATP licants Please fill in the workers' compensation affidavit completely,by checking the.box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the. Depatm rent of Industrial Accidents for.confxn ation of insurance coverage. Also'be sure to sign.and.date the affidavit. The amdavit should.b5 returned to the city ortown that the application>'or the permit or license is being requested, not the Dopar went of ludustrial Accidents. Should you have any questions regarding the "law"•or if you are required to.obtain a workers' compensation policy;please call�the Dopar raent at the number listed below. cfry or ''owns Please be sure that the affidavit is complete and printed ieD bly.. The Dcpanment has pro-,Aded a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you,regarding the applicant. Tlease.be sure to till in the permit/license number which will be used as a reference number. Thr-- affidavits. heaffidavits may be returned to the Department by mail or F�X unless other arrangements have,beta made, The Office of Investigations would Hke.to thank you in.advance for your cooperation and should you have any questions, please do not hesitate to give us a call. _7'he Bepczttmenf's address, telephone and fi= number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 'Washing Lon.Street . Boston,IYuk 02111 rax' (617) 727-7749 Telephone_ (617) 727-x'.900 e;�. 406;409, or 373 i NORTH Town ofover 0 ,...4 :� X0. 1 TZLA 0 - dower, Mass. 7• �D •�n0� 0 1 COC V 7�ADRATED S BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....;74.y. ...........•�i ..*..�. .A. .. .�.............................. ............................................. Foundation has permission to erect....)r10.................... buildings on 'fl..4th A N W RC� Rough to be occupied as........... V �� AA.4ft ........................ 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 By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 3r? / 73 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS CRough .. ....................................................................................::. 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 Lathingor D Wall To Be Done Until Inspected and roved b the Building Inspector. FIRE DEPARTMENT P Approved Y 9 P Burner Street No. SEE REVERSE SIDE Smoke Det.