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Home My WebLink AboutMiscellaneous - 8 Baldwin StreetI W 0 i 4 Location y No. ? 1 Date 14 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �l r i 17878 Building Inspector, TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: j DATE ISSUED SIGNATURE: Building Commissioner/1for of Buildings Date SECTION 1- SITE INFORMATION 1.1 . Property Address:: 1.2 Assessors Map and Parcel Number: Map Number� Parcel Number ty �Y Z 1.3 Zoning Information: Zoning Di;_ftic_t Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. blood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 110LUIlu LJ11JUIUL. T o 2.1 Owner of Record Name (PH Address for Service Sign re Telephone 2i,e2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: / � Licensed Construction Supervisor: `Addres Sag a Telephone Not Applicable 0 LicenseNumNer Expiration Date 3.2'Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone 0 z M 90 M z^ P1 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 ' ^1, t -I l� tt Brief Description of Proposed Work: W1 7 Ole O SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed b y permit a licant 3 (3F`FICIAL:IISE �C?IVI.Y 1. Building �— (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) v 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 ARGENT DECLARATION ,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 Prin e A!� at 7 6 of Owner e Date Y4. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS Isr2 ND 3 RD SPAN DIN ENSIONS OF SILLS DM ENSIGNS OF POSTS DHVIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBDvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 71. BOARDIIOI%ImLOILUiW.vVG''O��q.C, BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR c Number C 060825 Birthdate ,10/1971.959 Ekpires 1®/'912006 Tr. no: 6114.0 Restricted 00:,-!, JAMES C ERB ' 8 BALDWIN ST t NORTH ANDOVER MA -61845 Commissioner 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: Signature o ermit Applicant Yate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector A pORTM 04ts 1M0 F } TOWN OF NORTH ANDOVER QAC BUILDING DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER MA 01845 D. Robert Nicetta,. Building Commissioner 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE JOB LOCATI Number Street Address Map/Lot PRESENT MAILING ADDRESS Seq: yI e City/Town Home Phone, State Work Phone 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 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, one or two family dwelling, attached or detached structures attached or detached structures accessory 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 Department minimum inspection procec procedures and requirements. HOMEWOWNER'S SIGNA APROVAL OF BUILDING s the Town of North Andover Building and that he/sly will comply with said Y `� 1 N h v-%—* N a� IE a w cn O H w° p°G v U w a n4° w a a°4 w a a�' w 1110 O Q rA cn cn D J O E=4 c o :•m C ;= O O 16, O N c O CJ V �a= d e0 W r=m-. O o � m c o c. O M o� v 0 �� os m c a= :=m oCA Y � ch �$ .m � m aU� J _ Q Z 1110 O Q (' N`0 O E=4 c o :•m C ;= O O 16, O N c O CJ V �a= d e0 W r=m-. O o � m c o c. O M o� v 0 �� os m c a= E Ma s N go m oc cm c m a- C2 cm c 'c N CD Z r.. 0 Z O 5 cm O w P-4 I O , E . 0 L CD Z a O y c ccm C CO2.93 co O� i W co Ca CL m CL 3� a� � 0 0 cma c ev ca .5.c CD CO Z tS CL V N3 O c c C c .y O U) W W oc W U) :=m oCA ch �$ .m � m E Ma s N go m oc cm c m a- C2 cm c 'c N CD Z r.. 0 Z O 5 cm O w P-4 I O , E . 0 L CD Z a O y c ccm C CO2.93 co O� i W co Ca CL m CL 3� a� � 0 0 cma c ev ca .5.c CD CO Z tS CL V N3 O c c C c .y O U) W W oc W U) 25 y O = 60 m aU� m Lc C�a O 0 �Z 3 o`o s m o W2L c m�3 W C Wp cr Lu +. cw CL CD �- COD O� J2 :; W a.G..m E Ma s N go m oc cm c m a- C2 cm c 'c N CD Z r.. 0 Z O 5 cm O w P-4 I O , E . 0 L CD Z a O y c ccm C CO2.93 co O� i W co Ca CL m CL 3� a� � 0 0 cma c ev ca .5.c CD CO Z tS CL V N3 O c c C c .y O U) W W oc W U) .................................. Date ?- / /'F TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that / ..... ....................................... .... ... has permission to perform . ... ........................ ........................................... wiring in the building of ... ....... ....................................................... at........... ...... ..... .. ...... v .................. . North Andover, Mass. F'eO.5-:.G' .......... Lic. .. ..... ............... .. ...... ......................... --'—F'LEcrRicAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Al/Aqlqq iP!04 35.00 PAID Office Use O 1 uiqlof Cgommonwealtli of MOSSUC411setts Permit No. IBtpurtmtat of Public $afttq j Occupancy ,& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 1 :00 (PLEASE PRINT IN INK OR TYPE ALL INF RMATION� Date City or Town of V , To the Inspector of Wires: The udersigned a Location (Street i Owner or Tenant Owner's Address Is this permit in conjunction with at building permit: Yes ❑ No �T (Check Appropriate Boz) Purpose of Building Utifity Authorization No. Existing Service Amps _/ Volts Overhead ❑ • Undgrnd ❑ New Service Amps _ I Volts Overhead ❑ Undgrnd ❑ . Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Meters No. of Meters No. of Lighting Outlets No. of Hot lirbs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above in- grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices L ❑ Municipal [:]Other Cornectior. L No. of Ranges No. of Air Cond. Total tons No. of Disposals No.ol Heat Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers ry Heating Devices KIN g No. of Water Heaters KIN No. of No. of Signs Ballasts Low Voit Wirin G Cl L�QfL No. Hydro Message Nibs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES G NO O 1 have submitted valid proof of same to the Office. YES O NO O If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE O BOND. O OTHER O (Please Specify) (Expiration Date) Estimated Value of Ele tric 1 Work S (] n Work to Start 4 Inspection Date Requested: Rough Final l� l Signed under the Penalties of perjury: FIRM NAME LIC. NO. 12316 Licenses J)nnald A_ R ooks Signature LIC. NO.. 1231C_ Bus. Tel. No. (203) '741--4008 Address 111 Morse Street, Norwood. MA Alt. Tel. No. _(.Zf3�;-278-1131 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage or Its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please crock one) (� ,,. Telephone No. _ . _ PERMIT FEE $ (Signature of Owner or Agent)