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Home My WebLink AboutBuilding Permit # 5/13/2015 %AORT11 BUILDING PERMIT 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#q Date Received "Arev �sSgCHUS ER Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION C ai t" 111,o,\J lv" 4 AtJ-,I,r —T ( c"K Print PROPERTY OWNER t\y Print 100 Year Structure yes (DO MAP PARCEL:6 ZONING DISTRICT: Historic District yes 3n Qp, Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential D New Building El One family [I Addition [I Two or more family 11 Industrial [I Alteration No. of units: 11 Commercial A'Repair, replacement [I Assessory Bldg 11 Others: D Demolition D Other "SIA,,"'o I "',? I EPA � k�� y(' �,t��1��5,�,, ,��.�f��'�„ y ,�� , S'�i �. � �� r ,1,�� , DESCRIPTION OF WORK TO BE PERFORMED: 14 02 A-M A "oL7 w? Identification- Plea f Type or Print Clearly OWNER: Name: Phone:c??k 99 5 I?qc!r �/ U r, , I — Address: /[I Ai't t I I'e', d /v-,- -A A^d C Contractor Name: N. A. Phone: Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED 0#$125.00 PER S.F. Total Project Cost: $ .6Q4;a— /2- , dod FEE: Check No.: Receipt No. NOTE: Persons contracting ith unregistered contractors do not have access to the guaranty fund �1,011,1116NIl"Al"wKII /, &',g IAORTH 2 E. ...'.., f1dover vL -Town of ®No. 1. �• 't I _ ` O LAKE h ver, Mass, ' coc K ICKEWICK y1' S U BOARD OF HEALTH Food/Kitchen rIERMIT11t LD. Septic System THIS CERTIFIES THAT . .. „ ., '� .. ,.,,��,,�, . .. BUILDING INSPECTOR .................... .. .................. .... ..... • ......................... has permission to erect ... .... buildings on ... mt.(.(..P.&Y4.L00 A Foundation Rough to be occupied as ... .....A. .... ....... ......... Ar ............................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 I MONTH ELECTRICAL INSPECTOR LESS 0 TS Rough Service .... ......... ......... ................. .. ...................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required.t® Occupy Building 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. TO OF NORM AND OVEP, OFIRICE OF o b# .'ZSflfl ?�goa Sfz-00tBuilding20,•Sijk,2—'36 7 �Pr'17xn F4�'^C5 • 'NoithAndovex .Massachusattg 01845 • '¢'S�ACiIUs�� Gerald A.Brown. - - ` olaplwno(979)688 95445 nspectorofBi ldings _,Fay. (978)689-9542 -o: aw:�rE�.'x,�c.��rS�y'BI LIO r ' ' g ar MWET"PLICAMN please rin-E . DATE: , � , PB LtdC.A.TfON: CV`7 pAi Number Sfxo&Address 1V:Capl�ot • �C�'MEC)��R. w �� @mss "� � -' � :�. "�.� - l.V'ame. . zue Phone `Worlt:Phone ' PRESENT MU�4G.ADS)RFSS W1 AN7 (to&, s . ,. t= a,,, / - 11.E taVTL m • r8 fp• - dip coda TAO current exemption for"homeowners°'was exfent� d ie cludo ownex occtip'xed d�VoFings to t4vo units X" and to ollow aabh ho-mPol,vers to engage an.?ndivimaal.forhire vzno does notpossOBS a 7i0emse,provided thatthe owner acts as supervisor• ,S�iafe3uilding (Code Section,08.3,5.4) , DEMITZON OYHOMEOWE Polson(s)who gwns aparcel of land onwhich lle/site resides or intends to reside,on which there'is,ox is infended to 7bc,aDUD ortwof'azoilysfruetares, Apersouwhoconsfrtzetsmorethatonehomein•at e'yearpexiodshallnothe 00maidere'd a homeoWn..er. , T"G uuderszgned"homeowner"asstzuzesr-esponsiblli€yforcompliances wiM the SfatoBuilding Cade and ot7ier Applicable codes,by jaws,rules andxegulations- Theundaxsigned"homeoWnax"cexl essthat hc/BheendersfandstheTown ofXbrfb.AadoverBuzlding.Deiiatfuzent minimum inspecfion procedures and reel ' ents and that he/she will comply with;said pxocedurm and recluixement% , o APPROVAL Oli Buff I)Wa OFFICE fieyased9.2Qo9 - xbrm FSomm-Amers Bxemption 8QARD OF'APP.EAT 6$R-9541 CONSEMUON 6$$9534 MAM 16$8-9540 Pl;A.TININO6$$-9535 . The Commonwealth of Massachusetts Department of Industrial Accidents tl 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lezibly Name(Business/Organization/Individual): Address: (1 l Opt,3 City/State/Zip: -r"A Attic),,a r°,/A� 'o l i Phone 4: " q M Are you an employer?Check the appropriate box: Type of project(required): 1.Q I am a employer with employees(full and/or part-time).* 7. F1 New construction 2.F1 I am a sole proprietor or partnership and have no employees working for me in 8. []Remodeling any capacity.[No workers'comp.insurance required.] 9, El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10E]Building addition 4.®I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing tivot•kers'compensation insurance for nzy employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofpeijury that the information provided above is true and correct. Si nature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Millpond Homeowners Association, Inc. 123 Millpond North Andover,Massachusetts 01845 May 12,2015 Mr.Brian Leathe North Andover Building Department 1600 Osgood Street Building 20, Suite 2035 North Andover,MA 01845 Re.Request by Homeowner Nate Jenkins to Obtain Building Permit Dear Mr.Leathe; Several days ago,Nate Jenkins, owner of#117 Millpond,called me requesting a letter from the Millpond Homeowners Association,Inc.(MPHR)board of directors.According to Mr.Jenkins,said letter was needed by the North Andover Building Department before that department would issue a permit to build to Mr.Jenkins to renovate his kitchen. In a subsequent conversation regarding this same matter,you informed me that such a letter was necessary before you could legally issue a permit to build to a homeowner because Millpond structures were classified as"commercial'buildings and therefore required a licensed contractor to obtain a building permit,absent permission of the Association board of Directors. After review of the Millpond Master Declaration and its bylaws,it is clear that the MPHA board of directors has no authority over the interiors of the townhomes here at Millpond.As a planned unit development(not a condominium),our sole authority is limited to the exteriors of the townhomes and the land held in common by all homeowners.Therefore,the MPHA board of directors cannot issue a letter of "permission"permitting the Building Department to issue(or not issue)Mr. Jenkins(or any other homeowner)a building permit. As far as the MPHA board of directors is concerned,therefore,issuance of such a permit must be considered a matter strictly between Mr.Jenkins and the Building Department. Yours very truly, z �L ? r' William L.Anderson,PiVsident Millpond Homeowners Association,Inc.