The URL can be used to link to this page

Home My WebLink AboutBuilding Permit # 7/9/2015 OORTH BUILDING NGPERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received ArED �SSgcHus``� Date Issued: I ORTANT:Applicant must complete all items on this page LOCATION 43 134�16-47- 1,U00-b A-LIF- Print PROPERTY OWNER ZA-Ilb Print 100 Year Structure cya-1 no MAP PARCEL: ZONING DISTRICT: Historic District yes /"6`6',� Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building Y'One family 0 Addition Li Two or more family 11 Industrial 9Alteration No. of units: 11 Commercial [I Repair, replacement [I Assessory Bldg 0 Others: 0 Demolition [I Other DESCRIPTION OF WORK TO BE PERFORMED: P,6(Jts_0,-L_E SmAIST-ING- Identification- Please Type or Print Clearly OWNER: Name: ,b4(.-1r� A.1141,0,0_-(A Le, Phone 1 '2 "7 -7 1--l -91 9 Address:" 7r_- A?QA-1) Contractor Name: Phone: Email: Address: Supervisor's Construction License: mExp. Date: Home improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: "9-t" Lf-7 Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: oo(n —FEE: $ 9D - I Check N Receipt No.: C� - yoll my fund NOTE: do not have access to the guardnt ;7 e OT, Flans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanuing/Massage/Body Art ❑ Swumning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales :' ❑ Private(septic tank, etc. ❑ Peimanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed onIf Signature COMMENTS HEALTH Reviewed on Signature COMMENTS A —7'�-j r Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street hIRE:DEPAR ,HENT.—Temp Dumpster on site. yes Located at.124 Main`Street; Fire®epartmertt s gnatt re/date. . COMMENTS NOR._TH Town of E ndover I I n No. _ h ver,r Mass "0- A- COCNIC KlWKK � 7�ADR�ITE D ►P�,�'�y S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ..................................................................................jj..��..��..��.................................. has permission to erect buildings on �s �'' .11..t�' Foundation .......................... ..... . ...... ....... ...a. . _................... .1.4.. . .Y.`.:�.Y. Rough tobe occupied as ...... .. ... .. ..:................................................. Chimney provided that the person accepting his 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 IN 6 MONTHS ELECTRICAL INSPECTOR r3� UNLESS CONSTRUCTI ST TS Rough Service ................... ..... .................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to 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 Approved by the Building Inspector. Burner Street No. Smoke Det. To"O:` opaff AND OVER R OEEICE OF � wy^• � " � �`gip ['�'t • ' �Q d • :1600 Q,9900RSt):00t]3 zding2o,-gu%to-36 n: WOith And4-V'Ox Massachusetta 0.845 Gerald A.Bxoxvn � TeZepIone(97$)689-9345 ) speetorOf 37Aldings t o (978)689-9542, " Rte:-MO)3ER:LICENISE E fLYkTfO " 'leasepr"1nE . DATE: Number StreetAddzess 3VSap�-ot 7azae. . HQUI,L'Mono �rVoxTt�'bone PRESENT MA6NG.A.DDERSS 1,3 €` i'I'ot - Bf�tP. _ • dip Code '�'he cuxzextt eXemp9on for'IomeoWvnzexs"'teas extenaod to imTude ow.nex❑cctipxed debugs to UVO units•ar;Oss and fa a71ow sU lbh homPo,ra-ersto engage an.�uc9,�raduax.foxhire VAO does ao�,possess a 1icfm o pxovided thatthoWnex acts as supazvisoz. Suate30,ding (Codogmtio-- ZDS,3,5.�i Pessan(s)Who 9was a parcel of land on ur�ic��tels�e xes%des or intends to reside,on winch fhore is,OXIS xaten.ded to b,a one or tWo,family sfzueturos. .A.person who comtrnefs anoxe ffiat.one home in.a fwo-yearpmz 69 shall not bo mmsidered ahomeowner, The undexszgnod"Aomoawum"assumes?-esponAll3ty foroompHances-WitlZ the Stafe$nzlding Codeand oilier .Applicable codes,by-laws,x es and�egu�atzons, (Izenndexsignec "homeownex"cextxt�esthat keh:hounderstaudsMeTOW.UofbrihAndover3uiSdfng,Dr,&tuen-t minimum xnspePtionprocedures anal x-erluirements and thatl7.e�sho will comply with;saidpxoceduxes and requirezneats, , -UON n•O yy J,q RS SIONATME .Ad'PRC1`SJ.AL OF 33TUDWO OF'FZCt L RoYised X009 - )Fonn SozneoWnersFxem�tion �r 3OARD CFAPP.E M-688-9.541 C NSER`V'.�UON 588-9530 NEALTH 688-9540 Pr_ATrtTrl�ir �re�u«� The Commonwealth of Massachusetts Department of IndustrialAccidents ti 1 Congress Street, Suite 100 Boston,HA 02114-2017 - s��Y•w www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeWb Name(Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(a'equired): L❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.1e 1 am a sole proprietor or partnership and have no employees working forme in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. F1 Demolition XI11 Iam a homeowner doing all work myself.[No workers'comp.insurance required.]t10 ❑Building addition 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. 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13.F]Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.F1 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 41 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit'this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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,lficy must provide their workers'comp.policy number. lain an employer that is providing workers'compensation insurancefor my employees.' Below is the policy and job site information. Insurance Company Name; Policy#or Self-ins.Lia#: 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 ofpeijuiy that the information provided above is true and correct Signature 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#: 43 Brightwood Ave Deck Plan July 7,2015 2-2"X10' 12"SONO TUBES BEAM CONCRETE POUR 3PL MAX HEIGHT:,tS" FROM GROUND TO BOTTOM OF JOIST POSTS 3PL STAIRS or 1 2"x10° CONSTRUCTION 9'-101" TYPICAL 2 EXISTING DECK North Andover MIMAP June 25, 2015 p 1 %r r � r � G i O f CL" w (D� G N Interstates I —SR Horizontal Datum:MA Stateplane Coordinate System,Datum NAl Meters Data Sources:The data for this map was produced by Merrimack --Roads ,AORTH Valley Data Commission(MVPC)using data provided by the Tovrn of Cr Easements ,tor p� North Andover.Additional data provided by the Executive Office of et O MVPC Boundary 6 q Environmental Affalrs/MassGIS.The Information depicted on this map Is ? b� N Parcels •� L for planning purposes only. may not adequate for legal boundary—•� �" A definition or regulatory interpretation-THE TOWN OF NORTH ANDOVER y MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING IllTHE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY •, y OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT �► �o q° 4, ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION �SSAc►+u5�� V 38 ft ^�`