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HomeMy WebLinkAboutBuilding Permit # 12/3/2015 I o BULGING PERMIT TOWN OF NORTH ANDOVER -- APPLICATION FOR PLAN EXAMINATION P.I.I,.: ` Date Received— Date eceivedD to issued: "o TiViP®RTAli'T Ap kcaat must complete all itemsMINN on ttus page MEN ROPTY�oW\ESR `� Pit ��-�� ooY srHty ��.: PARCEL ���ZONINO�DISTRICT�� Histone DtstFc# �� y ,onoMF, ]ERE OF MPROVEMEN I PROPOSED USE Residential Non-Residential ONew Building ❑One family U Addition Two or more family - ❑Industrial ❑ ❑Alteration No.of units: ❑Commercial ❑Repair,replacement ❑Assessory Bldg ❑Others: ❑Demolition ❑Other ❑Septic. ❑Well tC Rlood lain ❑Wetlands ❑Watershed 11sfl P a� A A�. �y�w.. ...� ❑WaterFSewgf � ��..� e,. _ ,,D�ESCR�PTION OF VLtORK TO BE PERFORMER. �y- "r,", cahonP3ease Type or print ClaarTy - ' OWNER: Name: III Address Contractor Name k Phone i �uperviso�'s Construction License Home IRi.rrerryep#License ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE.SULDING PERMIT.'$12.00 PER$9000.00 OF THE TOTAL ESTIMATED CoSTSASED 0"$125 00 PER S.F. Total Project Cost:$ > L FEE:$ Check No.: Receipt No.:cIZ NOTE: Persons contracting w fth unregistered co actors do not have access to the guaranty fund ,Signature of Aja11,Owner iUq.me of.contraetor —� i New Full Shed Do—,r Alan Cuscia Full Shed Dormer Addition 69 Unoin Street North Andover House f 15-84 Left Elevation fr Colonial Drafting aM oom 9 eor A/an Carroll October 21, 2015 978-902-0131 j _ _ __ s.ne oaane:mv,n erow„g E-moi i,w.e rang oom .. .. .. ® .. ,. .. - Shed Dormer New Full Alan Cuscla _ Full Shed Dormer Addition 69 Onoin Street ® ® North Andover House f 95-84 Partial Back Ele w tion =r Colonial ® Drafting brow„q e Alan�Carroll October 21,E 2015 J]$-902—�J,jj xma opan��o.nxn erow;�g E moa oro��en,re.,g.�om 2 h 2 m b 0 i MM I I - - - - Alan Cuscia I Full Shed Dormer Addition - 69 Unoin Street North Andover House , 15-84 Colonial Ceiling & Roof Drafting Framing P/an ��ow/q eore, Alan�Corroll October 21, 2015 978-902-0131 s�oa Ocoee:roe n,n erowmg E-�»ob: oo.,r�e�orenq.�om 5 O- e S s E Closet Bath C md. Closet Os Alan Cuscia Bedrm 1 Ho11 ©� Bedrm 2 - Os r Ful/ Shed Dormer- Addition 69 Onoin Street s-,, _ North Andover Closet - — — — — — — — — 10S — — — - — — — — I I I Bedrm 13 I I House 1 15®84 Colonial Revised Second Floor Plan Drafting a,nwing Alan Ccrroll October 21, 2015 978-902-01.31 _ _ _ Sco/e applies for 11x1]OmMng E—moil: alan�dralfinq.com Closet 'Iy Closet �0Lav �f Ful/ Shed Dormer Addition 69 Unoin Street Bedrm 1 North Andover z' Bedrm 2 Io IF Closet U Closet I I Bedrm 3 I � D V d.-Z_0 House # 15-84 Coloniol Existing Second Floor P/an Drafting oew/g enle: Alan Corro// October 27, 2075 978-902-0139 -- Sco/e applies toy/1x17Oaw/ng E—mall: alon6rerafGng.mm Ridge Board 2 x 8 Collar Te®Q'-e"o.c. S/ope Cuf.(51-120 Nails Roo!Framing 2 x 10®1 B" %2"P oaod �� Noll 8d-6 Ceil/ng I-- \\ 2 �� SofHf �� 2x6®I6"oc. B8"studs �\ I/1"Sheofnl g \ Noi1 ErvsLrg 8 1/2"f/oor'bl" Alan Cuscia Full Shed Dormer Addition 59 Unoin Street North Andover House # 15-84 Colonial Dormer Cross Section Drafting©e� � Alan Carroll Ora wing dafe. October 21, 2015 978-902-0131 _ _ Sca/e oppl/es for Ilx>]drawing E—moil olon�.yrn/t/g.rom RT�-- Town of ndover 0 No, d f ver,Ma BOARD 01 HEALTH Septic System EPERMET ILD THIS CERTIFIES THAT BUILDING INSPECTOR ................. has permission to erect..........................buildings only..... M.......14. 0'.4............... 1;.�.• Rough to be occupied as chimney provided that the person accepting this permit shall in every respect conform to the terms of the application el on file in this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alt ration and Construction of Buildings in the Town of North Andover. 1111WEIIN.INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough EFinal PRW EXNRES N6 ON —ELEITRICALINSPECTOR UNLESS CONSTRUC ST S R-gh ........... ......... ......... ............... Final ................... BUILDING INSPECTOR CAI INSPECTOR LC(,u aRPett;LRequired toLQ Rough L_ Display in a Conspicuous Place on the Premises—Do Not Remove No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. B.—r Street No. Smoke Det. Fr� To"- OF ORTR A DOVEP, Fey $F1O WG- s ' ,',3��. '-:I61)O Dsgo¢d 55saeiBvslding.ZO;�Svife2-36 j �TNoiLF,vd¢v ,Massacfinseres QlSaS CezidA.Brown - - Tel puone(978585-.9345 ExspeetorofB witmgs _ ax (978}68E-9542 " ' �or�©VTNBIt'L.r_CaNSEExEDiCP`rroN . BbLt3TNGPEBI"bTT'7`Ap'PLTC�'A'Ii7iV pieasenanE _ ' TSBLoambN: " Nnmb, SueeEAdcLesa Map/T,of . . TovmrjER Name, iioxnePkone '9VorScE:none ' e . . Z;p ode TAa e-usenfear p{ionfor"Tmmeotvneis"was enLed se clndeowner-ocmipisd direIlngs fo n:?o isiis cr iris d fa aiIo+x such fiomeo+ine*aio engsge aa�dt:riduaLf shire wfio does natpossess a7ieeyse,provi3ed pitta owr�r ac�ass per��e}.s�eB�taing{eaaeseehenTos,s.s.�} DBIRxIT'ION O-VEOMEOWNBR Berson(s)who gwnsapazcei ofland onwTticTi3rersHeresides orintands fo rsida,anwSic"niheress,orisid�endedio oe,a one orfwo isailysirueicxes..Apersonwlxo conairacfs rorefTwtnne7zomeis atfre yearpariod slxsLnof be consideredafiome¢rmer, Tks mxdersignad`Aome6wner"asscm.esrengonsi6xl*�'yforcnmpLance,wits,$e SfafeBnx"lding Codeadorlxer Apnli STa codes,hy3arr,zetes zndxegulations. Tfiewndersigned`Lomeowner"c,Sn'es*h�Sre]sheunder��iands,$eTown ofN rEL.AmIoverBiiIdingD;him w, enp . i-;�„ inspecrionprocedu smmdreoxdxemenfa a.dthine/shewi]T co pIywlflx,saidproced�sand regniremess, � .-- �OWWBp'PTD7SBS APPROVAL Ok�BiALDII4G OFFICSST. ' zev;sea�,soos . DARDC'FA?P➢ALS688-9Ml CMSH-k.VAUON08-036 The Commonwealth of Massachusetts Department of ZndustriadAceidents X Congress Street,suite 100 Boston,Ma 02114-2017 e www.massgoV/&*gov/die Workers'Compensation Iusurauee Afridavit:Builders/Contxactors/Electricians/Plumb rs TO BE FTLED WITH THE PERMMMGAUTHORITY. Anylicantlaformation Please Print Legibly Name(l3rwmss/0rgensatmnIodividnal): Address: City/State/Zip: Phone#: Arego¢anemploycr?Checktb—ptiu,,iate box: - Type ofprojeet(required): 1.�Iam aemployervnth�_omployees(full-d/.,pot-time)., 7.Q him construction 2.01emasole pmpdetoroxparfnersbip and'nave ne—ply—w'od:ing formcia 8.[�',&Emodeling any .oapecity,[Noworkera'comp.in,--ry d.j 9.❑Demolition 3.01amahomeovmer doing ellwork myset£[Noworkers'comp.nrsumncereqused.]t 4. ahomeovmm'end itl bebiriag controc to Gond-ell work onmy property.Iwill so ematau conrmotoraeidrsrhave waders'compen u-lkrsureme Wane sole 11.Q Electrical repair ,additions proprietors wifhm empmy.s. 12.0 Plumbing repairs or additions 5.❑Iam ageaerelcontractor andIhave hied the sub-conhacmrs listed ontbeamchedsheet' 13.0Roofrepairs These sub-comactorsbxve employees andbave workus comp.ivsrsance.t 6.0 tl'e ire acorporationmdite o£Scerstave exycisedthearght ofexemptionperNrGL c. 14.0 OtheY_f�Z— 152,81(4),and webave no.,enployees.[No wnrkers'comp.iasuraazerequired.] - tf.""f.���J� �. 'Any pplicant drat checlu tiox'4l must also 5ll outffie sscEonbelow shoa4ngtbeaworkers'compeasationpolicyintbrmation. t Homeowners Ho submit ihisaf5darit indicaNngthy azedoivg all workandihenb+re eutside conhactors mvstsubmitanewzf5davit indicating snc6. ''Contras om}hat cbeckf's box mvs{'attached anaddi[ional sheet showing dre¢axs o£p.p,ltsy,nmm andetate whether or net thoseenlltiesbave . emplyees.Iftbe sub-con{raetors fieve emplyees,}Y.y mustpravidetheir workeis'comp.poliy numbed Iaman yloyertT:atispiovidangworkers'coyensadoninsuranceformye,ployees'Below is thepolicy ondjobsite information. hisuramce Company Name: Poly m or Self-ins.Lic.#: Expiration Date: lob Site Address: v� �\t�Vr City/Stafe/Zip: �" Attach a copy ofthe workers'compensation policy declaration page(showing the policy.—her and expiration date). Failure to scone coverage as required under MGL o.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 ofa STOP WORK ORDER and a fine ofp to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office oflnvestigatimw ofthe DTA for insurance coverage verifloation. Ido herebycemfy under U:epains and maul.ofp"j.\that the informuEionprovidedob,-is iruea�correct Si nature: i r Date: Z, , � Official use only.Do notwrite in this area,to be completed by cityor town ajjyciad. City or Town: Permit/License# IssningAuthority(circle one): 1.13 oardofHealth 2.BuildingDepartment 3.City/Town Clerk 4.Flectdcal laspector S.Plumbimg Inspector 6.Other Contact Person: Phone#: