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HomeMy WebLinkAboutBuilding Permit #229-2017 - Exception 9/1/2016 f �J NORTH ` �` 1 �. BUILDING PERMIT A40 `v U" TOWN OF NORTH ANDOVER 3 APPLICATION FOR PLAN EXAMINATION _ Permit No#: 77J., 1 Date Received �gssAcHus���5 rr Date Issued: vl t I IM ORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER\ke-3NA S v s c�► �,c MQ�S�1 Print 1 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ElAddition CYTwo or more family ❑ Industrial No. of units: ❑ Commercial El Alteration C�epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition El Other - - Septic ❑UUell! ❑ Floodplain 0 Wetlands ❑ 1Natershed"D_ istnct, o_.WateT/Sewer DESCRIPTION OF WORK TO BE PERFORMED: q eCtc.e. 1oweV Fco,me } ae-C1", 1,N CUACCkx \ yJ 't� h 1.4 Identification- Please Type or Print Clearly OWNER: Name: U OA a Phone: 6 Address: S 7. P Wk PC o v 1. �► o v Contractor Name: c o, cxc c e c` Phone: G`1 $- `VkL - 0 3 a`k Email' kirca j a.1cgor` a,6s' X �?yc�,�nno e.o rn Address: ao;i V\e.rx©-7_c,. 1± \ cx Q e- -\'%\\ NNa . Cit'R3 0 Supervisor's Construction License: C.S F R' ®tis%S o Exp. Date:3 a 1 I A o 11 Home Improvement License: 11 fo (A 0 ,S' Exp. Date: 11ACIZ1,01-1 ARCHITECT/ENGINEER Phone: Address: 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: $ W 633O,0 0 FEE: $ Check No.: 1 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund a 0 WhE of CO i-1,1 qtrgnfn�,�-v to Plans Submitted LTJ Plans Waived ❑` Certified Plot Plan ❑ Stamped PJains ❑ ,'r:fil ;': ;'`� TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body.Art ❑ Swiimning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on /(o Signature COMMENTS tl�o d,�, L NA �do HEALTH Reviewed ori Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes i Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street R Y b-�` 15.. l f y: 4 t-trial +� AFIRE DEPARENT� mp ® mpsteronsite, y,es � Loc-ated at 1.2,4 Ma� 5treet�- } - ���+��� ���. - F"'+.:�-m 'pr`,_ti"' �;T,� rrtment -ignaytu�re/date � 3 `�{ �'� �• r „� � 4 . 4 '' `� ;° ��: r, tt� �3,��-�h �Y""'f#'o.G-t ';l' ,����?�.ra�� ��' ,1,�� ,s� Y.t.•Y?P'�" ."..�,� �s Q > I� �,c r !a4 J k 31 i .s' '. a}�< '. to iK :.�, �#• ,�°4.!d ,. ` s, w"¢4 COMMENTS Y I, Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL.: Movement of Meter location, mast or service drop requires approval of Electrical Inspector yes No DANGER ZONE LITERATURE: yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) i I i i ii ® Notified for pickup Call Email Date Time Contact Name = t Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application 4, Certified Surveyed Plot Plan 4. Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report '(If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit 4, Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic.Calculations (If Applicable) Copy of Contract 2012 I ECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doe:Building Permit Revised 2014 li , Location " `, t_ No. r?�r�l� eta'r I Date � f TOWN OF NORTH ANDOVER t • _3 t . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL, $ Check# "� Building Inspector NORT" Town of . � _ ndover �.. b h ver, Mass, A_ COC NIC NlWKK y�. J,4 gDRAT E D S U BOARD OF HEALTH Food/Kitchen P. E ITN L D Septic System RM �� � BUILDING INSPECTOR THIS CERTIFIES THAT..... 11-...... ..4.sks......................... .... ........... ........................... �r.. .. .� ............. Foundation has permission to erect .......................... buildings on ...�.... � ..... ..... ' Rough to be occupied as .� .. .`. .. �.. .. ................................................ Chimney provided that the ersorTacce tin this permit shall in everyres ect conform to the terms of the application p p p g p p pp 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 PERMIPERMIT T EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TIO T Rough Service . .. . . .. ..... ... Zi+oii3i Final BUI 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. Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanaing/Massage/Sody Art T[JSwih7amjhg Pools ❑Well ❑ Tobacco Sales Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U.FORM PLANNING & DEVELOPMENT Reviewed On i VL� Signatu'r'­ a6 i COMMENTS_P CONSERVATION Reviewed on (e, Signature COMMENTS i\A l c, WEALTH Reviewed on Si nature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments 0 Conservation Decision: Comments Water& Sewer Connection/si nature& Date Drivewa Permi t q v DPW Town Engineer: Signature: +FIRE DEPA Located 384 Osgood Street RTMENT-'�Tem Dum ster o � Fire. De '� �.�.�� '��. , �. , .., � � � ,.�•, � �, k ' }�„w;Ar,:.��.p �CYI�@,nf.s�lgnat�ure/date�,�-�;r'.i#►�.t, "�� 4fF��'t t 1`'•i ;�++�;+:t'� ti1"'.#� �''�,� `z < �t�a _ ...,. ,s.r9.3_ri �•aa}x! -, a.. ',mi.`1.t�.L 4i:k`">1^ I i't r.tR.rc. .....>..�..,.,...« t � ` C)V �'� rr �rs �� � al srta�k V � ry1 h0rrNA 1 LA 6 C-orrN IEN 6eC-K1r\ sar.A tceCAAS r 2.X1 )N `P T, S'�r\r\j�er, SK.r T 74X 17 io Soaur`G -coh� � ��e �� J � �`s� system a,X $ PcesSvi' e 1' re. c, � e. c� ` 1711 O, C. s �- h a h o'e c S , L e, 9e na e-(A aid \a9 bC) e ,t C) S'Ccue� uE'e. 60:) co�nec Jack Barrier/Builder To: Henry and Susan Armitage 203 Kenoza St 52 Phillips Court Haverhill Ma. 01830 North Andover Ma. 6/8/2016 I hearby propose to supply the labor and materials to construct a 4' x 10' front entry deck with stairs , handrails and ballustrade with support posts for roof structure as follows 1. Remove existing deck , stairs handrails and any related deck structure. 2. Dig and pour concrete piers for deck supports. 3. Deck joists stem to � y be 2 x'8 pressure treated framed 16 inches on center. Outer frame to be doubled,.house ledger to be nailed and lagged . All joists to have metal hangers. All flashing to be done where deck adjoins house. 4. Decking to be composite with duplex screw fastners. Support posts to be 4 x 4 pressure treated with Azek trim. Outer deck and stair to be done with white Azek Trim. Stairs and platform to have white composite handrail with square ballusters . Lower deck to be enclosed with white vinyl lattice with Azek trim . Contractor agrees to remove and properly dispose of all project related debris . Duration of project to be six working days . Price for deck and trim $6300.00 . $2300.00 at start , $2000.00 when framing is complete , $2000.00 at completion . Acceptance of proposal ,A4A%. Date rri Proposal valid for 60 days. r Authorization of proposal . Date North Andover MIMAP . August 29, 2016 „ 095"0-0033 ►tea , krIlk, k X46,PHILLIPS CT s 31 PHI�LLI-PS CT .z • ;� � 095 0;0040 y H. A 09511 U t< � 43 P�HILLIPSCT ,� � a. 4p it S0 PHILLIPS CT A ' R {, e �_ _" 095 0003554 PHILLIPS CT . 095.0-0039 „ � •�Q t dr. � _� e " PLEASANT STS Qr .► •t - 095.A 0082: ' = M 095.0 6 095 A 0083 q a' PLEASANT S� J , sem . vt . H y 095.A-0095. s . E► � r� .�; a� x��'#i'= `" ''' � a�095.A-009- �V 095 0 0061 asc3i1(fSr �.����� :•° � �,,,��.�: �'� reef " ❑MVPC Bo Interstates,lrstateHorizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —SR Meters Data Sources:The data for this map was produced by Merrimack fRoads %40RTN Valley Planning Commission(MVPC)using data provided by the Town of North Andover.Additional data provided by the Executive Office of i r Easements ��� a r<e 00 Environmental Affairs/MassGIS.The information depicted on this map is D _ for planning purposes only.It may not be adequate for legal boundary Parcels F fe definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING t - THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT +t, p ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF �9'Oo �"�oj THIS INFORMATION 1SSACHUS�t V 48 ft -� I " Massachusetts Department of Public Safety o Board of Building Regulations and Standards License: CSFA-045850 a Construction Supervisor 1 & 2 Family IRA J BARRIER 203 KENOZA STREET u .r d HAVERHILL MA 01830 ' � ti et ttt`", 111 Expiration: Commissioner 03/26/2017 cl2UJn. J po�rvnaa9aureCIAlk 1/0/ daa Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR 176405 Type:, Registration:;='" a Expiration 81201201;7 Individual t ,i:IRA J.BARRIER 131 Fl-N& AW tIRA BARRIER t 0Y ice-� 3':KENOZA ST. .. I r AVERHI,L-L;MA 01830 -` Undersecretary 414 . f � �+ The Commonwealth ofMass�chasetts z Department ofindastriaZAccidents 1 Congress Street,Suite 100 t Bosto; , N�102114 2017 , - � www.mass govldia Wo ke&,Compensation h urance Af a-da-dt:Boflclers/Contractors)Fleetracians Timbers. TO BE Fff"WITH TSG pmuvQTMG AUTHORITY. ApIAR:=t 7nformationPlease Print Lezly e Dame (Business/Organization/Individual): -CC,(A, - Q► f r, Address: a. 0Q S�t' Gly/State/zip:�c ��e�`h i\\ M a O Phone#: Areyou an employer? checkflie app, opriaie box: Type of project(x'gmired): •o . l.E]I am a employerv&h employees(fall and/or part-time).* New coaisttuction 2.�amasoleproprietor orparinersbipand have ILO employees Worlciagfarmein 8. �emodelirig any capacity.[No woikers'comp.insurance required.] 9, ❑Demolition I Q I am a homeowner doing alt workmysDY:[No workers'comp.insurance required]t 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work ou my property. I will msure that all rs contractoeither have woikers'compensation ft nramc or are sole 11.[]Electrical repairs or.additions proprietors wilh no employees. 12:0 Plumbing repairs or additions 5.Q I am a general confractor and I have hired the sub-contractors listed on the attached sheet. 13:Q Roof- airs These sub-contractor-li employees andhaveworkers'comp_insurance.1 14.❑Other 6.Q We are acorporation_andits ofticershave exercisedtheirright of exemptionperMG2 c. - 152,§l(4),andwghaveno•employees.[Kpworkers'comp.insurance required.] *Any applicantthat cheeksbox#i must also frII out the section belowshowingtherworkers'compensation policyioformation i Homeowners who sift Eittpis affidavit indicatinghey are doing all work and thenhire outside contractors must s4bmit anew affidavit indicating such ?Confractors that check this bag must-gtaehed an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. Ifthe sub-cor$iracivrs have employees,&y must provide thein-workeis'comp.policy number. I amore an employer tri d ispiovzdingl,vorkers9 compensation insuYancefor my eTNT16yees'Bdoiv is thepoliey arid jab sate anfoNnadon. Insurance Company Name: Policy#or Self-ins.EG.#: ExpirationDate: Job Site Address: City/State/Zip: Attach a copy of theW()Kkers' cbxnpensationpolicy declaration page(showingtbepolicynumberand 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 b e forwarded to the Office of Investigations of the DIA.for insurance coverage verification- X do hef ehy ceYtify uaader the pains and penaldes ofpetjury that the infor mataonPrOidded above is due and correct Signafore: Date: c 0 b Phone#.- Ck7 $ CN L\ ©3Z, 4 - Official use only. Do not-write in this area,to he completed by city or town officaaz City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health.2.BuildingDepartanent 3.City/Towaa.Clerk 4.ElectricalInspector 5.Plumbinglnspector 6.Other Contact Pearson: Phone#: Informati®u and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contact of hire, express or implied,oral or written." An employer is defined as"an individual,partn.erslvp,asso ciation,corporation or other legal 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 ofea 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 anotherwho employs persons to do maintenance,construction 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, §25C(6)also states that"every state or to cal licensing agency shall withhold the issuance or renewal of a license or permit to operate a btaszaess or to construct buildings ha the commonwealth for any applicant who lias not produced acceptable evidence of compliance with the insurance coverage rcegmred" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any ofits political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill-out-the workers' compensation affidavit completely,by checking fihe boxes that apply to your situation and,if necessary, supply sub=con-tractoi(s)name(s),address(es)and•phone numbers)along with their cextiliicate(s)of insurance. Limited Liability Companies(LLG)or Limited Liability Partnerships(LLP)with no employees'otherthan the. members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavitmay be submitted to the Department of•In.dustdal Accidents for conf=ation of insurance coverage. Also b e sure to sign.and date the of adavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you'are required to obtain a workers' compensation policy,please call the Department•at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has-provided a space at the bottom of the affidavit for you to fill out in the event the Office of luvestigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as areference number. In addition,an applicant that must subnmit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file fox future permits or licenses. Anew affidavit must be filled out each year.where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or_peamit to bum leaves etc.)said person is NOT required to complete this affidavit. a The Department's address,telephone and fax number: The Commonwealth of Massachusetts - Department of Industrial Accid-ants 1 Congress Street, Suite 100 Boston,MA 02114-2017 W.# 617-•727-4900 ext. 7406 or 1-877-MA SAFE Fax#617-•727-7749 Revised 02-23-15 wwwmass.gov/dia