HomeMy WebLinkAboutApplication - 89 WINDSOR LANE 4/27/2010 BUILDING PERMIT 01 "°pT" '14,
TOWN OF NORTH ANDOVER ��Lg `- "6'` °A
APPLICATION FOR PLAN EXAMINATION
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Permit NO: Date Received
ArED
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION (, t
Print
..PROPERTY OWNER ' e-
Print
MAP 210 PARCEL: ZONING DISTRICT: 'Historic District yes
A*P-1-OT—PLOT 0- 0C-b—0.06 ----f 0o0 Machine Shop Village yes n "
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed District
Vater/Seiner
DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone: : V-dS:5 4-- ® s
i
Address: 6t)11-74,seY` ZdN<--
`CONTRACTOR Name Ph' rie
Address:'
Supervisor's Construction License: E
Home Improvernent'Llcense El
ARCHITECT/ENGINEER F >
Address: R
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMA
Total Project Cost: $ g 5 00 FEE: !
Check No.: Recei
NOTE: Persons contracting with nr-egistered contractors do not have access to the guarantyluna
o
Signature of Agent/Owner Signature of contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales
Private(septic tank,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF o U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on 4) Si nature �l (04
Ur
COMMENTS CU
HEALTH Reviewed on Signature
COMMENTS �6G� Ve `
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
FIRE DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS
North Andover MIMAP 89 Windsor Leas April 13, 2010
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Road HorimhisI Datum:MA Slateplane Coordinate System,Datum NAD83,
Roads Maters Ii Sources:The data for this map was produced by Merrimack
Easements HdRVH p Valley Planning Commission(MVPC)using data provided by the Town of
MVPC Boundary "'Ito b y�� Noah Andover.Additional data provided by the Executive Offlce of
Parcels ,'+' a� a p Environments)Affairs/MassGIS.The Information depicted on this map Is
O AL for planning purposes only.It may not be adequate for legal boundary
f„ o deflnitbn or regulatory Interpretation.THE TOWN OF NORTH ANDOVER
MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING
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Easements ,� 44R re 40 Environmental Affaira/MassGiS.The Information depicted on this map Is
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t%ORTH TOWN OF NORTH ANDOVER
�° OFFICE OF
° BUILDING DEPARTMENT
�o * 1600 Osgood Street Building 20, Suite 2-36
.9 A�q�ieo North Andover,Massachusetts 01845
ssgcHUSe
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE: �, X01 (?
U
JOB LOCATION: C/ y, L) 1 j-
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Number Street Address Map/Lot
HOMEOWNER J�/C� � 1,' 'S Y> ° �� � ��� Y- ESL ELI J
Name Home Phone Work Phone
PRESENT MAILING ADDRESS
C
��C,,4 4-v)c$ y" A14 u I 4
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings to 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,a one or two family structures. A person who constructs more that one home in a two-year period shall not be
considered a homeowner.
The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other
Applicable codes,by-laws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE A#,~
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 685-9530 HEALTH 688-9540 PLANNING 688-9.535