HomeMy WebLinkAboutBuilding Permit # 5/11/2016 Of HO oT" q�
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: G Date Received A<� �-•• '' "
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Date Issued: /o
IMPORTANT:Applicant must complete all items on this page
LOCATION 7W
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PROPERTY OWNER ? � �
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MAP NO: PARCEL: OI�IEIG 17iSTR(CT: Historic District yes
r
Y _ n Mach#rhe Shop V###age yes na
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
KRepair, replacement i i Assessory Bldg 1 1 Others:
❑ Demolition ❑ Other
i Sep fc Uel# Floodplain . 1tVet#ands , I �lllatershed Dlsfrict
n Water/Sower
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Identification Please Type or Print Clearly)
OWNER: Name: �.�d`1 1�t � J � 1���0 Ja Phone:
IJI
Address: %
C I!fTF ACTf}l [ am 'Phone
Address:.'
'SU 01"S Gntrict'tih Liel :. Exp, ate., ,
I-1brne� rovernen LFc se. .. E_ P_,: [)ate ;
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ ;-` � FEE: $
Check No.: Receipt No.: ?1;P5 6
NOTE: Persons con acting unregistered conte• a ors do not have access to the guaranty fund
Signature of Agent/Owner Sig afore of contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools f 1
Well ❑ Tobacco Sales ❑ Food Packaging/Sales Tl
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMENTS
CONSERVATION ❑ ❑ (p
COMMENTS N-13 j -4 cz.tin L,-,)/v"- ( oD'
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
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
Located at 384 Osgood Street
FIRE DEPARTMENT s Temp Durnpster on site yes . r>0
Located�t 1�4 l�Jain Sheet "
Fire p t' ttl tit Sigctet!lrEadate
COMMENTS .. . -
t4ORTH
T-own ofAndover
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No.
ver, Mass,
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SAYE®Lj
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BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT ..............�°.N... .>4� ........... BUILDING INSPECTOR
.... ......... .. ........... .................
d Ale-W I- ff- 4 14 Foundation
has permission to erect.......................... buildings on .. ....................................... ..................................
Rough
to be occupied as . � le.""'�
.� ... / .................
... ................................ 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 IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION T*TS Rough
.. Service
..................... ... .. .................. Final
BUILDING IN PECTOR
GAS INSPECTOR
Ccy2ancV Permit Required to Occuj2V Buildin Rough
Islay in a Conspicuous Place on thereses — of Remove Final
No Lathing or Be®
Wall To one FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
TOWN OF NORTH ANDOVER
OFFICE OF
z BUILDING DEPARTMENT
1600 Osgood Street,Building 20, Suite 2035
North Andover, Massachusetts 01845
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIIDING PERMIT APPLICATION
Please print
DATE:
JOB LOCATION:
Number treet Address Map/Lot
r
HOMEOWNER o 1.1 u, d—
Name
Home Phone Work Phone
s
PRESENT MAILING ADDRESS
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two family
dwellings and to allow such homeowners to engage an individual for hire who does not possess a license, provided
that the owner acts as supervisor.
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 dwelling, attached or detached structures accessory to such use and/or farm structures.A
person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 CMR
Section I IO.R5.1.2)
The undersigned"homeowner"assumes responsibility for compliance with 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 requiremeutslnd that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE _v v �.a
APPROVAL OF BUILDING OFFICIAL
Revised 8.2015
Form Homeowners Exemption
BOARD OF APPEALS 683-9541 CONVSERVATION 688-9530 HEALTH 688-9510 PLANNMIG 683-9535