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Home My WebLink AboutBuilding Permit #245 - 10 OLD FARM ROAD 9/28/2007 BUILDING PERMIT TOWN OF NORTH ANDOVER F - p APPLICATION FOR PLAN EXAMINATION Permit NO:2k Date Received 'll "' °RAis°"Pp cy 9SSACHUS Date Issued: "d IMPORTANT Applicant must complete all items on this page b`' Vpr ,'� � z. I 3 � 5 �� '�€�' w'S t< j ."--' �{ r ;x� �.' �1�1"llir�fiie''�� ,s'wwl�✓ �� >. W TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: [I Commercial epair, replacement ❑ Assessory Bldg n Others: ❑ D�+emolitio�n, ❑ Other 4-77777 3 4 DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name Dcx-bin � Phone:lol"1—'l�'Z-�32�Z Address: 1 40- 77 k �r� J��•3�$ T y��L . 1��/�vs y?"'h ' � S. �Y �£..�"¢ � { ��i 3 �� /''ef f �L4. � � ,, a � Tom, -g fes.'' s F £NO . 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: $ J"m FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with un r i to a contractors do of have access to the guaranty fund 7N S=iina�ar�e�r�f Age #/twnr Sig turofc� a�ot '� w . __ . � .. �. 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 - U FORM DATE REJECTED DATE APPROVED PLANNING &-DEVELOPMENT ❑ ❑ COMMENTS DAT9 REJECTED DATE APPROVED CONSERVATION ❑ . COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS a 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 � t � 1 ►RT ' NT Temp� tetn site °Y r77, 110 �@ pactrr�ets�gat+ureltlt� ` s ' J'%£ VT r ,.z y � .iyp 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 ❑ Notified for pickup - Date Doc-Building Permit Revised 2007 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 a 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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/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 NOTE: 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 ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location /0 0 No. Date 1401tTh TOWN OF NORTH ANDOVER 0 ►o s Certificate of Occupancy $ t<� Building/Frame Permit Fee $ s4GNU5 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # J 206 '. 4 C�- '-��uilding Inspector NORTH Town of Andover No. C/ 0 LA over, Mass., C0..'C WIC WICK O'Z?A'rr:D C BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System U. LAZO BUILDING INSPECTOR THIS CERTIFIES THAT...... . .... .... ............. .... Foundation has permission to .....erect ..................................... buildings on r ............do .... ........ Rough to be occupied as..... ... .. GOP`...... ............... Chimney very respect conform o the terms o th application on file in Final provided that the per on acceptingai is permit. wi;i.�" .. ..../p..x ..... 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 UNLESS CONSTRUC, S ELECTRICAL INSPECTOR Rough Service ............ ..................... . ......................................... ............................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ct MORT01, TOWN OF NORTH ANDOVER 3: 4.t;`'" "oo� OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 1sS�cNus�� Telephone(978)688-9545 GeraldA.Brown Fax (978)688-9542 Inspector of Buildings HOMEOWNER LICENSE EXEMPTION Plow pci t DATE: JOB LOCATION: Number Street Address MAP/Lot HOMEOWNER — 4/Z a 3&ESP- Name— Home Phone Work Phone PRESENT MAILING ADDRESS-- Z &Ulzz City Town State zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allm 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"homeowncr"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 n APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF WEALS 688-954.1 CU\SERVXfUI\688-9530 ITE.l1:fli 08-9540 PLANNING 688-9535