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Home My WebLink AboutBuilding Permit #276-11 - 100 GREAT POND ROAD 10/1/2010 BUILDING PERMITNORTH O�cs�-D "q1'O TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION _ ( ZlDate Received ��CRATED IS 5 Permit NO: gSSgCHus�� Date Issued: IMPORTANT:Applicant must complete all items on this page - S I ,� aPR®PER�T�Y4QINNER��A+�/-.� (�) -g- _ •�--=— _ ,�a .� Pnnt fMAP1N,0 9 ` PARCEL-'. a3z o6w5rTIRICT _ - [Histone®ist'rict eyes r Mach nerShop�Village ;yes. -- TYPE OF IMPROVEMENT P D USE esiden ' Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ _ OSe tie -tai Nell t❑Floodplain Wetlands *W__ Dist ct 0. „P DESCRIPTION OF WORK TO BE PREFORMED: IA)IO Iden icatio PleaseZte or Print Clearly) OWNER: Name: ,/ DSc°��P-� k 6 Phoe: �od 'y - 0 4�l�D Address: tCONTRACT�QR ,Phone`, Supervisq��stConst_ruction�License Exp EaDate _y s +HLome(Improvement1icense: . 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.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ,_ -�� r �� -�' Sdhature=ofyAgent/Owner{ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanning/MassageBody Art Elswimming Pools El 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 DPW Town Engineer: Signature: Located 384 Osgood Street IRE1DEPARTMENT Tdit umpster�onf5ite yes�� zno [Loeatediat 124rMainSt�eet (IFire4Depa'rtmentysignatu .._. . _. 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 1 I Doc.Building Permit Revised 2008 I 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 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 DEPARTMENTMFORM07 Revised 2.2008 Location No. Date �v 40RTM TOWN OF NORTH ANDOVER a Certificate of Occupancy $ Building/Frame Permit Fee $ .�11 Foundation Permit Fee $ Other Permit Fee $ i TOTAL $ Check # 235'13 Building Inspector ORTH 0 of o �_ - ,r.aV0 of 7( ' oZo LAKE o dover, Mass., � • � • �� If,.11 COCHICHEwICK �� ADRATED `�5 SS BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT N......... . a-w.v-V.. ............................................... Foundation has permission to erect..... ............ buildings on ........ .. ........... . .... ....... ..... Rough r to be occupied as ...................................................................................................... Chimney Ch' e provided that the person a cepting this permit shall in every respect conform to the terms of the application on file in Final 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 ONTHS ELECTRICAL INSPECTOR UNLESS CONSTRNTO ST Rough ......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE smoke Det. F NORTH TOWN OF NORTH ANDOVER 32o`,�eoL OFFICE OF 0 110— 10 19 BUILDING DEPARTMENT *��o 1600 Osgood Street Building 20, Suite 2-36 p North Andover,Massachusetts 01845 Sac►+us Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: JOB LOCATION: Number Street Address Map/Lot HOMEOWNER Name Home Phone Work Phone PRESENT MAILING ADDRESS City Town SL.t-- Zip Code r 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 procedures inspection roced P p and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATUREZ2� APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535