HomeMy WebLinkAboutBuilding Permit #2 - 101 CROSSBOW LANE 7/2/2007 NoRTH
BUILDING PERMIT o�t���°
TOWN OF NORTH ANDOVER '��
APPLICATION FOR PLAN EXAMINATION ,t
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Permit N0: Date Received — � "°q,rop
APPROVED
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Date Issued:
IMPORT rtt complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building JkOne family
gAddition pVSX.., ❑ Two or more family ❑ Industrial
❑ Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PREFORMED:
T O- r1,-,.W6TMLNEW 'fit'ASULNL-CM ON Old/�*V 4�E I.
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Identification Please Type or Print Clearly)
OWNER:' Name: ANDRE MD "Z'I<►y �P�C[�V�i I"fZ Phone: �'►►'�� � '7014k
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Address: OI C Ur so. 1400M Kt�D0\J�
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ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 1000.00 FEE: $ 9?
Check No.: /yo? Receipt No.:
NOTE: , Persons contracting with unregistered contractors do not have access to the guaranty fund
LT,@natu�e f g :n#10wne� y S�nage cif contract
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Location
No. Date U�
&O*Tq TOWN OF NORTH ANDOVER
3? � • OL _
+ +' Certificate of Occupancy $
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Building/Frame Permit Fee $
,sJ,�GMUgE�
Foundation Permit Fee $
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Other Permit Fee $
TOTAL $
Check #
Building Inspector
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
r DATE REJECTED DATE APPROVED
wPLANNING & DEVELOPMENT ❑
COMMENTS
E REJECTED DATE APPROVED
CONSERVATION
COMMENTS
DATE REJECTED DATE APPR VED
HEALTH
6 17,P 07
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COMMENTS_�f/'
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Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
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Planning Board Decision: Comments
Conservation Decision: Comments
Water$ Sewer Connection/Signature&Date Driveway Permit
Located at 384 Osgood Street
4I� PARTM� I ' - �'rr Diper orrt y r no
Fir®��e�artm�n���glna�u eldate q �` �t� „w s
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Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
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Total land area, sq. ft.:
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I 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
1
❑ Notified for pickup - Date
Doc.Building Permit Revised 2007
Building Department
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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
o Building Permit Application
o Workers Comp Affidavit
Li Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o 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
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Addition Or Decks
o Building Permit Application
o Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract 1
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And I
Hydraulic Calculations (If Applicable)
o 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 ConstructionSin le and Two Family)
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o Building Permit Application
o Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
o Mass check Energy Compliance Report
o 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
evised 2.2007
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NORTp TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
rev:►' tea North Andover,Massachusetts 01845
c►wss
Gerald A.Brown. Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
DATE: (PI I L110-7
JOB LOCATION: 10 I CP—Dssq;0 ti W
Number �IVStreet Address MapJLo
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HOMEOWNER �C N►� P U��1 1 �"18-2 S -7b1`t pJi k
Name Home Phone Work Phone
PRESENT MAII.ING ADDRESS tOl UOQ KJ L,,,3 -
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1J , Arson v a MA- ok
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 sash homeowners to engage an individual for hire who does not possess a license,provided that the
owner acts as supervisor). State Building (Code$ection 108.3.5.1)
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which helshe 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,nrles and regulations.
The undersigned"homeowner"certifies that Wshe understands the Town of North Andover Building Department
minimum inspection pmoadures and requirements and that he/she will comply with said procedures and
requirements.
PHOMEOWNERS SIGNATURE �
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Foran Homeowom Exemption
ROARD()F APPEALS 648-95.11 CONSERV.vrION 688-9530 HEALTH 688-9540 PLANNING 688-9535
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The Co
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Department of Fire Services
Office of the State Fire Marshal
P. O.Box."IM Stite Road Stow,11i1A 0I775
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PERMIT
��"""- North Andover
�� ermlf.No . Date:
(Gty.of Town) Dig Safe Num er.
accordance with the provisions of iM G_L (If Applicable)
1�+=8.Chap.ter 7 0 .as.provided in section S?7 f Rog 3 4
POOL\
This P-ermit"is grapted to: - L"`'�' i. ,7�- Stare Date / J !
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Full name;ofperson,Firm or Corporation
Permission to
locate dumpster for construction/renovation/demolition of building.
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Comments:: d u m p s.t e r . must be . 251
Res[iicrions' from structure if unable to place with re wired
clearance dumps"ter must be covered with
Plywood or tarp end of workday
at a ,6 6
("Give location by street and no.,or desc ' in
T Fee Paid.3 50.00 Hatt as" r r i a ion of location)
This Permit will exp - — - - - Fire Chief
Seffcalgnngni[)
Offcal granting;pemiit Title
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COCHICMEWICK
0RATED APS 5 BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT............�l..��...........P.,t��... Foundation
..... buildings
lon0. .. C . . Rough
has permission to erect................................... I ..... �. �.. .. ...................................
to be occupied as........ ��� ....... '.��V ......��t.i........0.14( imn....... ...... ....................................... Ch' e
y
provided that the person accepting 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 6 MONELECTRICAL INSPECTOR
UNLESS CONSTRU T S 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.
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