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Home My WebLink AboutBuilding Permit #174 - 105 HILLSIDE ROAD 9/5/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION oS"Eo 06'�tio 0 to Permit NO: ` `� Date Received 7'd-` , Date Issued: U SSAC H�1`��y IMPORTANT: Applicant must complete all items on this page I�� LOCATION I S� 9ok—, K 1• , U Y Print . PROPERTY OWNER Print MAP NO.: PARCEL: ZONING DISTRICT: 6i TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT— PROPOSED USE Residential Non- Residential ew Building 07_eef;)0 ❑One family ❑Industrial ❑Two or more family Y ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DE TION OF WORK TO BE PREFORMEDp Y: 1 ( a JZ4 k_ -A v v ca" Identification Please Type or Print Clearly) OWNER: Name: Cd6o0 r Phone: -A -) z;), 11 1 Address: 1 CONTRACTOR Name: Phone: 0 Address: 22C�Dd(yusc, �4 Q3 Vq Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PER MI Sa.00,ffR$1000.00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F. Total Project Cost S LP FEE:$ �l`f Check No.: Receipt No.: Page I of 4 I TYPE OF SEWERAGE DISPOSAL - ' Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer Tobacco Sales ❑ Well ❑ Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund I, Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑.Site Plan Special Permit ❑ Other COMMENTS t ATE REJECTED DATE APPROVED CONSERVATION COMMENTS �D .� � I1YC' Q�zfi�l - `Yylra2i/1av� 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 Temp Dumpster on site yes—no— Fire Department signature/date rG Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) I II F I 4 it Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan.2006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 Paap 4 of 4 Location � g, No. Date r �� 4 : R TOWN OF NORTH ANDOVER AL ' Certificate of Occupancy $ F•. ,�/ b+±mss'� � 'SsncMusEs� Building/Frame Permit Fee $ ' Foundation Permit Fee $ 3 Other Permit Fee $ TOTAL $ �-� Check # 19549 ' - Building Inspector ,A®RTiy own of 4 RAndover No. ® 17� z= o dover, Mass., T O - LA �. COCMICKEWICK V 7�S RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR Am il THIS CERTIFIES THAT..P.O.Y0%. A.......... . ......... �. ...................... Foundation r has permission to a t..........�...................... buildings on ...... .�i ..C......Klttd.rc....... ........... Rough to be occupied as... ..i. ...... .6 &..%....L.e.��.O Chimney 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 10*WWW ' PERMIT EXPIRES IN E MONTHS ELECTRICAL INSPECTOR UNLESS CONST RU TARTS. 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. EASTERN SHED DATE SHEo# `= - 1 SIZE x COMPANY Width x Length MODEL: 0 QUAKER O CHATEAU ❑GAMBREL ❑DELMAR [GAZEBO. J978) 688-4222 '' SIDING: ❑ PINE ❑CEDAR VINYL FAX: (978) 688-4244 WWW.EASTERNSHEID.COM Shed Price $ a` . Total cost of r options from below $ CUSTOMER INFORMATIONo° NAME �t",�1 % li� '„ +i ' , �/ Sub Total $ . 1 STREET t6 t.i .�A'��`r" # Sales Tax F E- Sub Total $ CITY'; ZIP Moving Charge STATE °i Carrying Charge $ J HOME PHONE ( )�1l f. WORD �' Delivery Charge $ K PHONE, ( '�a' ,), V � tr Sub Total $ " 1 REMARKSj. eco Deposit ( $ - . Total Amount Due - - Upon Delivery OPTIONS ...�� ' j FOR OFFICE USE ONLY Door Exchange $ Add Door $ Louvres ($35 pair) - $ Ramp $ ROOF COLOR: SALESPERSON Add 1 wal $ height LACK. VINYL SHED INFO ONLY: �' Pressure Treated Floor Plywood $ q_GREY Siding Color: 0 BROWN Cupola Shutter Color: $ Loft $ PLACEMENT OF DOORS AND WINDOWS (60 1� / SIDE FRONT FOTAL COST OF OPTIONS $ (Length) "OR OFFICE USE ONLY: SPECIAL INSTRUCTIONS )ate Delivered WOUNT RECEIVED$ Check# .1,2' x 20' Reetay le Vinyl F-4 Standard Roof with Cupola f Straight Rail FZ White Vinyl Straight Fascia and Halfmoon Brace Rubber Slate Shingle F4 Vertical Four Track Windows with Screens t Enclose Your Gazebo Windows eT' Solid Door 12'ac16' Quin Trin l f + I-4 Double Roof with Cupola Scalloped Facia Cf White Vinyl Victorian Braces Metal Roof Screens If Victorian Rail Y � 4 �c w �� ++aa55 5 ; fist Iu zKx . 5 lf 1�,t `'.Q, d'. +,,��'�b.5 I�,3 .�X�} Ww a�7' ;$�"e'` �' 1•t,,`''��f i.�r�'�,�P`�dF",�,X;,�.Y4}�'S. µORTH TOWN OF NORTH ANDOVER 32 Qg S7�t0 6��°oL OFFICE OF p .BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 North Andover, Massachusetts 01845 SSACHusE Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: �l b b co JOB LOCATION: (� l Is,f[ ' r Number Street Address Map/Lot HOMEOWNER S 2J 1 ame Home Phone Work Phone PRESENT MAILING ADDRESS i I Dl e i Kl�)• 4da4r y l �qs-_ 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 notossess a license,se,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 APPROVAL OF.BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 6889541 CONSERVATION 638-9530 HEALTH 688-9540 PLANNING 688- 9535