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HomeMy WebLinkAboutBuilding Permit #34 - 106 MIFFLIN DRIVE 7/16/2007 BUILDING PERMIT No 0 q�v TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �O 1eb Permit NO: Date Received Areo �SSACHl15�� Date Issued: •lig IMPORTANT: Applicant must complete all items on this page LOCATION ( ffljfzEL�n Ilc ( ti I LrO(/ P t PROPERTY OWNER JA lielf-AP Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/.Sewer DESCRIPTION OF WORK TO BE PREFORMED: P nO( entificationPlease Type or Print Clearly) OWNER: Name: fo Phone: Address: () Q MI r `° CONTRACTOR Name: Phone: 7 1 c& 2 C?l 7 Address: J \C kcuc(f,)C� 171 f' - Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: 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: $ 35 1&00 = q S 1 ( FEE: $ Check No.: q# Receipt No.: ( yo / NOTE: Persons ontracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ownignature of contractor 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 a--B-uilding Permit Application z—C-ertified Surveyed Plot Plan ❑� Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses .a-- 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 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 DATE REJECTED DATE APPROVED XCONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes r Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 Location No. �� Date NORT#j TOWN OF NORTH ANDOVER 041 °. • O9 Certificate of Occupancy $ Building/Frame Permit Fee $ s�cNus Foundation Permit Fee $ k Other Permit Fee $ TOTAL $ Check #I L �'. Building Inspector NORTH Town of sAndover 0 TO No. 3 Y7 C, = o '� dover, Mass., X14 C T Q LAKE COC MIC ME WICK V �d�0RATE D P' 7 v E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • A BUILDING INSPECTOR THIS CERTIFIES THAT.......... '..���.`� .. .V.....................................................�... .... 0... Foundation has permission to erect... ................................... buildings on I�..�....... � , � .�.......... Rough �....... to be occupied as �. .� Chimney ........ .. . . . . .. .. .fi �6 . . provided that the person accepting this p mit shall in every ret 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 S7 ipaw PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS V LESS CONSTR V C 1 1 Rough .. .. .... ...... ................... Service .. BUILDING INSPECTOR Final Occupancy Permit Required to Owipy. Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dy Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. of NORTH TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT + 1600 Osgood Street Building 20 Suite 2-36 �S�J�wne �5� North Andover,Massachusetts 01845 s'tcaust Gerald A Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please pmt DATE: JOB LOCATION: 106h �f i`i� V o�-A 12�d to ver 11�019el(�— Number Street Address Map/Lot HOMEOWNER uara ftP-Lp `oZGU� Name U Home Phone Work Phone PRESENT MAILING ADDRESS 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 not possess a license,provided that the owner acts as supervisor). State Building (Code lection 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 Reid 10.2005 Form Howwwom Exa w ion 1.30ARD OF WFALS 688-95.11 CONSFRVA:r[ON 688-9530 ITEAL'T11688-9540 PL.w\I`3 6880535 ---r---+.. 111V conTQ1Tw" Molq 'h^da as to xoning Ulbsck I + (0 Fo's 69 S" 3S Lp ,\ 1 _.�.. a-�- I'�L.o cls ll\ � I: L©T l o l`0 too �± I I _ I Ilo, o 1 IT es,terior arlitiona by j)er i t� du1.-1rlthe past; ton yP<Irs. TOTHE ( Interate National Mortgage Corp. tAND ITS TITLE INSURERS. MORTGAGE INSPECTION PLAN - I CERTIFY THAT THE BUILDINGS SHOWN DO ( CONFORM TO SETBACK REQUIREMENTS SAM IN I.E. (FRONT, SIDE, & REAR SETBACI( ONLY) OF l�o r t h An d o v e N 0 R T H A N D O V E R NNEN'�OFISTRUOTED, OR ARE EXEMPT FROM VIOLATION ENFORCEMENT ACTION LI+NDER MASS. G.L. FTLE vll, CHAPTER 40A, sEeeolloN Y@. LnJSIQEsQs oTNaRwISE fNO�TEnDp -arpA MASSACHUSETTS URTHER CERTTIFY Q TTHIS%SERTY 15 ;,p r LQC Q Tim E5TA9u5NED FLOOD HAZARD 'OOMMUN17Y PANEL NO.: DEED 250098 0003CDATE: 612193 BOOK 3082 MIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT T It )ATE OF THE LATEST DEED OF RECORD. 16 �MiENtVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM 111E PROPERTY UNE IT IS ADVISED PACE `MAT A MORE PRECISE SURVEY BE MADE TO VERIFY•TIESE_ AEASUREMENTS. CERT. NO. MIS—CERTIFICATION IS BASED ON THE LOCATION OF'M A.A`AAftAp OTHERS, AND DOES NOT PLAN BK. PAGE 2EPRESENT A PROPERTY SURVEY. VERIFICATION of SURk.-F�((��RRK R�+�,SiR AND OFFSETS, AS SHOWN, -IA BH ACCOMPl1SHED ONLY BY AN ACCURATE, INS d�lEt�T'.SURV ;;'•!�t�, + p 1657 DATED THIS CERTIFICATION TO BE USED FO rMD '�GAGE PURE' ,S ONLY. November 16 OFFSETS AS SHOWN �{�A It, 07r'TQ--�3E.', (995 USED FOR THE ESTABUSHME SCALE I-- 20' �- EPA?�RT;y�.l ES r. . 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