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HomeMy WebLinkAboutBuilding Permit #350 - 107 LIBERTY STREET 11/21/2008 .BUILDING PERMIT 0111"O DT bgti �r $` •6 v TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 3`sb Date Received gCHU Date Issued: /At IMPORTANT: IMPORTANT:Applicant must complete all items on this page LOCATION ! Print _ PROPERTY OWNER Print MAP NO: d, ARCEL:-.ZONING DISTRICTS Historic District yes o Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building .-- ne famil Additionwo or more family Industrial Alteration No. of units: Commercial Repair, replacement -Assessory Bldg Others:' Demolition Other Septic Well ' Floodplain Wetlands Watershed"District dater/Seance D SCRIPTION OF WORK TO BE PREFORMED: / Identification Please Type or Print Cl rl ) Z� G1� OWNER: Name: — "'� S -f L_ © Phone: Address: % 8 �� /15 -/ CONTRACTOR Name: /1-►'s f--�,�.� one: 9 2_S7348 Address: 73 Supervisor's Construction License: Exp. Date:' Home Improvement License: � � � � Exp. -Date: 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: $� FEE: $ L �• Check No.: 0 Receipt No.: NOTE: Persons contracting with unregisterentractors do not have access to the guaranty fund ignature of= :a _Signature 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 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 o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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:Building Permit Application Revised 2.2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Salesti Food Packaging/Sales ,, 1 Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICEtUSE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING &'DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH C- : 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/sic nature& Date Driveway Permit DPW Town Engineer: Signature: Located` 384 Osgood Street FIRE DEPARTMENT -Temp DUM'ster on site yes no Located at 1.24:Main Street Fire Departmentsignatire/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 2008 Location No. 350 ` Date �aR,M TOWN OF NORTH ANDOVER �: •` • AL FEW9 Certificate of Occupancy $ Building/Frame Permit Fee $ 3�`! P' Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ Check 21, 704 `' Building Inspector TAORT#q T Andown of m over �0 No.,36b dover, Mas -2/ 10 ) 0 LA 0 so COC HICHEWIC 11 ooA TIED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT vii... . ........... . ................................... .............. ......................................................... Foundation has permission to erect......................................... buildings on .............................................. Rough to be occupied as......................All- . . ...........vr'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 PERMIT[' EYLPI�ES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC-nON STARTS Rough ................. Service ......... ................................................................ BUILDING INSPECTOR Final occupancy Permit Required t® 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. MopTM TOWN OF NORTH ANDOVER OFFICE OF 3r •'i d * O BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 - - ssACNlI`�t� Gerald A Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)6W9542 HOMEOWNER LICENSE EXEMPTION PleaseLtt DATE: �d� . 2, 1 JOB LOCATION: 0-7 S- Number Street Address Ma!"Ot HOMEOWNER_ Name Home Phone Work Phone r PRESENT MAILING ADDRESS 07 City Town State Zip Code The carrem 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,an 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 Fmm Homeoums ExwWfian 130ARD OF \PPF,:IS 688 95 t1 CONSERV_MON 6188-9530 1IE.UJI1698-95.30 PLANNING 688-9535 CHELMSFORD FIRE ' , C PLACE CTR E CENTERLLC R%L 73 SUMMER ST !reet CHELMSFORD MA 01824 979-256.6328 4,01824 1-1742 ID; 76129422 Sale -6328 DAT ORDER NO. E ORDER NO. Ref 4: 0001 08/16/08 )-9474 Batch #: 382 10:06:40 -iH IP�TO --------- ....................................... ........... Appr Code: 9E949z I>tiva; 000001 -4 Customer Copy THANK YOU!! ......................... .................... ......................... ................. . ....... .............. ........... ........... .................. .......... .............................................. ................................................... .......... ............ ........... ............ .................... ------ No Refunds on Special Orders No refund after 30 days. Balance due upon pick up or installation of materials. All dimensions given by customer are not the responsibility of C.F.C. Any additional offsets or pipe will be extra. F I ireplace Width: Height: .......... Depth: ................ ................. Customer Signature: ........... 0