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HomeMy WebLinkAboutBuilding Permit #370-14 - 115 OLYMPIC LANE 10/21/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: 5 Date Received 02� Date Issued: Q Zi IMPORTANT: Applicant must complete all items on this page LQGATLONi >-_ Print PROPERTY OWNER_, _ a __-_ __ _-_ _ m Print 100 Year Old Structure yes no MAP NO: �aPARCEL': ZONING DISTRICT _,. _tHistoric District' yes Machine Shop Village yes _ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ane family ❑Addition ❑Two or more family ❑ Industrial 1§01teration No. of units: ❑ Commercial repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other peptic p Well ❑ Floodplain ❑Wetlands 0.Watershed District 0 Water/sewer DESCRIPTION OF WORK TO BE PERFORMED: Id ratification Please Type or Print Clearly) OWNER: Name, Phone: i Address: CONTRACTOR' Name: Phone: e Address: Supervisor's;Construction;License: e _ - _ " - Exp. Date:-__ Home Improyement License: _Exp. Date: _ r ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED //O/lN$125.00 PER SF Total Project Cost: $ FEE: $ Check No.: Receipt No.: 07 Wr NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sig t eru of�Agent/Owner w __ Srgature of contr�E] tor,__ �k Plans Submitted ❑ Plar s aived ❑ Certified Plot Plan Stamped Plans ❑ i Plans Submitted-0 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF=SEWERACTEDISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ . Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc._ ❑ - .:Permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE.APPROVED PLANNING & DEVELOPMENTS ❑ ❑ COMMENTS -CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature a 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 Tow;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTME"NT - Temp Dumpster on site yes no Located'at,124 Mair, Street 'Fire-Departnierif-signature/date ' COMMENTS i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions._ I .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 2010 i Building Department The fol;,awing 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 Li Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses Li 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 Li Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And 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 Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses Li 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 MOTE: 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 apo•,al 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: Doc.Building permit Revised 2012 i I Location ��� t!�t-t t r G ^4G/ve No. Date O '- TOWN OF NORTH ANDOVEF€ Certificate of Occupancy $ Building/Frame Permit Fee $ ' Foundation Permit Fee $ Other Permit Fee $ ftp TOTAL $ / % Check# 27015 uj(ding Inspector NORTH Town of t ndover o - 1 No. T O - LANE h , ver, Mass, � _s . COC HIC HI WICK ATE D AP�,`�(5 1 U BOARD OF HEALTH Food/Kitchen PERMI D Septic System THIS CERTIFIES THAT .....�.�� ,,,,,,,,,,,,,,,,,,,,,,,,,, BUILDING INSPECTOR . .............. .......�. ................................................ . :..�� Foundation has permission to erect .......................... buildings on .�.�, .. ...�.�. ......... ........................... ............ 1 .. /S'6 e�i�- /�i� !`tet . / . Rough tobe occupied as ..� ../ 1.............:....: F : ?. i...���.. ... .. ............................ .`� . Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service .......... . ... . .:. ..r.........g...................... Final BUILDING INSPECTOR GAS-INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE 101 � I ------ --------- 1 I I I I I I I I I I I I 1 1 I � I I � 101 1 I 101 I I I I > s1VT-E r-------- -------- I +•;pct{© I L II 101 I I O-; I PSS - �'r11T'Gh�� 1..6� � R�c1^�GJ�' °-»� w�.►mss►-�'C�'"D '" C>FE ` NbA Stolt-, SSE oG��o►JCS I I I i COX RESIDENCE SCHEMATIC PLAN LPG DESIGNS 10.8.13 -1 4" — V-0- I 101 r---------------i r---------------i o ' ' cant I I I I �aHOWE4� i Io0G.A, fl Ai I .. ,ol i i O i �1T'Ga r/ I SDA z w K, CASED � OP�1..11►JC-� I COX RESIDENCE SCHEMATIC PLAN LPG DESIGNS 10.8.13 1/4" — V-0" 4µoery OEitLeo ra'S:ya TO VY1`Y OF i; OR EI•t lgDO .� VER °m OFFICE OF BUILDING D EPARTMENT Osgood Street Building 20,-Suite 2-36 �7�ssA ��Sc�S North Andover,Massachusetts 01845 Gerald A.Brown Inspector ofBaildings Telephone(978)688-9545 HOMEOWNER-LICENSE EXEMPTION Fax (978)688-9542 33UTING PERMIT•A.PPLICATION Please print DATE: ' JpB LOCATION: I c Ap Number treet dress Map/Lot HOMEOWNER 11, a � 0/13 Name. Home Phone Work Phone PRESENT MAILING ADDRESS Cit- 7i P Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to to altos per homsor). :rers to engage an i rcivSdualfor hire who does not possess a license,provided that the oUVO Units-Or Gss wnernr1 acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who Awns a parcel of land on which he/she resides or intends to be,a one or two family structures. A person who constructs ,reside,on which there is,or is intended to considered a homeowner. more that one home in a Iwo-yearperiod shall not be The undersigned"home-dwner"assumes responsibilityfor compliances with the State Building Code and other Applicable codes,by-laws,rules andregulations, The undersigned"homeowner"certifies that he/she Understands the Town of North Andover Building De minimum inspection procedures and requirements andthat he/she will comply with said procedures and partment requirements, HOMEOWNERS SIGNATURE W C APPROVAL OF BUILDING OFFICIAL Revised 7.2009 FOSS Homeowners Exemption ` BOARD OF APPEALS 688-9541 , C01\SERV AMN 688-9530 HEALTH 688-9540 PUNNING 688-9535