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Home My WebLink AboutBuilding Permit #867-12 - 120 CAMPION ROAD 6/5/2012 i ` NORTH BUILDING PERMIT a TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: SSARA7ED / � CHU`�E� Date Issued: 7 IMPORTANT:Applicant must complete all items on this page 7 ��+T�,! ri{.�.� k` "�c � £� � �°� -'�i eTott3.ft`yt _rte - f t st- PROP RTYOWNER � � '� �`' t`PARCEL YZONING}DISTRICT�� Histonc"'Distnct '� r,� es no '.!s� a.,.,� :tea.Yet ,:. s a • *•5- --}-"�+�..c. ��.'t't.' �•�.�.� i' .. Y�4 f� � TYPE OF IMPROVEMENT PROPOSED USE Reside Non- Residential New Building ne famil Addition Two or more family Industrial teration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other rye�tic Well _ ;Floodplain Wetlands Watershed:Distnct� __Y"�� c 4 zi d� -` "�3 a •gni.�y,g�q� s4 � ,�' r g .t.��.� f'��` !. �-� '.,}f;�.j n �''.�c� ^( -. i ,� �.F f YL S`:. � S t'PiK' .."a� �. ,.F { E�4ri�i-Y r 9`'3•T •I x - p BE PRE MED: D� 0boo � i i PleaseTt "e or Print Clearly)Cdent OWNER: Name: OT[ Phone: Address: A-M P1 ON �1.w 1 ,{"" f «� �- L.,,. .3,-Gx-.. 4- s• '�-- '- '� .., .z.- _-. ,4+.=..- �,.y ,•,P� h ..::pc I" i3r.+,.,..-`�,�t•Y�y�`�`' :":��+�-.•.-�v�,t^, CONT�RAC,TOR"�Name4Phone =�g•a N.,y, ti �{v r .}a,*p s'c �sr i a _- -Y � � _ A- ,� T P t s43�p. -�y �s si,: ':7.i: � �'wTt k' Ti t- "rte �*T=��`,� s � a-�t -t" .� � "•-" s t 3KSo v�+re+. 6 4?g�s�' S.. lA:�' �.1�+ �e.s. '�: 4 ��h+'�2�,i � ca .-+4.� -�, ��`'�',`�9�rr.- ted.-`+�,FE *t �-•°. z3'�' ,�'it.x �„t .�' �. a� . ¢� {; at: v �,Asa 5 .. 3v 4�ddreSS`'^ -g'�,..�7'``7 � •ib r t��'ffi.+.i. _ � its-,#�•"-4N�� "� .�,u�s�A�a-�x.eaF c di . �' � � ; :�,,.�st?1"'��r..fir- ,r 4 -�r�. A ""�, .ate ,� �`�``.*�. '"$�'`�' '•tr Yx,r- r t .�+ g«•,� :. F EXp:.. Date c4. .. Supervisor s Construction Licensees - x =Hometlmprovement3Licen_se ENGINEER ��Ll� �t Phone: ARCHITECT/ 791 Address: 113 Reg. No. a 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: $ � oa 1Vill Check No.: 4/� .'J Receipt No.: NOTE: Persons contracti iih uriregistered contractors do not have access to the guar n nd \ -- - ----- - - - -- -- - - --r � Signature of Agent/OWn 'Signature of contractor ; .—N C� .- -- _. .__ -- .. . � . . - --- .. .. : i 11 / - . (1 Location �� A ��/ ,F6 7 - /2 No. Date /� . . .. . . . ,. . TOWN OF NORTH ANDOVER 1�CE0,s , S, c . ;. . 0MI Certificate of Occupancy $ � '`�`' Building/Frame Permit Fee $ G— .,' 4 _. - K, Foundation Permit Fee $ a�,„ x a 1 , `� Other Permit Fee $ TOTAL $ -;..;. '. Check# '- 3 � . 25365 BAi mg"Inspector ... 4 _ _ 11 - F I .. 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments a' Conservation Decision: Comments Water & Sewer Connection/Signature &Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREDEPARTMENT Temp Dumpster on site.` yes no Locate d';at-1241 ain! treet ' _ -.Fire•Department signature/date 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 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 ❑ 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 ❑ 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 (VOTE: 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 2.2008 TO" IIORTH Of _. O = .' OA �, o dover, Mass.,_ /z COCMI A. :... K �. ORATED P'Pa��(� U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... /................................................................................................. Foundation has permission to erect........................................ buildings on ./ .................................... Rough ./� 'i p 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 PEERM1IT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR NILESS CONS � � l S Rough ....................... ... .... ..,v ........................................ 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. 04"°oT 6�N TOWN OF NORTH ANDOVER `.�°of OFFICE OF 10 * BUILDING DEPARTMENT 1600 Osgood Street Building 20,.Suite 2-36 North Anoverd sq�Hus�. ,Massachusetts 01845 Gerald A.Brown Inspector of Buildings Telephone(978)688-9545 110MEOWNER-LICENSE EXEMPTION Fax (978) 688-9542 BUIDING PERMIT APPLICATION Please print DATE: 3 Z JOB LOCATION: Zd C P I m pp rr �� dk Number Street Address , - Map/Lot ROMEOWNER SCOTT A Name Home Phone Work Rhone PRESENT MAILING ADDRESS C-0 rvi/Y) 0 t _ 1� vin, •• I-� � - - Clty T et�n State. Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwelling to allow such bomeovS,ners to engage an individual-for hire who does not possess s to two units or less ar_d a license,provided that the owner 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 hintends to reside,on which there is,oris intended to be,a one or two family structures. A person who constructs more that e one home in atwo-year period o shall not e considered a homeowner. be The undersigned"homeowner"assumes responsibility for compliances with the State Building Co Applicable codes,by-laws,rules and regulations. de and other The undersigned"homeowner"certifies that he/sh er minimum inspection procedures and require pts an s Town of North Andover Building Department requirements, s e will c mPIY—with said procedures and HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-954] R • CONSERVATION 688-9530 •" HEALTH 688-9540 PLANNING 688-9535