HomeMy WebLinkAboutBuilding Permit #804 - 137 HIGH STREET 6/15/2006 10RT/
Of ,•ao ANO
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION\
9SSACMUSFt 15
Permit NO: O Date Received:
Date Issued:
I
IMPORTANT: Applicant must complete all items on this page
LOCATION / ! / l�! ff 14
Print /
PROPERTY OWNER
tint
MAP NO.: PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑New Building ❑One family
❑ Addition ❑Two or more family ❑ Industrial.
❑ Alteration No. of units:
❑ Repair, replacement ❑ Assessory Bldg ❑Commercial
❑ Demolition
❑ Moving(relocation) ❑Other ❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
Identification Please Type or Print Clearly) f7f-6"t 7
lQ
4 2 —
411 �S
OWNER: Name: ,63i ., #eZAI11 � ,�kU'[W 10f / Phone:9��
Address: 117 V ck, ��✓dc
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:510.0 ER$1000.00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F.
Total Project Cost :$ .22 D s x10.00=FEE:$ 3U
Check No.: Receipt No.:
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Page Iol'4
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Building Department
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The following is a list of the required firms to we filled out for thea appropriate permit to be obtained.NN N
Roofing, Siding, Interior Rehabilitation Permits
j ❑ 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
L3 Surveyed Plot Plan
o Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy O Contract
ontract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic
Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
o Building Pen-nit Application
o 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 DEPARTN1ENTAWFORIN05
Page 4 of 4
i
TYPE OF SEWARGE DISPOSA Swimming Pools M
Tanning/Massage/Body Art ❑ g
Public Sewer
Tobacco Sales ❑ Food Packaging/Sales L
Well F-]
❑ Permanent Dumpster on Site ElPrivate(septic tank,etc. Electric Meter location to
project
NOTE: Persons contracting with Unregistere ntractors do v cess to the guaranty fund
Signature of Agent/Owner/ �y tgnat e 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
DATE REJECTED DATE APPROV D
CONSERVATION ❑ M s
D
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH F]-
COM
COM ENTS
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer connection signature&date
Temp Dumpster on site yes—no)( Fire Department signature/date
Building Permit Approved and Issued by:
Page-2 of 4
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)
Page 3 ot'4
Doc:INSPECTIONAL SERVICES DEPARI'MENT:BPFORM05
Created JMC.Jan.2000
Location 137 /Arh fes'ter--
No. Date Z6 Zf
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NORTH TOWN OF NORTH ANDOVER
F 9
Certificate of Occupancy $
;�s'••a°•Ern Building/Frame Permit Fee $ -
s�cHus
Foundation Permit Fee $
Other Permit Fee $ 4.
TOTAL $
Check # l 3
Building Inspector
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r TEXTURED VINYL SHIELD COATED FRAME i
Full contoured molded resin covers.,
f"� ; 7 inch textured vinyl shield steel ledges.
y'. •<6inch Column Crystex@ coated steel verticals.
> 1 •'Resin coated steel universal top and bottom rails.
��( • •l�niversal'resin coated steel top and bottom plates.
$ �, * •Stainless Steel Hardware for extended life and high
`t • ;Y a sirength fasteners where required
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6 WI 52" POOL SIZES
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' ROUND SIZE OVAL SIZE
15ft.x 52 in. 24ft.x 15ft.x 52 in.
18ft.x 52 in 30ft.x 15ft.x 52 in.
.21 ft.x 52 in 33ft.x 18ft.x 52 in.
Give yourself a'nd your family the quality time you deserve.
24ft--R-52-in.
�'f•, 27ft.x 52 in.
® With any Sunshine pool in your backyard
you can enjoy the fun and
the freedom to use it anytime
DELUDE ENAMEL COATE R ME .• ''�
�.� -- day or night.
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52" POOL SIZES
(approximate)
' ROUND SIZE
` c 6 inch Roll-formed painted steel verticals. •Steel universal 15ft.x 52 in. 24ft.x 52 in.
•6 inch Roll-formed painted steel led top and bottom rails. - a
P ledges. 18ft.x 52 in. 27ft.x 52 in.
52 in.
Supporting corftovf-edmo�lde`d resin covers. • Blue color frame and wall. 21ft.x OVAL SIZE
� _. g,•Steel universal top and bottom`plat23- • Zinc Dichromate hardware. •' 30ft.x 15ft.x 52 in.
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Nov . 2 2004 7 :46AM 11813212501 No . 3202-P. 4
a REGISTRY: X /YD
TITLE REFERENCE: D¢ 1
PLAN REFERENCE:
lo 7' A? -
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20 7_25
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lap,
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This plan was not prepared from an instrument survey. MORTGAGE INSPECTION PLAN
Offsets and distances shown. should not be used to
establish property Gnes.
LOCATION X37 Al MSS`
This plan is intended.for mortgage purposes only. AIVDOV49R Md
D
I certify that the structure shown on this PlanSCALE•
� WAS in conformance with zoning setbacks
in effect at the time of construction. CERTIFIED TO:
I certify that the parcel shown is_&VToeated within 4r 'rf
a flood hazard area as depicted on THUD Flood Insurance
Rate, Maps for Community No: '750 U 2A,
CAMERON BROTHERS INC. Job No.
I I Touro Ave.Medford,MA (781)324- 566 I
N°Rrk TOWN OFNORTH ANDOVER
OFFICE OF
° BUILDING DEPARTMENT
400 Osgood Street
f"'l�y North Andover, Massachusetts 01845
4TSACNUs
Gerald A. Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:
JOB LOCATION:
Number d� Street Address Map/Lot
HOMEOWNER
Name Home Phone Work Phone
PRESENT MAILING ADDRESS 137y�
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 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 t he;sh understands the Town of Nort Ando r Building Department
minimum inspection procedures and r quirements and that he/she will co ply lth sai rocedures and
requirements.
IIOMEOWNERS SIGNATURE_
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005 --Form Hoino)wners Exemption
BOARD OF APPEALS 68-S-9541 CONSERVATION 08-0530 HFAL_TH 638-95+40 PLANNING o88-
9535
NORTH
own of : Andover
oto
ver, MaZe��As
ss.,
COCHIC HEWICK ��t•
oRATED
vv BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT............ 0.4c .........M.!r .efff.
......................................................
Foundation
has permission to erect........................................ buildings on./3.1......... h.. ................... Rough
to be occupied as 1 A#.L..... .... ��If'11�!► ......... ...w............................................................................. 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
0 #0110 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION S
Rough
Y Service
................................... •. •.............. .•••• • .......•
BUILDING R
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.
