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Home My WebLink AboutBuilding Permit #251 - 139 MASSACHUSETTS AVENUE 10/2/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION 0 o m Permit NO: Date Received + +' Date Issued: "2'9 3.gq�RAToo VSACHus� IMPORTANT: Applicant must complete all items on this page LOCATION Print _ PROPERTY OWNER 46r" 4,, 7-_o e'374 _ car Print MAP NO.: PARCEL: 3 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 Iteration No. of units: - - epair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Z7 ZZ Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: ,/,SS f2,—.5 Q,/SE</S C 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.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$_ Y4200 �' FEE:$ 9 — Check No.: Receipt No.: 1210 Y6,� Page Iof4 i I 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 i Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 Page 4 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools El Public Art ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner �_. < Signature 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS 4 FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 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 oP4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan2006 Location/3-9 ggjj� live— No. Date NORTq TOWN OF NORTH ANDOVER O?O,t,`•O I•,hOOw ° Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ g'r s K"usE 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check dip� 19642 Building Inspector " OWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTN[ENT 1600 Osgood Street Building 20, Suite 2-64 North Andover, Massachusetts 01845 �CHUSE� Gerald A. Brown Inspector of Buildings Telephone(978)688-9545 Fax (978)6.88-95421 HOMEOWNFR LICENSE EXEMPTION Please print DATE: Ate- P- oc- JOB LOCATION: Number Street Address — Map/Lot HOMEOWNER i Q� 7, �/ n�S Name 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 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 that he"she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that lie/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE__ APPROV,\L.OF BUILDING OFFI l,�'L Y RrVised I0.M5 — f'orm Holno)wncrs E.ernyxion `OARDOF,1FF1=,1L.,ih,;t `x`11 _c1'� I1?V.lflQ� r„y-'S1t) FC-:A'JNI\-Gv%w- F N0RTH Town of _tAndover O p mr .. .. No. C ".....e... ... over, Ma 2y wo oc COCMICNEWICK �ADRATE D F"17 CO '9s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... A,I 4 ...... .. .e.. 1.. .. . ............................................................................. Foundation V-00has permission to erect........................................ buildings on ...13.. ..........N*J ..... ........................ Rough to be occupied as. ..... ... , Al ..........J. .......................... Chimney h the arson act tin this permit shall 1Neve respect nform to the terms of the application on file in provided t at p p g p every P PP 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 O� PERMIT EXPIRES IN 6 MO THS ELECTRICAL INSPECTOR UNLESS CONSTRU N ARTS V4064RoughNAVA Service ..... ......... .......................................................... .......................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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.