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HomeMy WebLinkAboutBuilding Permit #029 - 143 MASSACHUSETTS AVENUE 7/15/2008 i P r►O RTF/ BUILDING PERMIT °Ftt�no ,6'�tio TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION X04 Permit NO: Date Received �, Q0RATeD �SSACHUS�� Date Issued:—2 I PORTANT:Applicant must complete all items on this page LOCATION,: IW M' 0 SS . - , Print PROPERTY OWNER_M'�_ ^ 4 h0 na Y\ Print . MAP NO: ARCEL: ZONING,DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands,': Watershed District "Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: I entificatiog,Please Type or Print Clearly) OWNER: Name: ref . Phone > Address: CONTRACTOR Name: 4EZ _r 00K/A/✓ Phone: ` 4? /d'-- ;_12 Address: / f3 /SSS ";EVL £ , Supervisor's.Con struction 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: $ lao. 00 FEE: $ Check No.: y�� e Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 0ignature�of Agent/OWne I nature 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 ❑ 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 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/ ody 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 Signature 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dun pster on si#e.` yes no Located at 124 Main Street : Fire Depar nent:signature/date.. u 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. 10 Date Al` 'z6'r �oRTh TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ ss�cus`� Building/Frame Permit Fee $ -� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ��� 2 i \321 /Building Inspector + µoRTil TOWN OF NORTH ANDOVER ° ie ' OFFICE OF BUILDING DEPARTMENT « 1600 Osgood Street Building 20, Suite 2-36 �►'*:,;.::�r�. North Andover Massachusetts 01845 Gerald A.Brown Telephone(978)688-9545 Inspecor of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please arta DATE: JOB LOCATION: 1,-13 n` o-s, . a(/r Number Street Address M* of HOMEOWNERm t L� Name Home Phone work Phone PRESENT MAILING ADDRESS �V RA4ok) r-.(- nen 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 lection 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parol 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 constricts more that one home in a two-year period shall not be considered a homeowner. The undeisigued"homeowner"assures 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 Departmert min;mnm inspection procedures and requires and that he/she will comply with said procedures and HOMEOWNERS SIGNATURE:2Y/� 94;�� APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Foam Homeowams Eumptim 11,0ARD()F VPE.0-S 699-9541 CU.NSERN'.v o\638-9530 ITEALM 688-9540 PL.LNNING(,8N-9535 I ti NORTH c T0VM Of over No. 0c�C? _ © * drover, Mass.,0 LA "'' COCHICMEWICK y1. ADRATED IPS\ �C `r BOARD OF HEALTH PERMIT T � D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT................../A//d....................... ................. ............................................................................................. Foundation has permission to erect........................................ buildings on �` � � — -5- `'� Rough .............................................................. ter} p�j� to be occupied as. l/�(t'l/9/ /c'�r/`� ....` l'66 F �` est...... �St'����S. 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 EMPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO STARTS Rough ..................................E .......... Service BUILDING INS PTPR 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.