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Home My WebLink AboutBuilding Permit #835 - 146 MIDDLESEX STREET 6/22/2006 Of � 1N p TOWN OF NORTH ANDOVER IVAPPLICATION FOR PLAN EXAMINATION �► °++no rq9 ,SSgC HU`+e't Permit NO: Date Received: Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Y 6 J—Z • ,-4 /9/fog f9&Ere=2e J7– W Print PROPERTY OWNER � T f 1,9g" Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF MIMING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential IL New Building 0 One family Addition E Two or more family Industrial r Alteration No. of units: Repair, replacement Assessory Bldg Commercial G Demolition C; Moving(relocation) ❑ Other ❑ Others: Foundation only DESCRIPTION OF WORK TO BE PREFORMED -� mac,.,E� - 11i,- S- Iac OrW C-H L-/ 1�,4/t-S' (-2) aV E,4 ty�r AAC,11 V/,0 e Ce-7-&D,- Identification Please Type or Print Clearly) OWNER: Name: 10 l- -?,f- /9/ 15,o}RA Phone: l� Address:—/ It-'6 /ill sT- At .e"0 I//-W� P CONTRACTOR Name: -S 62A Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT,%ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$10.00 PER$1000.00 OF THE TOT4L ESTIMATED COST BASED ON$125.00 PERS.F. Total Project Cost x 10.00=FEE:$ 15D Check No.: T Receipt No.: �l Page Io1'4 TYPE OF SEWARGE DISPOSAL _ Tanning/Nlassage.'Body Art .-j Swinuning Pools Public Sewer Tobacco Sales - Well Food Packaging;Sales _ Permanent Dumpster on Site _ Private(septic tank,etc. Electric Yleter location to project MOTE: 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 I DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION j Fj' COMMENTS DATE REJECTED DATE APPROVED HEALTH CONINIENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/rcecipt submitted yes Planning Board Decision:____________Comments Conservation Decision: Comments Building Setback (ft.) Front Yard Side Yard Rear Yard Re wired Provided Required Provides Required Provided Vater & Sewer connection signature&date Temp Dumpster on site yes—no K Fire Department signature/date Building Pen-nit Approved and Issued by: Page 2 of DIMENSION Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.:_ NOTES and DATA— For de artlnent use) Paye 3 of4 Doc:INSPH I'IONALSIAVI('ESDEPARIMEN I':13PPOR,N105 (hA c.l 1"A'.la n.:006 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 o Floor Plan Or Proposed Interior Work 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 La 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 I)EP,%R'I'N1EN'I':13PFORti1115 Page,t 44 Location / 7Y9 No. Date 7Z� NQRT1y TOWN OF NORTH ANDOVER f 9 • Certificate of Occupancy $ t i „ • T',s Eta' Building/Frame Permit Fee $ s� s�cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # t �' Building Inspector P .�"`_ ,- _ fi �- .` �� . - 4. NORTH Town of t 19Andover No. 6 . z !! 2 . 6 (" 0 _- L A E - dover, Mass., YI� COC Hi C ME W ICK y^ �ADRATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... ....... ......................................................................... Foundation has permission to erect........................................ buildings on lif .0-474A ..-Ar)t......xr. — Rough to be occupied as........sCftt .h...I^......1.I s.+.*%......e C.(%......#......Ammo......I'�4�Il�.�•�i.l..�..� 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 EXPIRES IN 6 MONTHS UNLESS CONSTRLJCTI ELECTRICAL INSPECTOR Rough Service BUILDING INSP 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. 3�04 �NoQrM e4, IUWiV UHOFFICEOFANDOVER 4' p BUILDING DEPARTMENT 01'. ��* 400 Osgood Street Ty ,'1�T.0 f �5 North Andover, Massachusetts 01 845 �,V ACHUSE{ Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 6 - 2 Zr o,t� JOB LOCATION: ICF,d --/,?—o �y y� L ,/�e��,b ✓Z— �j j� Number Street Address Map/Lot HOMEOWNER_kg9t9?r F!�2,j"-G,Rp'4oln I/ f 2,'`—()ez (o�Z Name Home Phone Work Phone PRESENT MAILING ADDRESS S� 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,lshe understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. IIOMEOWNERS SIGNATURE_--L/C?L'�� APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Honwowneis Exemption BOARD OF APPEALS 683-9541 CONSERVATION 038-9530 HEALTH 6W9540 PLANNING 08- Q535