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Home My WebLink AboutBuilding Permit #78 - 148 WAVERLY ROAD 8/4/2006 TOWN OF NORTH ANDOVER tLORTH APPLICATION FOR PLAN EXAMINATIONsgtio Permit NO: --2r Date Received o Date Issued: _ '04 ��Sso SACHUs�t�� IMPORTANT: Applicant must complete all items on this page LOCATION I X73 `(5-0 �t�, Print PROPERTY OWNER CIA �Z cSo ,A Me (_ Print 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 `ESCRIPTION OF WORK TQ BE PREFORMED .2 -G Identificationn� Please Type or Print Clear 1. c� OWNER: Name: 1ti _.� I�l P f C,, 14,� Phone: Address: (5�(� \,�aJe_,r� CONTRACTOR Name: Qr(e,c, (;oy1 S�I y Lpo Phone: 6 L233 Address: 5�5� (^' oVe vl' de-e_12� M Supervisor's Construction License: p Exp. Date: Home Improvement License: 2 o 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 S L� ,�/ —FEES J yb x Check No.: . -350 Receipt No.:IJ 3 Page Iof4 TYPE OF SEWERAGE DISPOSAL i wmmn SiPools ❑ F1Tanning/Massage/Body Art ❑ g Public Sewer Well ❑ Tobacco Sales ❑ Food Packaging/Sales El Permanent Dumpster on Site ❑ Private(septic tank,etc. 11 Permanent Meter location to proj ect NOTE: Persons contracting with unregistered contractors do not have access to the uaranty fund Signature of Agent/Owner'. Signature of contracto Plans Submitted ❑ Plans W iv d ❑ Certified Plot Plan El Stamped Plans El THE FOLL WING 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 APPROVED I CONSERVATION ❑ ❑ COMMENTS A a DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Temp Dumpster on site yesnK Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Re uiredProvided Required Provides Required Provided 4 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) r Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 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 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) a 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 Noe 4 of 4 Location No. Date NORTH TOWN OF NORTH ANDOVER Of «w , ,4•G . - s • _ ; . Certificate of Occupancy $ �'s'•n°'Eta' Building/Frame Permit Fee $ ACNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 11t� 193 '17 Building�lnsp�ector t NORTH own of _ Andover No. 7 o C A O dover, Mass., • GoC"L' ICMEWICK 'I. %p ADRATED PPp\ -`y `s BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...&.wb..lerson.......... ra.4..ctoo.1........X ............ Foundation has permission to erect.................. ........... buildings on ...�. .'... .. ... ........ ....... ............ Rough to be occupied as.(��.�;ll..�i..l.I�1..�..... .... ... .....a....�O�.Q.t`t..... ....... 1�......�,j Chimney e provided that the person accepting this permlt'sh�ll every respect conform to�e terms o the application on file m 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 344> ® PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRtJC T ELECTRICAL INSPECTOR Rough .............. . ............ ..... Service BUILDIN CTOR 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. g µORTF! TOWN OF NORTH ANDOVER 9 oma OFFICE OF ° p BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 41 pDgATiD�T¢`<� North Andover,Massachusetts 01845 �SSACHU5�S Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 3 fckIO6 JOB LOCATION: (16 w a Ue r d(.1 Rd /�e A y-d cwa-" Number Str t Address Map/Lot HOMEOWNER Name Home Phone Work Phone PRESENT MAILING ADDRESS 5 O WC ve r 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 requirem is and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNAT APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Fonn Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688- 9535