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Home My WebLink AboutBuilding Permit #149 - 16 WOODBERRY LANE 8/27/2008 BUILDING PERMIT of No oT1 a TOWN OF NORTH ANDOVER 32 ,fit.,,- X6,6 oL ° L .> APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received ^0-.1 D qy �% 7 �SSACHUs�t v Date Issued. �l' IMPORTANT: Applicant must complete all items on this page Pint - �PROPERTY OWNER - N nt MAP NO: —PARCE: IZONING DISTRICT: Historic District yes no Machine Chop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial 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: Al Identification Please Type r Print Clearly) OWNER: Name: Phone: 7;?;? 6,rd4 4 1 c4 Address: as �� t om, " � Avoo>,vc K4 CONTRACTOR Name: Phone.: e s Address: _ Supervisor's Construction License: 1. Exp, Date: Nome Improvement License: Exp, Date:` ARCHITECT/ENGINEER 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: $ 0 FEE: $ Check No.: l �� Receipt No.: 2 </5-6 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund §gnatIure of Agent/Owner- c W Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body 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 EIRE DEPARTMENT -Temp.Dumpster onsite yes no Located at 124 Allain Street: Fire Department signature/date 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 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 �r Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit 4 ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And t 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 NORTH Town of .._� Andover 'AVT � ® .:�_ .�4.• '^','.�'� nt'. � , 1 o. s * P LA 011.zdovert Mass., _ ,2714 cc HI CHEWICK "I �ADRATED PPS\ �y BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR G poi^ THISCERTIFIES THAT...................P.. ... . .. . ................ .................. .....��''C.................................................... Foundation has permission to erect........................................ buildings on ... ....L 'tDr... .... �................... Rough to be occupied as _• .file in Chimney /.......L. .5`........... ��1 i3-! .E`''�''"........ ''.' ?.fr....�.. � �f h ney provided that the person accepting this permit shall in every respect conform o the terms of the applicatio 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 T ELECTRICAL INSPECTOR CONSTRIJ ON TS Rough ............. ................ ................. Service BUILDING INSP OR 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. r l � ,f1, it Lp lot ev 60 , 14, 4��4y Ile � 1 + MORrM TOWN OF NORTH ANDOVER ,��`'•�e ' °o� OFFICE OF 41 BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 01845 s�c�a►st A Gerald A Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Pl_�nt DATE: g JOB LOCATION: Number Street Map/Lot HOMEOWNER ecu �rt ✓M Name Home P work Phone PRESENT MAILING ADDRESS City Town State 7jp Code The OnTent eReIDptlOn for"homeowners"was Wended to include owm r-occupied dwellings to two 11=yr 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 motion 108.3.5.1) DEFINITION OF HOMEOWNER. Person(s)who owns a parcel of Ind on which he/she resides or intends to on winch ms . inside, ch there' ,oris 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 mss,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Depamtment minimum inspection procedures and requirements and that he/she will fly with said procedures and J HOMEOWNERS SIGNATURE _�6�n APPROVAL,of BUILDING OMCLAL Revised 10.2005 Foam Homeownw Eumption TIOARD OF VPE:u S 688-9541 C0NSERv.1TI0�688-9530 diE.V I'1i 08-9540 PL.1\ti[NG Gs?8-9536