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Home My WebLink AboutBuilding Permit #571 - 161 COTUIT STREET 3/13/2000 f gORT►1, O t�ao • h0 - TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SgACMUSE� Permit NO: 6W Date Received: Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �(� 1 (_01 1-T' Print PROPERTY OWNER 1] d fA"'J �- yl—ey", 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: ,K Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED tJr_t.J V_oo F o J Cx Ns n#J(- I�00�`�10►� , K)ECJ 5\1314G o d No J s�• 0 Identification Please Type or Print Clearly) OWNER: Name: ��- D�lr� �.1�- Y-L-lvyA Phone: qn 6Kaagts Signature Address: CONTRACTOR Name: S ftM E Phone: 01l't 6 t57 OA"fr Address: Supervisor's Construction License: Exp. Date: It Ig-1/4f' Home Improvement License: 1'-�6 a 0 Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDINGff RMIT.•$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 70 Dp .B® xI0.00=FEE:$ _30. Oct Check No.: Receipt No.: lya 23 Page 1 of 4 Locatio No. J-2Z Date J//-Y/,06- NORTH TOWN OF NORTH ANDOVER N w A * ; , Certificate of Occupancy $ E<� Building/Frame Permit Fee $ sACMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # L/M � i -3 Building Inspector TYPE OF SEWARGE DISPOSAL Swimming Pools 11Tanning/Massage/Body Art Elg Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ F1 Permanent Dumpster on Site ❑ Private(septic tank,etc. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner C '-- Signature of Contractor Plans Submitted ❑ dans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING 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 CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ C 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 Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 Building Setback Front Yard Side Yard Rear Yard Required Provided Re uired Provides q 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 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan2006 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) ❑ 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 TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT � 400 Osgood Street North Andover, Massachusetts 01845 Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE:— JOB ATE:TJOB LOCATION: Number Street Address Map/Lot HOMEOWNERS Qq,J J'_ Y-L,6kn q_�l l�g�ya9� SA-+►�� Name Home Phone Work Phone PRESENT MAILING ADDRESS ((o �57 Y►'i 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 hirewho 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 he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Fort Homeowners Exemption F NORTH Town of 4Andover 7/ Y C" - CA E dover, Mass., T ;> COCHICKEWICK AERATED `r BOARD OF HEALTH Food/Kitchen PER I T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... ... ... .. .. ............ ... ... . ...... ...................................... .................... ••••••• Foundation has permission to erect........................................ buildings on ... ... d ✓....�. .1/... .......s��_... Rough to be occupied as............�'I.. f....A0../4.�.r.. ....... rt lf...� .. ..... Chimn y e r onform to th arms of tVa lication on file in provided that the person accepting thi rmd shall in every respect c 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 PERMIT EXPIRES IN 6 MON;YS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TS Rough Service BUI 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. NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 16 / Gc)'TU tT— is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: (Location of Facility) Sign#6ie of Permit Applicant Fire Department Sign off: , moo Dumpster Permit ' ate