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Home My WebLink AboutBuilding Permit #608 - 162 HAY MEADOW ROAD 5/12/2009 BUILDING PERMIT o*"°oT 6 TOWN OF NORTH ANDOVER 0 .` A. *° �° APPLICATION FOR PLAN EXAMINATION b Permit NO: b D r Date Received ^CHUS t Date Issued: /2 IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER - )euSe- Print MAP NO:� ;6CEL:��ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residentia Non- Residential New Building q2nefamilyAddition o or more family Industrial Alteration No. of units: Commercial e air re lacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: ReOlc,ce 000d4 ��A"kA Identification Please Type or Print Clearly) OWNER: Name: Fc9ta ^ e<<1'e Phone: l Address: CONTRACTOR Name: SeV� Phone: I(G0"3 ) eqS-- 8508 Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER n JA 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: $ (n, L100 FEE: $_�� Check No.: 0 Receipt No.: `2 2 d2 NOTE: Persons contractingn* nregistered 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 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 I 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 i Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Loc ed—384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date oe7v COMMENTS Dimension Number of Stories: 0 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 o 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 Location/ gZ No. Date ? _ &O RTH TOWN OF NORTH ANDOVER 41 F p i ; ; Certificate of Occupancy $ �SswcausE� Building/Frame Permit Fee $ �Z 7'�" Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ( �1 22023 '7 Building Inspector NORrM TOWN OF NORTH ANDOVER OFFICE OF p BUILDING DEPARTMENT * 1600 Osgood Street Building 20 Suite 2-36 North Andover'Massachusetts 01845 �Sswc►n►s'�t Gerald A Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: slit I I JOB LOCATION: I (o a 14 4 flecAnio Pa. Number Street Address Map/1& HOMEOWNER ,,;�n�i ease 1(q��l (o g7 I a'45 Name Home Phone Work Phone PRESENT MAILING ADDRESS I (02l Novfarne,3 �� - - `�l. Avtilo�er `rl1-I 0I8is- 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-yearPeriod 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 un "homeowner"certifies that he/she derstands the Town of North Andover Building Department minimum inspection procedures and and that he/she will comply with said p and r+eguire�rits. 7 HOMEOWNERS SIGNATURE t APPROVAL OF BUILDING OFFICIAL 1:evind 10.2005 Form Homwwnw Exemption I il(L\RD OF \PPEAI.S 688-9541 CO.\SERC.1'I'ION 688.9530 HEALTH 688-9540 PL.\-\,\I\G 688-9535 ` � I I 1 The Commonwealth of Massachusetts Department ®f Fire Services Off-ice of the State fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover, 1PermitNo :Di fe g SaNnm er (Cityof Tawn) (Lf Applicable) In accordance with the provisions of NLG-L.1 Li$Chapter_]_Q_as provided in section 9-22—EMR 3 4 start Dace / This Permit is granted to.. Full name of person,Firm or Corporation Pennissionto locate dumpster for construction/renovation/demolition of building. Comments dumpster must be . 25 ' from structure if unable to place with required Restrictions:clearance dumpster must be covered with Plywo. od or tarp end of work day at /C 117 i c,/ (Give locafion by street and no.,or descgibe in suchma to pro a4equate identification of location) Fee P aid$ 50.00 ? � 'w Fire Chief This Permit will expire �'/„1 - (Signature of offical granting permit) Oscal granting permit (Title) NORTH Town of 4Andover No. LE dover, Mass., C T Q COG MICMEwICK V 7d ADRATED C7 S E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR ............... ............... THIS CERTIFIES THAT........p G(1.. .1/..... ....('.c.; .r............................. Foundation has permission to erect........................................ buildings on .:/...6... �... . 4.. . ..../ .................. Rough 1 t , to be occupied as........ ,d .....��z. .... ... f. .. ....... r.'.�:�r � ! ................................................ Chimney provided that the person accepting this permit s6l,in every r pact 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 ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough ...............................� .........4c" /..... .................. Service BUILDIN INSPECTOR Final Occupancy Permit Required t0 Omipy 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.