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Home My WebLink AboutBuilding Permit #421 - 1797 SALEM STREET 11/22/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION O` 1"oT 6 4, O A Permit NO: ,2 Date Received 'LZ — * i AT Date Issued: 'Z��f� �9SSACHu5E�� IMPORTANT: Applicant must complete all items on this page LOCATION / 77 q , G ,I s/-- /,, j PROPERTY OWNER Z?6 c/C; /./I` S Print IC/�j, /,,S 061 ef 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 ❑A r tion No. of units: epair, replacement ❑Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCAIPTION OF ORK TO BE PREFORMED � �tJ Identification Please Type or Print Clearly) �?OWNER: Name: O t1 4 ��/y1�4 �� Phone: 917f- O a Address: Z 7 Z7 CONTRACTOR Name: /46 Z&W Phone: Address: S/9/16M �' 71- /�Q rj /��J cele Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMA TEDf7OST BASED ON$125.00 PER S.F. Total Project Cost :$ lr 1 q00 FEE:$ �- J r Check No.: Receipt No.: k-61- Page I of 4 r TYPE OF SEWERAGE DISPOSAL Swimming Pools El❑ Tanning/Massage/Body Art ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to project XOTV Persons contracting with unregister a ontractors do not have access to the guaranty fun 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS ,c Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes l?, Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit i Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides 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) i i i -i i Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.1an2006 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 i ❑ 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 PP 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 1 Location%2 5 No. Date NORTh TOWN OF NORTH ANDOVER 10- 9 Certificate of Occupancy $ Building/Frame Permit Fee $ 7 s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1 19826 Building Inspector x.10 R Tly Town of tAndover 0 No. 0 LAKE o �` dover, Mass., // Z Z awo G o I� COCMICMEw1CK 7d ADRATED `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT..... BUILDING INSPECTOR P.01J j.C.�....... *.:�...�~ ............................................................... Foundation has permission to erect........................................ buildings on g .171..4'....'S* ..�/.rl.....J..4100�............. Rough tobe occupied as Re � 51410C........................................................................................................................... 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU T S Rough ....... ....... .. Service BUILDING INS 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. Page of ' Pmposai �- – - - ... r, / P03)631)-20C.5 PROPOSAL SUBMITTED TO PHONE DATE STREET - y/ JOB NAME CITY,STATE and ZIP CODE JOB LOCATION /. /i' /. r/i. •1/� ARCHITECT DATE OF PLANS JOB PHONE We hereby submit estimates for: .J � -� If�'L. JL- C ` //� r �/� f � �/•G LJ i1 r r � r J / 0 Jjt Lr 1 Lt C We Propose hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: V L dollars($ Payment to be made as follows: All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices. Any alteration or Authorized �f / r deviation from above specifications involving extra costs will be executed Signature - �-- - only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. NOTE:This proposal may be Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. Amptance of ftpO " — The above prices, specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified. Payment Signature will be made as outlined above. Date of Acceptance: > > - Signature AG T11 TONY OF NORTH ANDOVER OFFICE OF U6BUILDING DEPARVvIENT 1600 Osgood Street Building 20, Suite 2-64 Hu t.� North Andover, Massachusetts 01845 Gerald A. Brown Inspector of Buildings Telephone(9?S)684.9545 HO'�1EOV6 \;ER LIC"SE EXEMPTION Fax (9;.i)688-9542 P!case print DATE: JOB LOCATION: ,L— Number Street;\ddress / --- Map;Lot HOMEOWNERQ � .9 _ Na ome Phone d Work Phone PRESENT MAILING ADDRESS /A o/F � x�j Cary sown `e o �� 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 no acts as supervisor). State Building (Code Section 108.3.5.1) t possess a license,provided that the owner 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 th .+pplicable codes, by-laws,rules and regulations. e State Building Code and other The undersigned"homeoi ner"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 SIGHAl'LRE _4D_, / APPROV,\I.OF RLIL.DING OFFICIAL