HomeMy WebLinkAboutBuilding Permit #817 - 183 CARTER FIELD ROAD 5/14/2012BUILDING PERMIT
TOWN OF NORTH ANDOVER -
APPLICATION FOR PLAN EXAMINATION
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Permit NO: tate Received _ _ � �'7s� ATE. •.���-c�
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
11 Two or more family
❑Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
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OWNER: Name: /`0 r-) r �e�' Phone: a5 8 -a9 7 a
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ARCHITECT/ENGINEER,
Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED
BAASSED,
ON $125.00 PER F.
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Total Project Cost: $ D FEE: $ ”`
Check No.:� Receipt No.: o�S
NOTE: Persons contracting withl0hW4tered contractors do not have access to the guaranty fund
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Location
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No. / Date
0. TOWN OF NORTH ANDOVER
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` Certificate of Occupancy ,' $ .
Building/Frame Permit Fee $
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' Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #50�+ v
25298 Building Inspector
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 ❑ f y
COMMENTS bo /�%/ t-e�,� �t-e
CONSERVATION
COMMENTS lM
HEALTH
COMMENTS
Reviewed on '-5-
Reviewed
CD 0`
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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:
4
Located 384 Osgood Street
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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
DOTE: 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
V®TE: 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
o 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
M OTE: 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 trust 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 DEPARTMENTMFORM07
Revised 2.2008
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TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, -Suite 2-36
North Andover, Massachusetts 01845
Gerald A. Brown
Inspector of Buildings Telephone (97$) 688-9545
UONMOWNER-LICENSE PX EW Fax (978) 688-9542
BUIDING PERMIT APPLICATION
Please print
DATE:
JOB LOCATION:
Number Street Address
Map/Lot %.7
�10MEOWNER Ue—h
Name Home Phone %VCI�S rJ� 02 g % a
Work Phone
PRESENT mAi LING ,A,DDRESS
Cit Tr'VM/ V
. St„ +e . Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings to ttivo units
State Building (Code Section 108.3.5.1)
to allow such homeol, ens to engage an individual -for hire who does not possess a license, provided that the own rnd
acts as supervisor).
DEFINITION OF HOMEOWNER
Persons) who gwns a parcel of land on which he/she resides or intends to reside, on which there is, oris intended to
considered a homeowner.
be, a one or two family structures. A person who constructs more that one home in a two-year period shall not e
be
The undersigned "homeowner" assumes responsde and other
ibility for compliances with the State Building Co
Applicable codes, by-laws, rules and regulations.
The undersigned `homeowner" c
ertlfies that
minimum inspection procedures and equine eats a�that he/she will comply w th,said s the Town Of North oroceduresver mg Department
requirements. P and
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONTSERVATION 688-9530F '
HEALTH 688-9540 PLANNWG 688-9535
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