The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #248-12 - 19 SURREY DRIVE 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: q( /L--, Date Received Date Issued: Il%APORTANT:Applicant must complete all items on this age LOCATION `1 Sia f-4 br. N�o fk NNLcr ei 61� 01$4� _ Print PROPERTY OWNER Csk z nv\ Unit# Print MAP NO: 7 y PARCEL: yb ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: 0 Other h CfiDepmolition -I ,,_ AY� ri lo dplav�� DWetlarids ®W t edD sbrct }`' (® Se tic (❑We11- i � DESCRIPTION OF WORK TO BE PERFORMED: �'eAc:n, Q,�1 d\�. kc� ,� o nJ� �•�` fy r �<:�c�et. ce 1"oAek We y�c�VL D� Lc7r`f�.C�ur CcIA-,n` pec,.! (Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: [�l ��, rrc, �r CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: " Home Improvement License: Exp. Date: 4 , ARCHITECT/ENGINEER Phone: Address: Reg. No. - FEE SCHEDULE.BULDING PERMIT.'$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: s I% FEE: $ /4'_f.Oe1 Check No.: IZ7'- Receipt No.: NOTE: Persons contracting WA unregisMrecontractors do not have access to the guaranty fund . .....::. . . r 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 FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 1 ❑ 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 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 VOTE: 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 CIerks 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: Doc.Building Permit Revised 2008mi Location No. a?!i -/Z Date AORT" TOWN OF NORTH ANDOVER 0v, 0, O L a i • • > . Certificate of Occupancy $ s�CHUS<� Building/Frame Permit Fee $ Z 5'e/ — Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # =— i 246'11 B ilding Inspector of µ0 or a�ti TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20,-Suite 2=36 North Andover,Massachusetts 01 845 SAFNUSE Gerald A.Brown Telephone(978}688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERYHT APPLICATION Please print DATE: 3 JOB LOCATION: Number Street Address Map/Lot HOMEOWNER`T � t #1 . Nafne Home Phone Work Phone PRESENT MAILING ADDRESS— PL-_,r - 'y Town Zip Code- The odeThe 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)whoAwns 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 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 NORT1y Town of r =_ o , dover, Mass., • CoC MIC ME WICK AD5'4 TED o`PF`�,�5 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT..................... ...0. !! ............. ... .. !........................................................................ Foundation has permission to erect........................................ buildm son ,. S. P • g ... ..... ........... �P......%. ....... Rough to be occupied as.... N...... ' .. ......... ...... .�.�......'Life. .111 .......1sr. . provided that the arson ccs a tin this ermit shall in eve r p p g p ry aspect conform to the terms of thepplication on file m Tinal"" 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 D3 rip ELECTRICAL INSPECTOR UNLESS V LESS CONS V C O T S Rough ........................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough 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.