HomeMy WebLinkAboutBuilding Permit #831 - 2 HAROLD STREET 6/21/2006SA
Pennit NO:- S1,3/ -
Date Issued: Z:�z - Q -,(e
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received: (4, 6e
IMPORTANT: AoDlicant must comr)lete all items on this
LOCATION 1-1,qw-0Lz1> -5-1—
PROPERTY OWNER
Print A,
MAP NO.: 1--) PARCEL:
TYPE AND USE OF BUII,DING
ZONING DISTRICT:
HISTORIC DISTRICT YES 0
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
L-11 New Building
-i Addition
'L-- Alteration
BOne family
E Two or more family
No. of units:
Industrial
-�--�epair, replacement
--I Demolition
E, Assessory Bldg
C Commercial
F Moving (relocation)
L] Other
E, Others:
.-J- Foundation only
I
DESCRIPTION OF WORK TO BE PREFORMED fa - 1 -o -le .4cvr e- ,
Identifleation Please Type or Print Clearly)
OWNER: Name: Xll--141q�e-b F-,-r11Erz- Phone:
Address:— 1-14,e01--1> -C7-
CONTRACTOR Name: Phone: -
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECTIENGINEER Name: Phone:
Address:
Reg. No.
rEESCHEDULE: BULDINGPER1111T. $10.00 PER $1000.00 OF THE TOTAL ESTIMA TED COST BASED ON $125.00 PER S.F.
lotal Project Cost:$ xlO.00=FEE:$-30
Check No.: Receipt No.:4�,4
Pa -C lol'4
TYPE OF SEWARGE DISPOSAL
Tanning/Massage.,Body Art I
Swin-nuing Pools
Public SeNver
Well
Tobacco Sales
Food Packaging/Sales
Permanent Dumpster on Site
Private (septic tank, etc.
Electric Meter location to
project
iNv i t: Persons conti-acting ivith unregistered contractors do not have access to the guai-antyfitnd
Signature of Agent/Owner
Contractor
Plans Submitted
11
Signature of
Plans Waived 0 Certified Plot Plan El Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COIN/1NIENTS
DATE REJECTED DATE APPROVED
1-1 F1
[]Water Shed Special Pen -nit
El Site Plan Special Permit
El Other
DATE REJECTED DATE APPROVED
1-1 Ell
DATE REJECTED DATEAPPROVED
Zoning Board of'Appeals: Variance, Pctition No:
Zoning Decision/rcceipt submitted yes
Planning Board Decision: — ---- --soinments
Conservation Decision: Comments
Building Setback (ft.)
Front Yard
Side Yard
Rear Yard
Required
Provided
Requ t2q
Provides
Required
Provided
/
& Sewer connection signature & date
Tenip Dunipster on site yes—no— Fire Department signature/date
Building Pennit Approved and Issued by:
Page 2 of 4
DIMENSION
Number of Stories:
Total land area, sq. ft.:
14k) I tn�) an(i UA I A — (I- or
Pal -e 3 o 1'4
Total square feet of floor area, based on Exterior dimensions.
Doc: INNT( I IONAL SERVICU'S DITAR I MENTA311FOR
("Calcd.114C. 1:1,1_00f)
Water
j
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) -
Li Copy of Contract
u 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: I NSPECTIONALSERVICES DEPA RrMEN'r:RPF0RM05
Pal -e 4 44
Locationa t--4 j -)--
No. Date
Check #
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
s Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
�auii(�Ihonspector
104
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Gerald A. Brown
Inspector of Buildings
Please print
DATE: �;/-z //0,/,
'FOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 0 1845
HOMEOWNER LICENSE EXEMPTION
Telephone (978) 688-9545
Fax (978) 688-9542
JOB LOCATION: -2 h�4'e 4 Z> r r
Number Street Address Map/Lot
HOMEOWNER W,,,A_6 f*�,shTl,, /- F.�_ -1,5-�7�
Name Home Phone Work Phone
PRESENT MAILING ADDRESS 2 h�qecl_f) ,r/-
1410 12W e)IFYT, —
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-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
tilinimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Form Homeowner,,; Exemption
BOARD OFAPPEALS 63,P)541 CONSERVATION 088-Q530 HFALTH ()."-9540 PLANANC,
,)S3.5