HomeMy WebLinkAboutBuilding Permit #491-16 - 201 OSGOOD STREET 10/16/2015BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received l4 (1✓ 20f
Permit Ido#:
Date Issued:
IMPORTANT: Appli
LOCATION ZOl
S
must
all items on this
S<T�eEE
Print '::; -2�y�
PROPERTY OWNER
Print 100Y I ear Structure
MAP __PARCEL:_ ZONING DISTRICT:_ Historic District
Machine Shop Village
TYPE -OF
❑ New Building
❑ Addition
❑ Alteration
'9 Repair, replacement
❑ Demolition
PROPOSED USE
Residential
,K One family
❑ Two or more family
No. of units:
❑ Assessory Bldg —
❑ Other
4
yes no
yes no
yes no
Non- Residential
❑ Industrial
❑ Commercial
❑ Others:
Sept[c
� a1Nell',i M%1_11w®oapiain, u.Wyci 94�, i v:..
~'Water/Sewer
4L..
DESCRIPTION OF WORK TO BE PERFORMED:
OWNER: Name
Address: 20
Contractor Name:
Email:
Address:
%'(
(00.,0
tr
,r,�,iYLr�a V/7 Bt,
Supervisor's Construction License: Exp. Date:
Home Improvement License:
Date:
ARCHITECT/ENGINEER -Se et/— Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F.
Total Project Cost: $ l3,
FEE: $ /�k� V
Check No.:
__Receipt No.: ;29-�r.3 %
NOTE: Persons contacting with unregistered contractors do not have access to the guaranty fund
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tannin S
wimming Pools ❑
g/Massage/Body Art g
well ❑ Tobacco Sales
ckaging/Sales ❑Private (septic tank, etc. ❑ Permanent Dempster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
d
COMMENTS
Reviewed On Signature
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Comments
'later & Sewer Connection Driveway Permit
][)PW Town Engineer: Signature:
Located 384 Osgood Street
FIRE7DEPA Ili' , , r
R 16��NT - Tern
P: � _ yes
Located at,v4+Main ' LIIYI A -
�.. , _ , .Street
s er on site
+ I
FireiDe
partm�n sigriature/date
t _ F:
COMMENTS ,
Dimension
Number of Stories:_________ Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
EI EGTRICAL4: Movement of Meter location, wast or service drop requires approval of
Electrical Inspector Yes MO
®ANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.s1oo-sio0o fine
Doc.Building Permit Revised 2014
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
OTE: 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/Cross Section/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
OTE: 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
2012 IECC Energy code
Engineering Affidavits for Engineered products
TOTE: 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: Building Permit Revised 2014
Location 2,v
No.
Check # —7 :2n
Date ( 1
TOWN OF NORTH ANDOVER
t
Certificate of Occupancy $
Building/Frame Permit Fee $:166
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Building Inspector
Of NORTH TOWN OF NORTH ANDOVER
et OFFICE OF
A BUILDING DEPARTMENT
1600 Osgood Street, Building 20, Suite 2035
�,,,, �•���y North Andover, Massachusetts 01845
Gerald A. Brown
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE: /0& /20/S
JOB LOCATION: 20j 700,6
Number Street Address
HOMEOWNER
'�_3 a\K
Telephone (978) 688-9545
Fax (978)688-9542
Map/Lot
Name Home Phone Work Phone
PRESENT MAILING ADDRESS 6S000-6 S7f_f-F_7'
V, A" c) li� / h C /S �-
City Town State Zip Code
The current exemption for "homeowners" was extended to include owner occupied dwellings of one or two family
dwellings and to allow such homeowners to engage an individual for hire who does not possess a license,rop vided
that the owner acts as supervisor.
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 dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 CMR
Section I IO.R5.1.2)
The undersigned "homeowner" assumes responsibility for compliance with 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 8.2015
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535