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Home My WebLink AboutBuilding Permit #084-14 - 21 MERRIMACK STREET 7/25/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ® Gf` Date Received Date Issued: �J IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNERS V .��/ Print 100 Year Old Structure s MAP NO:un PARCEL: ZONING DISTRICT: Historic District es 0 Machine Shop Village TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 2111fepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District El Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Al �ntificafi�► Please Ty a or Print Clearly) OWNER: Name: �J� � C.-/�f� �� Phone:09 �D-- SY6 Address: � LT/1�/?-�/t'yd _ CONTRACTOR Name: cY hone: ' Address: 99 llt,-17td-A-,� loq boo M),, �6",9V&C, Supervisor's Construction License: o635727 Exp. Date: 01 41 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. 9 � FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: // Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner _ TSi-nature.of contractor tl Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE:OF`SEWERAGE DiSP.OSAL ! 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 i 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 Dumoter on site 'yes. no Located at 124 Mair, Street Fire Departinert signature/date r COMMENTS T 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 I ® Notified for pickup - Date Doe.Building Permit Revised 2010 Building Department The fohnwing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses L3 Copy of Contract o Floor Plan Or Proposed Interior Work Li Engineering Affidavits for Engineered products prior to issuance of Bldg Permit permits require sign NOTE: All dumpster pe n off from Fire Department p q g Addition Or Decks Li Building Permit Application { o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: 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 apo-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm:?ted with the building application Doc: Doc.Bui?ding Permit Revised 2012 Location 7� G < - No. Date 71.1 0/ L • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ �` Foundation Permit Fee $ Other Permit Fee $ TOTAL $ a Check#J 7 f j v Q Building Inspector i i Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS-063987 rIICHOLAS A IPPOUT O J -T, 89 AUTRAN AVE -,r} N ANDOVER MA,01845 Jam• ��t41"X.N Expiration Commissioner 03/25/2014 NORTH Town of s EAndover 094 14 _ _ h , ver, Mass, : Q coc CHlW.CK[ 1' A0'SATED S V BOARD OF HEALTH PER T L D Food/Kitchen Septic System / BUILDING INSPECTOR THISCERTIFIES THAT ......... ..... .. . ... ....................................................................... has permission to erect buildings on �� '`�^"'�� Foundation .......................... ............................................................................ Rough to be occupied as ............ .d1..✓. -�'l .C..,� a.........!. . �✓. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ............................................... Service ........ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE �{ .r0tD r Nd rrl� Ol} NOR Q -�o TO TH ANDOVER Otte- ' ° OFFICE OF BUILDING DEPARTMENT a�ii --• ph �` :'1600 Qsgood Street Building 20,-Suite 2-36 y�ssAPLIS c�y •North Andover,Massachusetts 01845 Gerald A.Brown Inspector of Buildings Telephone(978)688-9545 HOMEOWNER'LTCENSE EXEMPTION ` Fax (978)688-9542 ]GUIDING PERMIT APPLICATION Please mint DATE: 2 j J013 LOCATION: Number SireetAddress r Map/Lot I�TOIvSEQViTNERJ�� /�6 ��i`_ y ' Name. Home Phone p 3 5-�� Work Phone PRESENT rvrarr" �^ ING ADDRESS _4 T zz _C`m Stafte. Zip Code The current exemption for"homeowners"was extended to include owner-occupied dtveltings to two units or I- „ to allow such i�o,nPo,.tnexs to engage an i�dividual•for hire wao does not possess a-license,provided That the owner d acts as supervisor). State Building (Code Section for hir,' DEFINITION OFHOMEOWNER Parson(s)who Qwns a parcel of land on which he/she resides or intends to reside,on which where is be,a one or two family structures. A person who constructs more that one home in a two-yeher eis,O shall not e or is intended to considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Applicable codes,by-laws,rules andregulations• Building Code and other ' The undersigned",Homeowner"certifies that he/she minimum inspection procedures understands the Town of North,AndoverDepartment De artment and requirements a requirements, rid that he/she will comply witn,said procedures and HOMEOWNERS SIGNATURE AI'P.ROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-954] CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535