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Home My WebLink AboutBuilding Permit #250-15 - 21 MERRIMACK STREET 9/12/2014 NORTH BUILDING PERMIT o` TOWN OF NORTH ANDOVER o ..I��) APPLICATION FOR PLAN EXAMINATION '' Permit No#. Date Received �DRArED gSSACHU`+�� Date Issued: Fzk///-/ IMPORTANT: Applicant must complete all items on this page j LOCATION , �Z) � / Print PROPERTY OWNER ,� I- �JPJQ� Print 100 Year Structure yes no MAP 0�1 PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial pp(teration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PEF?FORMED: Identification- Please T or Print Clearly _ OWNER: Name: 2 Z--" N-f Phone: Address: SP Contractor Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ t1� ,j a FEE: $ fJ r Check No.: 347/& Receipt No.: � 7)� NOTE: Persons contracting with unregistered contractors do not have access to the uaranty fund + Signature of Agent/Owner � ' Signature of contractor i I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans F1 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 PLANNING & DEVELOPMENT Reviewed On Signature_ 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 i Located at 124 Main Street Fire Department signature/date COMMENTS it Dimension i 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 Call Email Date Time Contact Name 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 o 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 o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses. o 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) 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) ❑ 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 o Mass check Energy Compliance Report ❑ 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 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 Doe:Building Permit Revised 2014 Location Z No. �'l�r� / Date Z • - TOWN OF NORTH ANDOVER D ` • . Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 1 �4 r 7 LJ 44- J - , BuiOing Inspector NORTfi Town of ndover o - - "t No. 15 * 1 h o ", h ver, Mass, SQA C.-C"t-IC" N, eo S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System r THIS CERTIFIES THAT ........ �.� ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, BUILDING INSPECTOR ......................................................... Foundation has.permission to erect buildings on �� '� ............. p .................................................. � .F ... ... gyp. Rough y t0 be OCCU ied as ./. Chimne 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 ST RTS Rough Service ....................... . .......... ... ........... .......... """" Final UI D G I RECT0R 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. 4�uxry TO"OFigORM.STDO {R. , - OFFICE OB BUffiDINGDEPARTAMNT ' ��p�`yb.� . :'I50D OsgoodStreetButlding2Q,•Surte?-36 7-�S� c u5�c�� •NorthAndovex,Massachusetts 01845 Gerald A.$rows, Telephone(978)688-9545 SnspectorofBuildings Fax (978)629-9542 ' . J0M 4WNER•LICEN,0E E�MNJPTION MUM�PRPMT APPLICATION Please PrLm DATE: , 13 LOCATION., a 1 ` _VIM Number S:�eetA.ddress r MaplZ of aMOWNER - Name• Home Phone _ Work Phone lRE,�ENT MAU-WG.ADDREss . .. . Ce Tot_=n7,p CDC! The current exemption for"-homeowners"•ryas extended to I chide owner-occupied diwelings to i��o units ox;ess and to allow such homed;vers to engage an,,_aj�idual•for hire who does notpossess a iicGnse,provided that the owner acts as supezvisor). State3uijding (Code Secf?on DEFMITION 0FROMEOWNEIR. Person s ()Who Awns aparcei of land on which he/she resides or intends to reside,an which %cIZ there xs,or is xnfended to be,a one or Cwo fau�ily structures. A p erson who constru cts more that one home iu.a i hi h fhoro rxo d shaij not c cansidered ahomeowner, The undersigned``horueowner"assumes responsibility for cbmpli.auces with the State Build' .Applicable codes,by laws,rules and-regulations. mg Code and other Thetmdersigned"homeowner"certfes that helshe imderstands the Town ofhlortb AndoverBuilding Departrnent "r"n;mum inspection procedures and requirements and that helshe will compiy withrsaid procedures and requirements, HOMEOWN$RS SIGNATME L� A�RP.ROVAL OF$TT I)MG OFFICIAL Revised 7.200.9 P'orm.Homeowners Exemption . '$OARI]OFA.PPEAT.S 688-954Ir T CONSERVATION 6889530 PIMLTH 688-9540 PL.&NNlNG 6889535