HomeMy WebLinkAboutBuilding Permit #426 - 21 MORRIS STREET 11/27/2006 TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION o�<t�•° 6,91'0
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Permit NO: �Y Date Received �d
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Date Issued: z , 9SsgCHU
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IMPORTANT: Applicant must complete all items on this page
LOCATION - o r V'6 � --
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PROPERTY OWNER Et n do v�k '�a rl;4�,� � /ry101-+��a P&4,-QeL t S
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MAP NO.: PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑New Building g One family
❑ Addition ❑Two or more family ❑ Industrial
Alteration No. of units:
❑ Repair, replacement ❑Assessory Bldg ❑ Commercial
❑ Demolition
❑ Moving(relocation) ❑ Other ❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
Identification Please Type or Print Clearly)
OWNER: Name: Ir-oho ?Gra u t A-Kw Q �d-t S Phone: 00
f SC7 0
Address: ZRd r(i S cJrheC4 , N` �ni��vcr 01$`��
CONTRACTOR Name: lW+vle. Ezc Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATE CST BASED ON$125.00 PER S.F.
Total Project Cost :$ 20 ,00o.(3O FEE:$ D --
Check No.: d' �jReceipt No.: LJ 1-3
Page 1 of 4
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well F1Tobacco Sales ElFood Packaging/Sales El
Permanent Dumpster on Site 11Private(septic tank,etc. ❑ Electric Meter location to
project
NOTE: Persons contracting with un istered c ctors do not have access to the guarantyfund
Signature of Agent/OwnerSignature of contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
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INTERDEPARTMENTAL SIGN OFF-U FORM
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DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
ermit
❑ Other
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
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
Temp Dumpster on site yes_ V" Fire Department signature/date
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Building Setback(ft.)
Front Yard Side Yard Rear Yard
Required Provided Required Provides Required Provided-
Dimension
rovidedDimension
Number of Stories: Total square feet of floor area,based on Exterior dimensions.
Total land area, sq. ft.:
NOTES and DATA—(For department use)
11/0
Page 3 of 4
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created IMC.Jan.2006
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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)
❑ Copy of Contract
❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Page.4 of 4
Location /,;-I Iva n-2i jyr--
No. ?li Date f 'ate
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N°RTM TOWN OF NORTH ANDOVER
1 9
10 Certificate of Occupancy $
Building/Frame(Frame Permit Fee $
s'4cMust 9
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # rl
19831
V Building Inspector
NORT#1 '9
ONM Of _ Andover
o �` dower, Mass.
COC NICHE WICK
SRATED C3
BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
THIS CERTIFIES THAT......jj.P.-.4. rh........ « rf ................ ...................................................... BUILDING INSPECTOR
Foundation
has permission to ere ........................................ buildings on .Al......... Q",. .........W .................... Rough
to be occupied as... f �s .r ���*!N �....... Chimney
.. ................................................................
provided that the person accepting this permd shall in every respect conform to the terms of the application on file in Final
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
DO av PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRU N TS Rough
........ .. .... ....... .. ........... Service
. .... .. ... . .. . .. .....................
BUILDING INSPECTOR
Final
Occupancy Permit Required to Ocmpy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. Bumex DEPARTMENT
Street No.
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LIVING AREA
1388 sq ft
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BASEMENT DEPRESS TOP OF
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p� ry�RTH TOWN OF NORTH ANDOVER
OFFICE OF
p BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-64
Q���TFO rTP`<y North Andover, Massachusetts 01845
9SS qc wusE�
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:
JOB LOCATION: 02 M�1�V I S StvuX
Number Street Address Map/Lot
HOMEOWNER Bre,vi&pvi Avg lvia. Pis �_P,- Sq-8' R
Name Home Phone Work Phone
PRESENT MAILING ADDRESS at k psi S S-h/ g,J-
Nfbv Avj pvtv- MA o t f5
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
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Fenn Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-
9535