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HomeMy WebLinkAboutBuilding Permit #649 - 214 SUTTON HILL ROAD 4/6/2007i Permit NO: zlq Date Issued: h /,7 --7 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE AND USE OF BUILDING utcrnnr�q T%VL w"Mw. — _ TYPE OF IMPROVEMENT PROPOSED USE ❑ New Building ❑ Addition . ErAlteration Residential ,Bane family ❑ Two or more'family No. of units: ❑ Assessory Bldg Non- Residential 0 Industrial ❑ Repair, replacement 0 Demolition ❑ Commercial 0 Moving relocation 0 Foundation only nPgrUTVTTnM nu 11unDi/ -r^ nr. ❑ Other ❑ Others: — a --am vi TV % lU%m 1 V 13z rr%jcrUMML1J '7Z;41 tW ,* y CN LA0 2 Cov, Lta Identification Please Type or Print Clearly) OWNER: Name:_ -7/Voa p/L f-�ISA Address: GG CONTRACTOR Name: Phone Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: /i JhIT Address: Reg. No. FEE SCHEDULE: BULDING PERMIT.• $12.00 PER $100a00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER &F. 10__t21 Project Cost :$ S I., -<ZO FEE:$ 1 - f - Check No.. a ?16 b Receipt No.: o� Page I of 4 t TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art E]Public Swimming Pools ❑ Sewer ❑ ❑ ❑ Tobacco Sales Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site 11 Private (septic tank, etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Own :� Signature of contractor Plans Submitted ❑ Plans Waived ❑ e 'fled Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION COMMENTS HEALTH DATE REJECTED DATE APPROVED 0 DATE REJECTED DATE APPROVED ❑ ❑ COMMENTS - FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 I Building Setback ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided / / Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions._ Total land area, sq. ft.: NOTES and VATA - 3 of 4 Created )MC. Jen.2006 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 o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/or C.S.L. Licenses a Copy of Contract a Floor Plan Or Proposed Interior Work Addition Or Decks o Building Permit Application a Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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) o 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 Doe: INSPECTIONAL SERVICES DEPARTMENT:BPFORMOS Page 4 of 4 Locaiion I,, 6�0 -11A241 - No. g< Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ 't Building/Frame Permit Fee $ CHU Foundation Permit Fee $ Other Permit Fee TOTAL Check # a;_�CM— — 20'164 A � Building Inspector � rr � C � x O x a C +�+ O N C V C3 d10 a .0 , U w O w x w°' w w a` o cn LIJ z E z w N N CD O oc ca c m 0 CD C C A • 4w O Z O g 0 T 0 W a O U U) O .3 v P4 y O '7E CD it O v ev y 0 c. y 0 V O C _cc C. CA G 67 C. CA C O CM C C O•— C � CD •� m m 3 .o O o` L d O a c_a = C •o a� Z CL C W 0 U) U) 19 W W W N C � O � O C +�+ O N C V C3 d10 C C W W m ;= O O E a CF a` o 0 n o N E c �m o O� ald N C ;C m �Co.= �c N � = N E� m o a� j v N ev Z _ m 3 W C Z W C F. W N E O.Z � m�cm rs.1 y N a� N= �aOm E z w N N CD O oc ca c m 0 CD C C A • 4w O Z O g 0 T 0 W a O U U) O .3 v P4 y O '7E CD it O v ev y 0 c. y 0 V O C _cc C. CA G 67 C. CA C O CM C C O•— C � CD •� m m 3 .o O o` L d O a c_a = C •o a� Z CL C W 0 U) U) 19 W W W N TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building ?0, Suite 2-64 �4 North.kndover, Massachusetts 01845 Gerald A. Brown Inspector of Buildings DATE: Telephone (97g) 6,S&95= HOMEOWNER LICENSE E`CE%IPTIOIN Fax 197y) 6,S,9-954 JOB LOCATION: Number Street :Address �— Map/Lot HOMEOWNER��„ p o,G � L/..S/�— � me� Name Hochore Work Phone PRESENT MAILING ADDRESS 0i A e4wrD a � City Town State �.i Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less 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) and 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 be, a one or two Family structures. A person who constructs more that one home in a two-year period shall not he considered a homeowner. to The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws. rules and regulations. The undersigned "homeovmer" certifies that he, she understands the Town of North Andover BuildingDepartment - minimum inspection procedures and requirements and that he.'she will comply with said procedures and requirements. �p.urtment 11O IEOWNERS SIGNATURE 1PPROV;A1. OF RUILDING OFFICLkl- ;; � � - `.I-�.��, I•., , �. "{ I :�.1L�H ,.-,'.iii {, � o , . - o . \ .§ . � 2 . . � 2 \ 10 .® � ; \ LO . k }.< o - c k) e U)k cm Q0 ■ G 2 )� § a § § \ § E 2 0 §Q '& .1a 2 3 E k ) )§ k k2 ©Ea2 «@a E M 'D� 2 § L © « m � £ � ±2 );§ 32)) Lf) . rrF § 0 A? k ) . 0 ) e �� D- AD - 22 § { 2 �\E . § o e Lu o { a t & ffmK . �--- }/ — �Q � � 0 0 n Q X O c 7 C O N M c} V O " Z C C C l0 y N (� z ta�pp SSC U N ui U w o in 'a c N N t 0� f0 EL 6 � Q � LU00 F _0 o t c . o O c L N C o 0 O) O z N o N d' C: Z O a i c LU N o 0 L � Y cy w c3 T N w i O aD N I i C_ O � tp � W � � to i i --- --- — - - - -------------- - --- m to O Q z c N a u9l£ NO N O _. C N C ` C 9 r % C 'O 7 O C1 Z TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 1600 OSGOOD ST BUILDING 20 SUITE 2-36 NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE 4f/61 o % JOB LOCATION 2 �� SAN T"SGL / j / 00W 7ir?0VVZ Of NORT1{ 4,llC �b O�Q F A s SACHuse Number % Street Address p Map/Lot HOMEOWNER � jp0L //Kt 4 t,% � 7U 69f f Z(� Z_ Name Home Phone Work Phone PRESENT MAILING ADDRESS City/Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of 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, one or two family dwelling, attached or detached structures 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. The undersigned "homeowner" assumes responsibility for compliance 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. HOMEWOWNER'S SIGNATURE _ APROVAL OF BUILDING OFFICIAL