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HomeMy WebLinkAboutBuilding Permit #640-13 - 22 LINDEN AVENUE 4/2/2013TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 6'Var Date Received Date Issued: �4'z 13 IMPORTANT: Applicant must complete all items on this page 5 r 1 PR.OPERTY7OVVNER Print 100 Year OIdSt�ucture yes no, MAP'NO:; Z PARCEL=_:_- 5 ZONING' l$-jTiRICT:. HistoricDistrict. `� yes) no, Machine Sl opNillagei yes,, no. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: 0 Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition 0 Other ❑ Septic ❑ Well ❑. Floodplaitl Wetlands: 6 V1/ate,rshedrDistrict. . D .Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: ARCHITECT/ENGINEER Phone: 0 Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ �2; n©y FEE: $ :36. O 0 Check No.: '-;?6/ Receipt No.: �26-2,i7 . NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature ofAgent/Qwner' Signature of'contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comm uonsen,ation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Towu Engineer: Signature: Located 384 Os ood Street FIRE DEP�4RTMENT Temp Dumpster on site yes no Located at 124sMat�Street .:fir,"a.; +3. �- A.t�+t '„•t.w• - J Fire—D” COMMENTS. ,.^!1"' y... 4. ,�atp i �1.. { elf t o' e t i < ' + � a e �--..r ik. ..:Fr {y r�"`r:t ct '*}•; `E.r 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 ® Notified for pickup - Date Doe.Building Permit Revised 2010 Building Department The foOwing 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 u Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks u Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit u 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) u Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Copy of Contract D 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 app, 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;tted with the building application Doc: Doc.Building Permit Revised 2012 2�-4) Location I -/I /. -,-/ We --v No. -6 1-3 Date Y/az/ TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL Check # 26247 /building inspector M x J LU LL O cl: O m O LL E Y ? V) Q V) O Z Z m c 2 p 3 LL � N CC C U f7 C LL 0 V Z Z ca J d t 7 p w C LL Ot-• W Z J U u W J W t to O O' U y V) LL c O LLI d V1 Z c7 t 7 O c LL z W Q ui LLJ 25 LL v 7 CO z +'' N �+ V) y E V) O O U W :a Z Z 0 d1 �O zV W Z w0 ~ Un �w a Z C: .N W D U) W W oC .W H 11 c O c cC p CL D �a o N V E g L N yp+ c � O 0 0 E cn Q 3 in "s $ > Cc c °' d O O U W :a Z Z 0 d1 �O zV W Z w0 ~ Un �w a Z C: .N W D U) W W oC .W H 11 }ofµ moo' .y4 TO" NO1tTH ANDOVER 6 afi OFFICE OF BUILDING DEPART • � MENT ` a ,Ph _1600 Osgood Street Building 20, -Suite 2-36 f •PO ca•u,t.�R. �V rec�5 North Andover, Massachusetts 01845 Gerald A. Brown Telephone (978) 688-9545 Inspector ofBuildings Fax (978) 688-9542 + E HOMEORNER•LICENSE EXEMPTION BUMING PERMIT .APPLICATION ]ease rint DATE:_ 4-/& 3 J013 LOCATION: `2, - L v Number Sir'eetAddress IJOMEOWNER el- ASO N Name 11ome Phone PRESENT MAILING ADDRESS Map/Lot 1 2 StjL/ -S4' 2 Work Phone City Town Statp . ZiCode The current exemption for "homeowners- was extended to incl, owner-occdpied dwellings to two units.or less and to allow such homPot;ners to engage an i;idividual•forhlre who does not possess a i cense, provided that the owner acts as supervisor). Slate Building (Code Section 108.3.5.?) DEFINITION OF HOMEOWNER Persons) who gwns 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 farm- ly structures. A person who constructs more that -one home in a two-yearperiod 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 Forth Andover Building Department require rn inspection procedures and requirements and that he/she will comply with,said procedures and requirements, HOMEOWNERS SIGNATURE .A1PPROVAL OF BUILDING OFFI Revised 9.2009 Form Homeowners Exemption BOARD OF APPEALS 688-954o. 1 CONSERZ, AT10N 688-9530 HEALTH 688-954D • PLANNING 688-9531 If 41 lu 451- 14 Iq 04 0 4/(/2013 RA !� CA? ll,yll F.T.- 06Wr(IlT65-(-S 4) AD9 - \AJ( t4A 0 Cl e PS Vx-tof-,r -rw/t-ps-t 2x4-P.1-tAAOo-FAi�, st)Mjz7rS - '51MC-7LC ©ms ID' -s 4Ai�J-DV-AtL-� 22 t-IMVt-:rl AVS, NOV-114 AftID6V5'P-,fvA61 i N4" - E5'x I S-ri 0 C, F1