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Home My WebLink AboutBuilding Permit #865-11 - 22 RALEIGH TAVERN LANE 6/17/2011mit lit TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ?K S // Date Issued: (01/7/// EVRORTANT: Date Received icant must complete Print Print MAP NO: .,# PARCEL:/ ZONING DISTRICT: all items on this Ll. Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT I PROPOSED USE Residential Non- Residential ❑ New Building grOne family ❑ Addition ❑ Two or more family No. ❑ Industrial ((Alteration of units: ❑ Commercial 'Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other M OF WORD TO B l�-ER�rO ,D: (Identification Please Type or Print Address:— 12 C-ft�E CONTRACTOR Name: Address: Supervisor's Construction License: Home Improvement License: ARCHITECT/ENGINEER )Exp. Date: )3xp. Date: Phone: lit Address: Reg. No Phone: 6,5s- tubo 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: $ 3 oz� Check No.: Receipt No.: P YZ 7 7 NOTE: Persons contractin it unregistered contractors do not have access to the guaranty fund A Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Wel ❑ 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 COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED Is DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board'Decision: Comments Conservation Decision: Comments W. Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Deparhnent signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. i.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval or 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 de artment use ® Notified for pickup - Date Doc:.Building Permit Revised 2008mi 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 13a"porkers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Per Addition Or Decks ❑ Building Permit Application ❑ Certified 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Perr 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 ❑ Engineering Affidavits for Engineered products I"OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Fern 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: Doc.Building Permit Revised 2008mi -7 Location No. F4 // Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ IT us I Building/Frame Permit Fee $ Check # Foundation Permit Fee $ Other Permit Fee TOTAL 2 4 Zi Building Inspector NORTH TOWN OF NORTH ANDOVER o OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2=36 '7�s A,,,, North Andover, Massachusetts 01845 SAc►+uS Gerald A. Brown Telephone (978) 688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERYHT APPLICATION Please print DATE: !d JOB LOCATION: Number Street HOMEOWNER � U'Vt.1-t_.{ Name Home Phone Map/Lot 6ss1100 Work Phone PRESENT MAILING ADDRESS 22,R-�; cry/ UV Uty Tovrn . S+„ rw . . 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 Awns 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 WWthat he/she will comply with,said procedures and requirements. HOMEOWNERS SIGNA X_ APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 0 z x o V w cn U A4 w w U w" W w w W a4 v cn u. x O c� u. z w , co zCd cn v Q V). E CD L Z y O i N C cm 0 cc O7 C m O C! c �C N CD t 0 Z J 0 o L 0 O H C I CO CM C C CA o 'a o � m m c ` O_ y CD 0 VO V Cc a- 0 d CMQ C CL CJ J .� ea p �• : t G C..± h 0 .0 C _cc h A E Q 0 m C 0 c. h O m mC o .s . Ca o iv 'a '= C h A m LSO CD 0 . CLU L N m � V.a=z CD 22� hcc Cj Z H m C. : C42 - -m CD o� 3 C, O VD W CO r.'C •N .n.. C A C � •E C � C.tLL, y V O V .0 _v CD p JCD C_ C. 0'.� O .0 COD V) 2-5 0yo 2 =wa4-m E CD L Z y O i N C cm 0 cc O7 C m O C! c �C N CD t 0 Z J 0 W 0 0 C4 OC W LLI 19 LLIW 0 L 0 O H C I CO CM C C CA o 'a ■- m m 0 CD CD 0 O Cc a- 0 d CMQ C c Cc CJ J .� C 0 CD CL C..± h 0 .0 C _cc CL C* 0 W 0 0 C4 OC W LLI 19 LLIW 0