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Home My WebLink AboutBuilding Permit #406 - 23 FOREST STREET 11/29/2007 BUILDING PERMIT of pORTF1.,UF° s,qti TOWN OF NORTH ANDOVER0 02 APPLICATION FOR PLAN EXAMINATION Permit NO: Z-62L Date Received w �SSACHU`�� Date Issued: I/--f/7 IMPORTANT:Applicant must complete all items on this page LOCATION " Fo to."t N A. 1 P v1_t1rint ` ' PROPERTY OWNER f Q.✓� y^ Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no 'Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed'District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: WDL>ck co/T Identification Please Type or Print Clearly) OWNER: Name: �Se•ny Cc��,D7vf; Phone: Address: 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: $ -$Ud FEE: $ I,/� Check No.: /feu Receipt No.: '-qa,?2 7 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund r. Signature of Agent/Owner Signature of contractor Location3 No. 7 Date �ORT� TOWN OF NORTH ANDOVER 3? ' OL F 'y Certificate of Occupancy $ t<� Building/Frame Permit Fee $ 8ACMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 C . 1 � /Building Inspector 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 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 Con nection/Sig nature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 i Doc.Building Permit Revised 2007 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 ❑ 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 ❑ 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 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 ❑ 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 NORTH own of Andover No. 40 (0 ? 0 dover, Mass.,- 0 COC L11 WIC A. 004 MIC HEWICK\11 C2 RATED 0 BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT.........../_� '^7-/ V .............................................. ....... .................... ............................. Foundation has permission to erect........................................ buildings on ...... rf.'.5. e.............................................. Rough to be occupied as.................... zz)a 0—C/ d. ................................................................... Chimney provided that the person accepting this permit shall in eve rV 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 PERMU EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIOY S ARTS Rough ............. ..... .............. .................. Service.......... BUILDIN PECTOR 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SUDE Smoke Det. ,�ORTq TOWN OF NORTH ANDOVER ° t"'° '• '" OFFICE OF BUILDING DEPARTMENT s° 1, +� 1600 Osgood Street Building 20, Suite 2-36 o�.�`�# North Andover,Massachusetts 01845 1ssACMUs�t Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please 1 DATE:, JOB LOCATION: �c}✓e �1' S Number Street Address C Map/1.ot HOMEOWNER l Ai'''1 E Name Home Phone Work Phone PRESENT MAILING ADDRESS 5 A 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. (n�. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Fo m Homeowners Exemption ROARD OF \PPE.U.S(M-9541 CUNS.ERV.vrio�688-9530 ITE_ rrii 688-9540 PLANNING 6 8-9535