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Home My WebLink AboutBuilding Permit #153 - 247 GREENE STREET 8/28/2006 TOWN OF NORTH ANDOVER 1iORTh APPLICATION FOR PLAN EXAMINATION 0`�1"o 16}9tiO 2 0 i A Permit NO: J Date Received LS- q�RArno Date Issued: [i "b �S'N CHU5-� IMPORTANT: Applicant must complete all items on this page LOCATION e,-, Print PROPERTY OWNER Print MAP NO.: ARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: epair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRI TION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: �� Phone:52f— Address: CONTRACTOR Name: 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 ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ FEE:$ ,C.dl Check No.: A11A Receipt No.: / Page 1 of 4 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 Pane,4 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools 11❑ Tanning/Massage/Body Art E]Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ 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_no Fire Department signature/date QE/ 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 DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 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 DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC.Jan2006 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ F1Tanning/Massage/Body Art E]Public Sewer Well 11Tobacco Sales ElFood Packaging/Sales El❑ Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans aived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ 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 Vno Fire Department signature/date Q �— i 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 Noe 4 of 4 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONNORTh O t�eo 06�+ O o ti toPermit NO: r A Date Received r2 O e5 x t Q�,Z _ D Date Issued: �9SSAC MUSEt�s IMPORTANT:Applicant must complete all items on this page LOCATION PROPERTY OWNERPrint Print MAP NO.: ARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑ One family ❑Addition ❑ Two or more famil ❑ Alteration y ❑ Industrial No. of units: epair, replacement ❑Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRI TION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: -- �� Phone:�7eC~ Address: CONTRACTOR Name: Phone Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:SI2.00 PER x1000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S.F. Total Project Cost 24 FEE:$ Check No.: ,vA Receipt No.: / Page I of 4 r Location , 7�` &Yee, Yr — Location 4A3 . Date I ( 00(� - MORTq TOWN OF NORTH ANDOVER � P • y Certificate of Occupancy $ ��a ^°•E<�' Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ r, Other Permit Fee $ TOTAL $ Check # BuildingInspector yyoRTH TOWN OF NORTH ANDOVER oy''�� OFFICE OF ~ BUILDING DEPARTMENT �ol + 1600 Osgood Street Building 20, Suite 2-64 North Andover, Massachusetts 01 845 9SS^CHUSEt Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: Z, -F-06 JOB LOCATION: Number Street Address Map/Lot HOMEOWNER Wale Home Phone Work Phone PRESENT MAILING ADDRESS 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 6889541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688- 9535 �I The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.0.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover permit No Dig Safe NuI (City of Town) (If Applicable) In accordance with the provisions of M_G.L.14$Chap(ter_lQ as provided in section S L 7 (,MR 34 Start Date This Permit is granted to: J�✓ ; (' /`'�G1r��'i`.�J-�i Full name of person,Firm or Corporation Permissionto locate dumpster for construction/renovation/demolition of bi Comments: dumpster must be 25 ' from structure if unable to place with Restrictions: clearance dumpster must be covered with plywood or tarp end c at (Give location by street and no.,or describe in such manner as to grgvied adequate identification of location) Fee Paid$ 50 .00 �.' tv/kYA", Fire This Permit will expire (Signature of offical granting permit) Offical granting pemut (T TWIG DFDMIT MI ICT RD rf)KICDIrI If111C1 V Df14ZTr:n I IDf1AI TUC DDC:RAICCC I