HomeMy WebLinkAboutBuilding Permit #693 - 25 HARWOOD STREET 4/25/2007BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO:
Date Issued:
IMPORTANT:
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PROPERTY 0
40
MAP.'N 7�,ZONINGJI
Date Received
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
0 New Building
)(One family
D Addition
D Two or more family
0 Industrial
D Alteration
No. of units:
0 Assessory Bldg
0 Commercial
0 Repair, replacement
0 Others:
El Demolition
El Other
-0, Wat""A' d' ,District`
DESCRIPTION OF WORK TO BE PREFORMED:
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'-4 1"'t- 0 V ;S�tqri 14 N-71 S e - ,,(
Identification Please Type or Print Clearly)
OWNER: Narne:S4�e'(,&J '-- Yqvt dJ'Z'L-' lu C( fins P h o n e:
Address:
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: $ A0'50 FEE: $
Check No.: Fle-- Receipt No.: -ol
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
t/Signaturez'oftbotractor
Signature - of 'Ag 6. In-, "- 6 1d, a-dJUL ant&�o'�- -m
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art ❑
Swimming Pools ;,i
Well ❑
Tobacco Sales ❑
°
Food Packaging/Sim
Private (septic tank, etc. ❑
Permanent Dumpster on Site ❑
•
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THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION ❑
COMMENTS
HEALTH
COMMENTS
C
DATE REJECTED DATE APPROVED
❑N
DATE REJECTED nATF APPRr)VC:n i L
0
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Comments
Water $ SewerACpnnection/Signature 8 Date Driveway Permit
Located at 384 Osgood Street
FIRE DEPAR W64T - Temp Dumpster on site yes
Located at 124 Main Street
Fire Department signature/date
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 2 1 A —F and G min.$100-$1000 fine
Doc.Building Permit Revised 2007
4
F
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
Location
No. 5 < F Date
. NURTM, TOWN OF NORTH ANDOVER
M .. 9
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Certificate of Occupancy
$
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Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
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Gerald A. Brown
Inspector of Buildings
Please grim
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
North Andover, Massachusetts 01845
HOMEOWNER LICENSE EXEMPTION
DATE: �f [oZ—j �Di
Telephone (978) 688-9545
Fax (978)688-9542
JOB LOCATION: a.5 N -dr -Wood St.
Number Street Address Map/Lot
HOMEOWNER Aurib-a ` - Steen 1,t)jl/iarnS N)? -y- 3 969-� Com,
Name Home Phone Work Phone 3137—
PRESENT
/37—
PRESENT MAILING ADDRESS h(O-r(,cZ 0
Nyr4l? ur-er M/q- 0/&!5
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 helshe 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 SIGNA
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Fom Homeowners Exemption
BOARD OF APPF.US 688-9541 CONSERVATION 688-9530 I{EALTH 688-9540 PLANNING 688-9535