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HomeMy WebLinkAboutBuilding Permit #379 - 25 MONTEIRO WAY 11/7/2006 TOWN OF NORTH ANDOVER NoRrM APPLICATION FOR PLAN EXAMINATION of tt�•o �tio ,, •6 F p Permit NO: Date Received r o Date Issued: / 7 1,2 y is CH IMPORTANT: Applicant must complete all items on this page LOCATION /00/QZ7E/R4' y PH9�t PROPERTY OWNER A445©6U1> A41464z42 Print MAP NO.: PARCEL( ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building POne family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED DE,06 FIA2121134TA4406 Identification Please Type or Print Clearly) OWNER: Name: AWS,961 (JQi4i�l� 9r-_ Phone: 97 6a,07 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$125.00 PER S.F. Total Project Cost :$ Z46w� 06 FEE:$ �C`? Check No.: 2. Receipt No.: l �� Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art ❑ Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales El❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered c ntractors do not have access to the guarantyfund 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS T FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 Drivewav Permit 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 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 Page 4 of 4 Location o� ?i��t,r e- No. Date 0.1 HORTN TOWN OF NORTH ANDOVER 3? ° • 0 Certificate of Occupancy $ ;�sem'•°uEta Building/Frame Permit Fee $ cMs Foundation Permit Fee $ ' Other Permit Fee $ TOTAL $ Check #112 9 7 U Y Building Inspector NORTIy Town of And No. 219 _ o dover, Mass., O COC MIC ME WICK 1 7�S RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT.... a .O.W.W....................lli�..�j. .. .1... /�w................................ """"""""""' Foundation has permission to erect........................................ buildings on4;.S'...... .......4.e...?! Rough to be occupied as..��.I. ►.0!r........ .. ........ .......5.?V.fif R..................................................... Chimney provided that the person accepting this permit shall in every 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 13000M IT PERMEXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU T40<1 S Rough Service • BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. IFTE7E REVERSE SIDE Smoke Det. TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1(100 Osgood ood Street Building 20, Suite 2-64 '° North.Andover, Massachusetts 01845 +CHU5 Gerald A. Brown Inspector of Buildings Telephone 1978)688-9545 HOMEOWNER LICENSE EXEMPTION Fax 19"4)688-95,42 Please print DATE: 7—G JOB LOCATION: Z5`�lifd��j�U :dumber Street;Address Map/Lot — HOMEOWNER /l,�(Jjj q Name Home Phone 7 g- l 7—E'`_-�n7 Work Phone PRESENT MAILING ADDRESS Z5 -00/0 City Town I All f�f 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 be,a one or two family structures. A person who constructs more that one home in a two-year period shall to considered a homeowner. P all not he The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other :Applicable codes, by-laws, rules and regulations. The undersigned"homeo� ner"certifies that he,she understands the Town of North Andovcr Building Department minimum inspection procedures and requirements and that he/she will compl requirements. with said procedures and HOMEOWNERS SIGNATURE _-- APPROV.m.OF BUILDING OFFICIAL I, .'m Hnnu•�an'rs F.�.rrplir.n al_I['H .•-,'.tri f'1. :�' -