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Home My WebLink AboutBuilding Permit #555 - 266 MAIN STREET 5/1/2018 i BUILDING PERMITc "° " pT TOWN OF NORTH ANDOVER 3 _ 0Z_ APPLICATION FOR PLAN EXAMINATION p �h Permit NO: Date Received 3q"°+ATED�•�yq`�* Date Issued: sSwc HuSe� IMPORTANT: Applicant must complete all items on this page LOCATION, Pri PROPERTY OWNER / Print MAP NO: PARCELJyz, ZONING DISTRICT:002 0 HISTORIC DISTRICT ryes) 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 Public Sewer. Water ❑Flood Iain 0 Wetlands' ❑ Watershed District DESCRIPTION OF WORK TO BE PREFORMED: A J 1 r1 fi GI t i �`cki bi 04's 'stip-444. 9 U& i t�� bo i -�� -► l�E 1 S DAyklb VDm V\4 Identifi n Please Type or Print Clea rl OWNER: Name: — Phone: _ - /9// ess:4 (o L. /Jo fi/yja t1z-,4_ ),w�-a�2 k3 G CONTRACTOR Name. - Phone: Address: r 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: $ /Jyr, el-j FEE: $ Check No.: Receipt No.:--/ �/ 919 NOTE: Persons contractinz,with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own Signature of contractor --- r { 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 ❑ ❑ i COMMENTS DATE REJECTED DATE APPROVED ` CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ COMMENTS 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 ❑ 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 Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS yl 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.s100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date ..._...._..-..............................................................._.......................................................................................................... J 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 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 New Construction (Single and Two Family) S ❑ 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 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 T - -- — - — — Location v2 No. Date 2 xz10 7 �ORT� TOWN OF NORTH ANDOVER f? + : , Certificate of Occupancy $ �'�s''• E<� Building/Frame Permit Fee $ Aw — JwcNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �D X999; Building Inspector °f OORT#t TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT > - 400 Osgood Street �•''�;,;,;:ter h# North Andover, Massachusetts 01845 �ssAc►�►j5 fc Gerald A.Brown Telephone(978)688-95454 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: 0( Number Street Address / �11 t 6 7/1 4f HOMEOWNER (/S KlM -',` f Name Home Phone Work Phone PRESENT MAILING ADDRESS SAMP-- 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 p 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 Fom►Homeowners ExcnW ion BOARD OF.APPE ALS 688-9541 CONSFRVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 t&ORTH Town of t 19Andover No. ♦ - - Aa as =0 LA E dover, Mass., 0 COCKICKEWICK V 7,9 ADRATED Ok �5 `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THATN......... ....... Ilt..�. . .......................................................................... Foundation has permission to erect............ .................. buildings on.......2-AC. AV.f.%� jr.7....... Rough to be occupied as FiW1s*-jhmk*S*h'aE �' . y.. ..../ .`..�.........1 /.�* ................ Chimney provided that the person accepti every respect cortfordf 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TARTS OPARough eA me/ Service BUILDING INSP 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 Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.