HomeMy WebLinkAboutBuilding Permit #669 - 27 SECOND STREET 4/21/2006Ot NORTH 1ti
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Permit NO:
Date Issued:
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received: 6
IMPORTANT: Applicant must complete all items on this page
LOCATION 2. ` <3ecc)
PROPERTY OWNER
MAP NO.: , ,50 PARCEL:
TYPE AND USE OF BUILDING
ZONING DISTRICT:
WA
HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT
PROPOSED USE
Residen ial
Non- Residential
❑ New Buildingne
family
❑_ Addition
P o or more family
❑Industrial
NAlteration
No. of units:
❑ Assessory Bldg
L epair, replacement
C Commercial
enrol ition
❑ Moving (relocation)
L Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED 1JC:JneJ0
C -4)I. vdcjCJ s
OWNER: Name:
Address:
CONTRACTOR Name:
Identification Please Type or Print Clearly)
C
d 19 3C)
el
Address:6?U (//I SI(?3cD
Supervisor's Construction License: 9:3 Y7 Exp. Date: 6 Z I Z�
Home Improvement License: f I -1q 6 ?, ( Exp. Date: (6/z, 7 Z0kJ- 6
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT. • $10.00 PER 51000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S.F.
Total Project Cost :$ x10.00=FEE:$ /
Check No.: �5� Receipt No.:- -�Z
Pmye Ior4
a
TYPE OF SEWARGE DISPOSAL
Tanning/Massage/Body Art 1
Swimming Pools ❑
Public Sewer ❑
Well ❑
_
Tobacco Sales
Food Packaging/Sales ❑
❑
Permanent Dumpster on Site LlPrivate
(septic tank, etc.
Electric Meter location to
project
NOTE: Persons contrac=Waived
s do not have access to the guaranty fund
Signature of Agent/OwnerSignature of Contractor
Plans Submitted ❑ ified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED
❑ ❑
[]Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
DATE REJECTED
CONSERVATION ❑
COMMENTS
DATE REJECTED
HEALTH ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition N
Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Water & Sewer connection signature & date
Comments
Commen
Temp Dumpster on site yes—no— Fire Department signature/date
Building Permit Approved and Issued by:
Page 2 of 4
DATE APPROVED
DATE APPROVED
11
DATE APPROVED
Building Setback (ft.)
Front Yard
Side Yard
Rear Yard
Required
Provided
Required
Provides
Required
Provided
TiX fl'T- W
-T
"IMM' 11431Vir
Number of Stories:
Total land area, sq. ft.:
Total square feet of Floor area, based on Exterior dimensions.
l rented JMC. Jnn.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: INSPFCnONAL SERVICES DEPARTNIF.N"r:RPFORN105
Page 4 of 4
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C;K I — Iq
Locationz,4 I
No. Date
TOWN OF NORTH ANDOVER
ok
Certificate of Occupancy $
Building/Frame Permit Fee $
Found -at ion-Perxai1-Fqe $
Other Permit Fee $
TOTAL $
Check #
It C, *' 4, Ir,
9 1 -J, Building Inspector
tjoRTM
TOWN OF NORTH ANDOVER
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,t.,, '.e °oL
OFFICE OF
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BUILDING DEPARTMENT
*
400 Osgood Street
North Andover, Massachusetts 01845
Gerald A. Brown
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: ( V
JOB LOCATION: Z 7`2 5CCC nd S
Number Street Address
HOMEOWNER
Name Home Phone
PRESENT MAILING ADDRESS
City Town
State
Telephone (978) 688-9545
Fax (978) 688-9542
oue
Map/Lot
Work Phone
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 requireme anthat he/she!:o�y with said procedures and
requirements.i
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Fenn Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-
9535
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