HomeMy WebLinkAboutBuilding Permit #695 - 28 30 Bay Street 4/26/2007BUILDING PERMIT of -fur. 0 6,6
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION '' ~
Permit NO: Date Received i1 `DR4TtD (5
V 9SSAC HU`�ES
Date Issued: ?•t n-1 I
DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: *-De-n ; S .:� . Ol Ai' e- t
Phone: 9 TO q 7S- X I a
ARCHITECT/ENGINEER Ale -us &o1aAA F6'\gMAQf,i tt Phone: �/8 88d J�7 g
�.
Address: 16� ���� �, %�� Reg. No.
1600
Z7
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: $ Piz
Check No.: i S3 Receipt No.: Jo
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Si�riature`of
Location
No. Dmf/
TOWN OF NaRTH .ANDOVER
:''..ao 'a •ti C
•a
9
Certificate of Occupancy $
�,s'••a'• E1�'+ Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
llr, ;7 ..y
Check # /,-
20) 52
,'
20152 '
Building Inspector
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art—`❑
Swimmin Pools �� t
g
Well
Well ❑
Tobacco Sales ❑
Food Packa in t„al ''
g g ��
Private (septic tank, etc. ❑❑
Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
DA E R� JECTED DATE APPROVED
CONSERVATIO ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
Toning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Water & Sewer Connecti
Located at 384 Osgood Street
Comments
Dimension
to
Number of Stories: Total square feet of floor area, based on Exterior dimensions. I
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.$100-$1000 fine
7 77777 Doc.Building Permit Revised 2007
".
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
u Building Permit Application
u Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
o Floor Plan Or Proposed Interior Work
u Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
Li Certified Surveyed Plot Plan
u Workers Comp Affidavit
u Photo Copy of H.I.C. And C.S.L. Licenses
u Copy Of Contract
Li Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Mass check Energy Compliance Report (If Applicable)
u 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)
u Building Permit Application
u Certified Proposed Plot Plan
u Photo of H.I.C. And C.S.L. Licenses
u Workers Comp Affidavit
u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Copy of Contract
u Mass check Energy Compliance Report
u 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
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TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
1600 OSGOOD ST
BUILDING 20_SUITE 2-36
NORTH ANDOVER MA 01845
978-688-9545
978-688-9542 Fax
HOMEOWNER LICENSE EXEMPTION
Please print
DATE V/ )
Ot ,AO TH
0 - 9
SSACHUSE
JOB LOCATION 30 to /�6/
Number Street Address Map/Lot
HOMEOWNER �4%!?/.5 11 i��%het x/1.9 gJ$=12z7/(�
Name
Home Phone
PRESENT MAILING ADDRESS
City/Town
44 S -s.
State
Work Phone
61M,
Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings of
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, one or two family dwelling, attached or detached structures attached or detached structures
accessory to such use and/or farm structures. A person who constructs more than one home in a two-year
period shall not be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliance 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. _
HOMEWOWNER'S SIGNATURE
%s
V
APROVAL OF BUILDING