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HomeMy WebLinkAboutBuilding Permit #540-2016 - 28 STONEWEDGE CIRCLE 11/2/2016SO4WA/ED // -S - /s BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date Issued:IMPORTANT: Applicant must complete all items on this Daae ILOQ�ATIiONi P;R.OPE'R0TY 01NN (MAP PAR, ZONING DIIS TRI C,T:_ Historic Dis'trtct; yyes� n01 ra,o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition 0 Two or more family ❑ Industrial 0 Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ ❑ ;Septic ❑ 1/Vell+ _ -tic _ P080 ❑Flood la_in� ❑Wetlands ^_ ❑Waters edk _istrict o _❑ Water/Sewer L� OWNER: Name: Address: RIPTION OF WORK TO BE PERFORMED: - Please Type or Print Clearly .\/A.11 M I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ �L FEE: $ Check No.: 1116 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑r Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On COMMENTS CONSERVATION COMMENTS ,HEALTH 1 ' COMMENTS Signature_ Reviewed on Signature Reviewed on Signature 0 Z%ning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes T. 4 Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPRTM.EN�'..Temp ©urr�pster on Leeatetl at 4 M.�,ain S" F ., . treet x �• s r � ,�, F'ir IJepa.r#meint s=i nat ru a/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 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 e 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 o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses, a Copy of Contract a Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit ❑ Building Permit Application ` o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application a . Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products DOTE: 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: Building Permit Revised 2014 Location No /�� � �~ Date TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee � Foundation Permit Fee Other Permit Fee ^ TOTAL $- - `7 Building Inspector 9 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: L%� "' �%� Date Received Date Issued: I WORTANT: Applicant must complete all items on this pal (PROnE,RT�'OW P,, _ s iPFPtb � _ 100 Fear �S ructu�e MAP�ARCyEL�:' ZONIN'G�,'®IrSTRaICTN`_� ;'Histo�� i®tst�ic h-0) Ch`-nnti v �tyeO '64•NO .iia e�.,�`• ° �L ti A TYPE OF IMPROVEMENT PROPOSED USE ryesPDS Residential 1_a e` ;yes tno' 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 �Z] tSlept- is ��UUell� `` .�,t� . � :" F-60-- l'ai`d m Wefland`' � �,,,�-� � � a ❑, 1I1/.ate�hed�Distr�ictc ,-�-�.- -� c �W�ater/Sewers �, �� ,r,a _e - - _ .� OWNER: Address: CRIPTION OF WORK TO BE PERFORMED: ion - Please Type or Print Clearly uv4vl Phone: i /I t w, �W iii i"Cont�Factor +Names _ GPhone° - Ad'dr'�essa Supe�nii r `�J `Constr�ucti©.n�'L`icense _ H lmprovementl,L`in �_� A Exp r©ate , ___, _Ixg®ate -- ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT.- $12.00 PER $9000.00 OF THE TOTAL EST/MATED COST BASED ON $125.00 PER S. F. Total Project Cost: $ FEE: $� -� Check No.: Receipt No.: NOTE: .Persons contracting with unregistered contractors do not have access to the guaranty fund 0 O 0 O O O = <D• rCDL n 0 o rt O• f'i ;moO O: -a cn• _i O O 'CL 7 m 0°� y SDcCl) m CD v = '. a) m D U3 r -L r« cn• o � r' v1 �,z CDP INV CD -0 CD .0 -i c s' : I J o co 0, z nCDrt Q N C-) ='• 0 CL 0 CD �QCD � h -9(3 r y N rt Cl CD CD CD K D m CL O (D* m rLn Nr rD z v c70 V y m m z 0 W 3 G1 z H 0 O r m O W m m y r vZf m m 0 O M T v C C z O N m 02 O � (� =rO 7 c T O = Q o� � W C v H m O� N N -O n Ln 3 T O Q \ 3 M p v O 2 D � 0M O � D O z� � 2) cn =ra �o D ,^ (Q N m s� N n— v� �� o z CL Cf)0 �. � = �r CD O CD O CD '='AA a CD O N N. 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Brown Telephone (978) 688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please rint JOB LOCATION: 21—t smm"awls� Number Street Address Map/Lot HOMEOWNER Name Home Work Phone PRESENT MAILING ADDRESS Town State Zip The current exemption for "homeowners" was extended to include owner occupied dwellings of one or two family dwellings and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as su ern visor. 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 dwelling, 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. (780 CMR Section 110.R5.1.2) The undersigned "homeowner" assumes responsibility for compliance with 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 SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 8.2015 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535