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Home My WebLink AboutBuilding Permit #247 - 308 MIDDLESEX STREET 9/29/2006 TOWN OF NORTH ANDOVER pORT1i APPLICATION FOR PLAN EXAMINATION O`StLUC 06gtio 3? a.. '• 6 OL t° ti 'A f Permit NO: � % � Date Received 04 ..<12_ •> Arlo Date Issued: A6R 9SSAC HU`�� IMPORTANT: Applicant must complete all items on this page LOCATION PH t PROPERTY OWNER R, i Q U A R- F�, Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Resi ntial Non- Residential ❑New Building Ybne family ❑ A/pIdition ❑Two or more family ❑ Industrial ❑ Iteration No. of units: Repair, replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED N eCA. ) R-o u t=!NG S 14/1VG (,GS < Identification Please Type or Print Clearly) y) OWNER: Name: t C_4 r�CC t) 4 IV/VI�'y Phone: Address: U ISu1J►�SI }L S CONTRACTOR Name: V 15tLG 6-- Phone: Address: S—G L o P 15R-2-y 12• o 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$1000.00 OF THE TOTAL ESTIMATED C ST BASED ON 5125.00 PER S.F. Total Project Cost :$ x/600. vo FEE:$ D� Check No.: �� Receipt No.: S� Page 1 of 4 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 Li 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 TYPE OF SEWERAGE DISPOSAL Swimming Pools El Tanning/Massage/Body Art E] Public Sewer Well Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ ' Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ dertified 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 o- I . DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no V 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 Driveway Permit i 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) i I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 I Created JMC.Jart2006 I Location No. 4✓4Date � f HpRTF1 TOWN OF NORTH ANDOVER 4 p? 1- A 4491 4 ' Certificate of Occupancy $ i a • r0° ti � Building/Frame Permit Fee $ sACHUs Foundation Permit Fee $ Other Permit Fee $ TOTAL $ P ` Check # elloepr 19635 Building Inspector TOWN OF NORTH ANDOVER '• OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 ;�.. ... �cHu5ENorth,\ndover, Massachusetts 01845 Gerald A. Brown Inspector of Buildings Telephone(97,S)688-95 I5 Fax (97Q)688-9542H0.%. 1 V4'NER L[CE'VSE EYEMPTION Plca'se print DATE: �- S�c, JOB LOCATION:__3 G�_ L-, �- Number Street Address I ' tiiap;Lot HOMEOWNER (2.1 C o e a2 to �qNA16 Y 9 7?6 " Name 7�� r� 7'�� Home Phone V Work Phone PRESENT MAILING ADDRESS 3 1v, a b Dinn,Nec c.�� 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 acts as supervisor). State Building (Code Section 108.3.5,1 not possess a license,provided that the owner DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on"hich tcre is, or is be,a one or two F roily structures. A person who constructs more that one home in a two year period shall,not intended be, to 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 Andovcr Building Department minimum inspection procedures and requirements and that he/she will comply with said requirements. procedures and I HOMEOWNERS SIGNATURE o APPROVM.OF RUILDING OFFICIAL 0'005 �, nn Hnnu',nanrrs E�„�nt��iirn HFALM f F AORTH 0 of No. y , - C% - A KE dover, Mass., COCHICHEWICK V R �®Ao .4TED PPS` S t; BOARD OF HEALTH Food/Kitchen PER T Septic System BUILDING INSPECTOR I T D THIS CERTIFIES THAT....... ... .. 4W.n4.. .......4-a-m-N-A.... ................... Foundation • build' gs onr�� + ............. 4... �..5�. ... Rough has permission to erect........... to be occupied as................... Chimney P provided that the person accepti mit s Iry r pest 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 Final y� PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TARTS Rough ...... Service UI DING INSPEC R 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.