HomeMy WebLinkAboutBuilding Permit #721 - 315 SOUTH BRADFORD STREET 6/23/2009BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: 71-1 Date Received
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
= One family
Addition
Two or more family
Industrial
Alteration
No. of units:
Commercial
Repair epracement
Assessory
Others:
Demolition
Other
Septic Well`
Floodplain Wetlands
Watershed District
- Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED:
Ifo
e- el C-4-1 'd 661, r (/I 4,041-f
" Ide tification Plea a Type or P 'nt Clearly)
OWNER: Name: ,/�</�C-. � �p � m j Phone: 7 �°� �0 �
Address: 5^ S�
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE. BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S. F.
Total Project Cost: $ d 0 FEE: $ b
Check No.: / 7,1rV- Receipt No.: 2 � / �/ 4 --
NOTE: Persons contracting with unregistered contractors do not have access to the Quaranty 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
Food Packaging/Sales
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
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Pl!- ning Board Decision: Comments
0
66nservation Decision:
Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
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 - Date
i
Doe.Building Permit Revised 2008
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
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
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
NOTE: All dumpster permits require sign off from Fire Department prior -to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o 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
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 2.2008
Location
No. L21 Date ( � C3�
�aRT� TOWN OF NORTH ANDOVER
Certificate of Occupancy $
MUs t� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # ,
22 42
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f pORTM TOWN OF NORTH ANDOVER
O ��s '6'54
•`,� A� OFFICE OF
A BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
�•�,°`*•e .�'�'� North Andover� Massachusetts 01845
Gerald A. Brown Telephone (978) 688-9545
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: 141
JOB LOCATION:_
Number. Street Address
HOMEOWNER ,a -
N 7Home Phone�/J
PRESENT MAILING ADDRESS
City Town
MRplLot
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 resade, on which there is, or is intended
to be, a one or two family strucwres. 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 "homeowuei certifies that he/she finds the Town of North Andover Building Department
minimum inspection procedures and requirements and tial he/she will comply with said proodhnes and
requirements. If �
HOMEOWNERS SIGNATURE
APPROVAL OF BUR.DING OFFICIAL
Reid 102005
Form Homaowtum F.mmpti m
ROARDOF \PPF:\I.S6R9-9511 CONSERV.1'I oN(,tvR-953 HEALTH 488-95 0r �
PLANNING (88-9535