HomeMy WebLinkAboutBuilding Permit #734 - 32 ELMWOOD STREET 5/26/2006Permit NO: Le
Date Issued:
TONN'N OF NORTH ANDOVER
,APPLICATION FOR PLAN EXAMfNATION
INIPORTANT: Applicant must
LOC.\TION
PROPERTY OWNER
MA NO.:
DMeel (C
Date Received: ��7—o
all items on this
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A) APG I, T
Print
PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT
TYPE OF IMPROVEMENT PROPOSED USE
Residential
]EE9
New Building One family
Addition - Two or more family
Alteration No. of units:
Repair, replacement Assessory Bldg
ilic Demolition
r Moving(relocation) =Other
= Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
YES ❑
Non- Residential
Industrial
Commercial
Others:
Identification Please Type � r, eq
Print Clearly) G
O1QVN'ER: '.Mame:
e q/ C ! v A Pa L l4 t9 /7 b Phone: q 70 C&a� l 7<
Address- 3 CZ I2 j o o S'j�^e e
CONTR.CTOR Name: S(? ry r r(6 Phone:
;address:
Super,. isor's Construction License:
I come Improvement License:
z
Exp. Date: —
Exp. Date:
ARC HITLC F EtiCINCER Vimc: I'hcrtc:
\.ddress:
Reg. No.
FEE SCIIEDL %E: BULD1.NG PERMIT: 510.;30 FER S,'900.60 OF THE TOT I L ESTl.t1, I TED COST 3,ISED OA 5125.00 PER S_ 1�
Total Project Cost :$__ xIO.00= FEE:$
(:heck No.: A(I- ( RecciptNo.:L 2/4�—,
Location(�� j,ES�Cf4 l'�
No. 3 Date 54 o (v
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HQRTIy TOWN OF NORTH ANDOVER
F? •. , 6 Q�
9 F
t •
Certificate of Occupancy $ --
cMus Building/Frame Permit Fee $
s►
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
0
192) 6
W Building Inspector
TYPE OF SEIKARGE DISPOSAL
Public Seiner
\Aell
Tanning'\lassage Body .art
Tobacco Sales
Permanent Dumpster on Site _
Pri\ate (septic tank. etc. _ Electric `deter location to
project
MOTE: Persons contracting with unregistered contractors do not have access to the guaranty. and
Signature of .Agent, Owned' Signature of Contractor
Plans Submitted Plans Waived � Certified Plot Plan � Stamped Plans
S" imming Pools
Food PackaQin2 Sales
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑
❑Water Shed Special Permit
1J Site Plan Special Permit
] Other
CONNINIENTS
CONSERVATION
COMMENTS
HEALTI1
CO3M-MENTS
DATE REJECTED
IJ
DATE REJECTED
Zoning Board of Appeals: %ariance. Petition No:
Zoninw Decision; receipt submitted des
P!;umin, B -mrd Deci.;ion; conuncnhs
1 ooscr\aticn Dcci' ion: Ci�mnunts
'V;acr & S,-6Lr connection si,;naturc & ,late
DATE APPROVED
!J
DA'rE APPROVED
J
icmp Dumpster r_n �:tc ec— -no _ fire Department i`natun gate — — -- --- _ --
Building Permit Appro%c;d Lind fssuc:d by:
Building Setback (ft.
Front Yard
uired Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
Side Yard
juired Provides
Rear Yard _
.ired Provided
Total square feet of floor area, based on Exterior dimensions.
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Goofing, Siding, interior Rehabilitation Permits
u Building Permit Application
u Workers Comp Affidavit
.j Photo Copy Of H.I.C. And/Or C.S.L. Licenses
j Copy of Contract
:i Floor Plan Or Proposed Interior Work
Addition Or Decks
❑ Building Permit Application
Surveyed Plot Plan
❑ Workers Comp Affidavit
a 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 Hydra
Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
• Building Permit Application
• Certified Proposed Plot Plan
j Photo of H.I.C. And C.S.L. Licenses
j Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
j 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 i
%ppeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One cop) an
proof of recording must be submitted with the building application
nuc: 1\'NIIA 110\.\1 til{R\ 1( IC'; DVVJ R I WI 1:014,01 M5
I'.r'e 4 1 I' 1
µORTH TOWN OF NORTH ANDOVER
OFFICE OF
4�r o
o BUILDING DEPARTMENT
* 400 Osgood Street
y.9�°j�+rco+aat.cy North Andover, Massachusetts 01845
Gerald A. Brown Telephone (978) 688-9545
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:
JOB LOCATION: -3a �Lrxcv 6yd
Number Street (Address Map/Lot
HOMEOWNER Df /ve t v
c I i-f�o L t� fi n b
Name Home Phone r Work Phone
PRESENT MAILING ADDRESS 3a 1 G d 4 d S'�` e C�
o �fti 1444V er /716(. 111F Y�
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 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 requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Fonn Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-
9535
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