HomeMy WebLinkAboutBuilding Permit #557 - 329 OSGOOD STREET 3/17/2010 BUILDING PERMITof"°pT bgti
TOWN OF NORTH ANDOVER 3� 4 '`''- `-*'•,d 0
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APPLICATION FOR PLAN EXAMINATION
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Permit NO: J! S /
Date Received � " "•
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Date Issued: 3 w
IMPORTANT:Applicant must complete all items on this page
PR�PERTI'OWNER Q� �; GL'�1 a� O e
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MAP t'0El
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PARCEL: ZONING DISTRICT": Flistorc�istric# yes
MactaneShop Uall�ge yes �o
TYPE OF IMPROVEMENT PROPOSED USE
Resi Non- Residential
New Building 60ne family
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, re lacement Assessory Bldg Others:
Demolition Other
�j�'c�WlaterlSewerl
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DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please T e or Print Clearly)
OWNER: Name: .l �eg Phone: c'1$•(o
Address:
II C��N RACT4R ,'ewe: Phone: ,
I
Address.•
Supervisor's.Cons#roction: .icense: Exp, Late:
Honn��rn�rovement icense: Ex Da e. � , `7
ARCHITECT/ENGINEER No N E-- Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
00 4- r
Total Project Cost: $ 1 $,606 . FEE: $ �/
Check No.: LI(13 Receipt No.: a 2 PG
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
rAgent/Own ignatureofcoritractor
r
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
❑ Workers Comp Affidavit
o Two Sets of Building Plans (One To BeReturned) to Include Sprinkler Plan And
i
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
i must be submitted with the building application
I
Doc:Building Permit Revised 2008
j
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
i
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
rlanning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT Temp Dumpster on its yes 'no
Located at 324 Main Street
Fire Departrnent,signataredate
COMMENTS
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
Doc.Building Permit Revised 2010
Location 1c2
_ l
No. �'S Date
TOWN OF NORTH ANDOVER
F 9
i y
• � ; , Certificate of Occupancy $
T '•° EZA Building/Frame Permit Fee $
Ss�CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # Z/0/1 ,
22861
Buil6ing Inspector
o.1ORT'
Tovm o t: 4
Andover
No. SOX� o .....�..,,.,.. ... �,
o LAKEdover, Mass.,
C0'CHICHE WICK
ADRA rE D
S
BOARD OF HEALTH
Food/Kitchen
PERM. IT T
Septic System
THIS CERTIFIES THAT (/el; v 6,5_ vC A �d�a � BUILDING INSPECTOR
Foundation
has permission to erect.........
............................... bwldings on ..u�-?.I�........ ..:S�r...l�...r'..�'.....�,�
............................... Rough
to be occupied as.. .....�..�������
7fi�
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Chimney
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final
Buildings in the Town of North Andover.
VIOLATION of the Zoning or Building Regulations Voids this Permit. PLUMBING INSPECTOR
,{11� ro Rough
PER1V1E11V17�1RES IN 6 MONTHS Final
UNLESS CONSTRUCTION RUCTION S- ARTS ELECTRICAL INSPECTOR
Rough
. �_............................... Service
BUILDING INSPECTOR
n Final
Occupancy-Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
No Lathing or Dry Wall To -Be Done Final
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
Street No.
SEE REVERSE SIDE Smoke Det.
µORTH TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
oR;rep North Andover,Massachusetts 01845
'4 i
SSACH0
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE: 311-712.0( 0
JOB LOCATION: 31 ("� 5 Cfl ova
Numb r Street Address Map/Lot
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HOMEOWNER1 �t`iS•6$�O' 3 8l�o
La4nA 418 'COcis9 •Ct
3 �
Name Home Phone Work Phone
PRESENT MAILING ADDRESS a 2ct Q s
t10r+� AylaoVeJT_ Mk 0tfsLS;'
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
APPROVALILDIN F BUILDING U G OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
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