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Home My WebLink AboutBuilding Permit #641 - 34 HEMLOCK STREET 4/4/2007Permit NO: ,+I Date Issued: `7 " BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received Q Sq�.ED 16•NO TYPE OF IMPROVEMENT PROPOSED USE COR Name! Phone Residential Non- Residential ❑ New Building ❑ One family Addressy: ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other l peptic ❑ 1Nell#�F�oodpiai ' �eftt 'C Watershed District Cliater/Sewer' DESCRIPTION OF WORK TO BE PREFORMED: S4r� 2 4,-c L,x & 4�0 OWNER: Name Urir110M Identifications PI se Type or Print Clearly) 3q I -le, lc, �4e d�_� Phon '7- -2'k-__O;�22 �.' Y2 ARCHITECT/ENGINEER Address: Phone: 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: $ FEE: $ Ob Check No.: //6 Receipt No.: 5 `096 NOTE: Persons contracting w' unregistere contractors do not have access to the guaranty fund Signature of AgenV w er Signa ure,of'contractor; COR Name! Phone Addressy: supervisor's Construction License ExpDate: ''.`., . :.. s•' G fn v►cImrrnxenmert l ntance - Pv°t� . afrs•.. . ARCHITECT/ENGINEER Address: Phone: 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: $ FEE: $ Ob Check No.: //6 Receipt No.: 5 `096 NOTE: Persons contracting w' unregistere contractors do not have access to the guaranty fund Signature of AgenV w er Signa ure,of'contractor; 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 ❑ ❑ •uu CONSERVATION COMMENTS DATE REJECTED El DATE APPROVED El DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: Conservation Decision: Water & Sewer Connection/S Located at 384 Osgood Street Comments Comments Zoning Decision/receipt submitted yes CC?i1/IMENTS F .. � "W Dimension Number of Stories Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. 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 2007 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 ❑ 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 2.2007 Location 3,,l No. 411, -,// Date LORTI, TOWN OF NORTH ANDOVER Certificate of Occupancy s Building/Frame Permit Fee $ C" Foundation Permit Fee $ 4P Other Permit Fee $ TOTAL $ Check # 20696 1,/ Building Insp6cior C4 m m 4 m m mm co) C � '0 O CD az y CLO RC2 C C y a� �o d CD o p CDCL O cr W*� ��CD Er CD CD C CD y� dv y CD I S v y O 1 Z CD O CD 3 C CD wv 0 O Z7 Oq• C W ?� = -4 s cMaQ 0 EEC So 'H F CL S y CL 9 T C! Z �-C Or O�o md. 0 .. In comm o y ogle. m i > > • O U2O 1 O fA � C � s •• 3 d CMCI _ m o =r Z:# : f► O m N C aC m :� ce V N a'ID cr c C _ C O `cO N HA v, H ti t m�. cc �7:coo h-� O O m O N C, O m g . CD=c op 70 5 I O m m c - nn: 0 C2: • . O 0 p�� 10. 0 C� 7d G43 Cy � b x . TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 1600 OSGOOD ST BUILDING 20 SUITE 2-36 NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE NO DTM K��o y49*i SSICNUSEt JOB LOCATION 3 /km IOC— A, NumberStreet AddressMap/Lot HOMEOWNER �.4G/um4r Z5 Name / jHome Phone _j Work Phone PRESENT MAILING ADDRESS `"7 �''! &c k S Tr e City/Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of 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, one or two family dwelling, attached or detached structures 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. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she rstands the Town of North Andover Bt Department minimum inspection procedures and uirements and that he/she will comply with procedures and requirements. HOMEWOWNER'S SIGNATURE APROVAL.OF BUILDING OFFICIAL