HomeMy WebLinkAboutBuilding Permit #857 - 35 COLUMBIA ROAD 6/30/2006Permit NO:_EE�
Date Issued: -o` b4/
TOV4'N OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received: �
IMPORTANT: Applicant must complete all items on this
LOCATION �s�3� �}ItJ� ion JVp �ddl�
Print
PROPERTY OVk'NER
Print L
MAP NO.: PAING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES 0
TYPE OF IMPROVEMENT PROPOSED USE Non- Residential
Residential
= New Building One family
Addition XTwo or more family =Industrial
Alteration No. of units:
Repai replacement Assessury Bldg Commercial
is Demolition
MovingOther Others:
Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
Ex IsI---IB l7"�
01 NER: ` Name
MM
Identification Please Type or Print Clearly)
Address:
CONTRI�CTOR Marne:
-- -- --- ... Phone:.- . 73 ''1 7
;address:
Super -v isor's Construction License:
Exp. Date:
Home Impro%-ement License: Exp. Date:
ARCHITECT. EVGCvEER N.amc: Phcne:
kddress: Reg. No.
FEE SCHEDULE: IBULDIAG PERMIT. S10.30 PER S1100.00 OF THE TOT IL VSTIJI.-1 TED COST "BASED Oa S1?5 V PER S. F.
Total Project Cost :$,___._.- x10.00= FEES
beck No.: � 1� Receipt No.:-.61ILL
Parx 1t,(4
Location eA.
No. Date (,40-o(w
Check# It
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit.Fee $
v
Other Permit7Fee $
TOTAL �-"
-<D ->eA
'-*tuildinj�r�s-p-ector
9
TYPE OF SEW'ARGE DISPOSAL
Public Sewer
Well _
Private (septic tank, etc.
Tann i ng'%l assagelBody Art S" imming Pools —
Tobacco Sales — Food Packaging Sales
Permanent Dumpster on Site _
Electric deter location to
project
:VOTE: Persons contracting with unregistered cont actors do not have access to the guaramy l4nd
Signature of Agent, Owner Signature of Contractor
Plans Submitted Plans Waived .;Certified Plot Plan Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - l; FORM
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED
❑Water Shed Special Permit
CJ Site Plan Special Permit
❑ Other
DATE APPROVED
DATE REJECTED DATE APPROVED
CONSERVATION ❑
COMMENTS
HEALTH
•
1
COMMENTS
e
Zoning Board of Appeals: % ariance, Petition No:
Zoning Decision; receipt submitted acs
i�
DATE REJECTED
P!annmg Board Decision: Commcnts
Cvoscr�:iticn Deemion:
W:,tcr 4& S, ,,m r connection i:;naturc L9: date
Common
T cmp Dumpster cn site yc�_ no Fire Department si -nature .late
Building Permit Appro%cd and ISsucd by
DATEAPPROVED
Building Setback (.)
Front Yard
Side Yard
Rear Yard
Required
Provided
Required
Provides
Required
Provided
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
c, 1A ; ,,
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
u Workers Comp Attidav t
Photo Copy Of H.I.C. And/Or C.S.L. Licenses
Copy of Contract
Floor Plan Or Proposed interior V11'ork
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
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydrau'
Calculations (If Applicable)
Mass check Energy Compliance Report (If Applicable)
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 Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o 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 cop3 and
proof of recording must be submitted with the building application
?nc: I\til'h.l`I'11)\.1L. SERVI('FS OFT %R'1*)1F%, 1`.ilPF(MV1115
1':Y -e 4 11 1
KORTH
TOWN OF NORTH ANDOVER
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OFFICE OF
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BUILDING DEPARTMENT
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400 Osgood Street
North Andover, Massachusetts 01845
Gerald A. Brown Telephone (978) 688-9545)
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: ("Ado 6ZT
JOB LOCATION: -35-91
Number
HOMEO
Name
Street Address
c • �9`f-
Home Phone
PRESENT MAILING ADDRESS 37
City Town
State
iu 4 6
Map/Lot
7f-3eyoe '�27
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 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
Foran Hoinamners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 638-9530 HEALTH 688-9540 PLANNING 688-
9535
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