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Home My WebLink AboutBuilding Permit #549 - 35 MEADOWOOD ROAD 2/15/2007V Permit NO: Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received �-` 1-r' Q I IMPORTANT: ADDlicant must complete all items on this nape I LOCATION PROPERTY OWNER Print � c el �'�^s ri[ aryn. MAP NO.: A �- PARCEL: a TYPE AND USE OF BUILDING ZONING DISTRICT: HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition ❑ Alteration ❑ One family 0 Two or morefamily No. of units: ❑ Industrial ❑ Repair, replacement 0 Demolition 0 Assessory Bldg 0 Commercial 0 Moving relocation ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identifcation Please Type or Print Clearly) OWNER: Name: Address: 3S- 1,�e4cewcvd Ad, CONTRACTOR Name: / Phone: Address: i Supervisor's Construction License: / Exp. Date: Home Improvement License: / Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE. BOLDING PERMIT. x12.00 PER ,51000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PERS F. T_ Project Cost :$ FEE:$ c3y Check No.: I Receipt No.: Page 10f 4 TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ g Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ Electric Meter location to project NOTE: Persons contracting with unregist r contractors do not have access to the guaranty fund Signature of Agent/Owner 9AJ /� 44 Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEVELOPMENT ❑ COMMENTS DATE REJECTED CONSERVATION COMMENTS DATE REJECTED HEALTH ` COMMENTS FIRE DEPARTMENT - Temp Dumpster on site DATE APPROVED DATE APPROVED IN DATE APPROVED Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature & Date Driveway Permit Building Setback ft. Front Yard Side Yard Rear Yard Required Provided Re uired Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. 3 Total land area, sq. I: 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 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 Hydraulic 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 ❑ 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 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 h 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 Doe: INSPECrIONAL SERVICES DEPARTMENTMFORMOS Page 4 of 4 Location wM ��'�d— 1,J �a No. SM. • Date t2 NaRTM TOWN OF NORTH ANDOVER � 9 Certificate of Occupancy $ �' "°'••.°''<� Building/Frame Permit Fee $ 30 ,SJACHUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 3 " 19988 a Building Inspector Gerald A. Brown Inspector of Buildings Please print DATE:—a -o-q- TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION Telephone (978) 688-95454 Fax (978)688-9542 JOB LOCATION: Number Street Address Map/Lot HOMEOWNER 1078— Name Home Phone Work Phone PRESENT MAILING ADDRESS L-;I:f City Town State Zip 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 SIGNA APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF .APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I P r� I q • y ' o � c m; m c c_Wis c �a x O J a x C As. O A •d z :o 0 CL c A A v q RCM v CD OCD o0 a 3 N �••' • r0. CLS as y mom~ c O O+=•+ -L •C w ''= 1. 0c .n • O C N 93 co 0.0oc o w a Jg $ ar m w o cw U G w" t)D o ra '� w" a w a w c� Go w" w a ra z , cn cn q • i EQ CF m.9 _ is on N E c :gym c� O o mcm c N y ' o ` m c m; m c c_Wis c �a O J a c N O C As. 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