HomeMy WebLinkAboutBuilding Permit #898-13 - 35 MERRIMACK STREET 6/24/2013TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: U Date Received -
Date Issued:
IMPORTANT: Applicant must complete all items on this page
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TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
El New Building
El One family
11 Addition
D Two or more family
El Industrial
El Alteration
No. of units:
El Commercial
M.Repair, replacement
D Assessory Bldg
El Others:
11 Demolition
11 Other
i EE iVV lands;
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W, eLr/,S 60ry 1..
DESCRIPTION OF WORK TO BE PERFORMED:
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1vt ( ooP For P
Identification-, Please TYD.e or
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OWNER: Nam ,,rWt;
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Address: AwLe" r)
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ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE: BULDINGPERMIT.• $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST AS $125.00 PER S.F.
Total Project Cost:$ /Z-3,57`0 FEE:
Check No.: 34�� Receipt No.:
NOTE: Persons contracyw-g-th tinregisteW contractors do not have access tot e! uarant Y d
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n ure of.A.pen w Yk 1 -
Signgtore-U-copt cf"'
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan El Stamped Plans El
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Plans Submitted ❑ Plans Waived -0 Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF-SEWERADE.DISPDSAL
Public Sewer ❑
Tanning/Massage/BodyArt ❑ ..
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
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
DATE REJECTED DATE APPROVED
❑ ❑
Reviewed on Siqnature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Commen
Conservation Decision: Comments
Water & Sewer Connection /Signature & ®ate Driveway Permit
DPW Tow;! Engineer: Signature:
Located 384 nsnnnd StrPPt
FIRE .DEPARTM'EjN' T - Temp Dumpster on site yes no
Located *at -124 Main`Strdet
Fire Pep ar6he* it.sigriati.ireldate
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
mLECTRICAL: Movement of Meter location, mast or service drop requires approval of
:Electrical Inspector Yes No
)ANGER ZONE LITERATURE: Yes No
AGL Chapter 166 Section 21A -F and G min.$100-$1000 fine
loc.Building Permit Revised 2010
Building Department
The following is a list of the required forms to be filled out for the appropriate.permit to be obtained.
R.00firig, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L.- Licenses
a Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
10TE: All dumpster -permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
o Certified Surveyed Plot Plan
o Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
o 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)
Li Engineering Afiidavits for Engineered products
OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
P Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o 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
o� Engineering Affidavits for Engineered products
ME: 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 period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be subm:-tted with the building application
Doc: Doc.Bui!ding permit Revised 2012
Location .7 '/4r� e -
No. Date /2 4,1,_7
'2
Check# _,w
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee s
Foundation Permit Fee
Other Permit Fee
TOTAL $
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rt'l�l O.[� NORTH
pF iteo � 'i TOV Ra-.[7 •[iND
-trLONTR
OFFICE OF
' a emery^ BUILDING DEPARTMENT
Osgood Street Building 20,-Suite 2-36
y�ssapou5��North Andover, Massachusetts 01845
Gerald A. Brown
Inspector of Buildings Telephone (978) 688--9545
HOMEOWNER_LICENSE EXENlpTION Fax (978) 688-9542
BUIDING PEST APPLICATION
Pleas--- a print
DATE.-✓LC� 02 I , , 13 '
JOB LOCATION: UM'C
Number Street Address
Map/Lot
ljoMEo. {R r ; s ha r/e �-J(>h n_
Ktc0
- Name Home Phone
Work phone
PRESENT MAl qrj ADDRESS 3 �5_ r/-,' , r C (ti • S�c!ii e �
'
State • �,....,. • - Zip Code
The current exemption for "homeowners" was extended to include owner-occu ted
to allow su;h homeot;iners to engage an individual"for hire who does not posse a �Cjense provided That the oin r Gwne an
acts as supervisor). State Building (Code Section 108.3.5. i)
DEFINITION OFHOMEOWNER
Persons) who Qwns a parcel of land on which he/she resides or intends to reside, on which there is, oris intended to
be, a one or two family. structures. A person who constructs mote that one home in a which
her eriod shall not e
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
minimum understands the Town of Forth Andover Building Department
inspection procedures and requirements and that he/she will comply with,said procedures and
requirements,
I-IOMEOWNERS SIGNAT t/� c. ✓� .
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541
_.- - -- - - —_V -
C01\rSERVATI0N 688-9530
HEALTH 688-9540
PLANNING 688-953i