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HomeMy WebLinkAboutBuilding Permit #556 - 35 OLD FARM ROAD 3/3/2001 O, NORTH 1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �SSdIC64 Permit NO:;�' Date Receive ©< Date ISSL[cd: IIMPORTANT: Applicant must complete all items on this page CJ LOCATION J LOCATION I _ 1'rint i PROPERTY OWNER Print NIAP NO.: _PARCEL: U ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building T-ene family Addition Two or more family ` Industrial Alteration No. of units: _ Repair, replacement _ Assessory Bldg Commercial Demolition Moving(relocation) '-s ether Others: Foundation only DESCRIPTION OF WORK TO BE PREFORMED/ / y\, I GlP -�- f y l G (oo ;�v�� b r-/� e r�`P�C t f C (mac,r✓1 Identifwation Please T e or Pant Clearly) OWNER: Name: Gice,,, Phone: ��� Signature Address: 31-0 6�'vn CONTRACTOR Name: © UvW( d DYE - Phone Address: Supervisor's Construction License: Exp. Date: Ifume Improvement License: Exp. Date: :1RC1-IITEC'T:FN(iINT F'R Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.-510.00 PER$1000.00 OF THE TOTAL ESTIJI,ATED COST BASED ON S125.00PER S.F. Total Project Cost :$ OOO a'D t x10.00 FEE:`5 1 Check No.: Receipt No.: ,-90ecc i i 'TYPE F SEVvARGE DISPOSAL Sv,inu»ing Pools Tannin�-Alassag e Body,art Public Sewer -- __ Tobacco Sales - I Food Packaging,Sales Well Permanent Dempster on Site Private(septic tank, etc. NOTE: Persons contmethig with intregistere(I contruclurs du irul hove itecess to the gutirtint),f and Signature of Agent;Owner `� ✓�2`e ( Signature of Contractor v Plans Submitted ❑ Plans Waived tJ Certified Plot Plan I Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT U LJ []Water Shed Special Permit iJ Site Plan Special Permit ❑ Other COMMENTS DATE, RF..JFCTFD r, \TE APPROVED CONSERVATION ❑ I� COMMENTS DATE REJECTED DATt LPPROVED HEALTH n COMMENTS Lonin_ Board of Appeals: Variance, Petition No: Zoning Decision.5-eccipt submitted yes Plannnru. Board Decision: Comments Conservation Decision: Comments -------_—_-- —_-- ._-- Water& Sewer connection signature&, date Temp Dum ,ter on site csl— no_ Fire Department sivnature.'date Building Permit approved and Issued by: —_. Building Setback (ft.) Front Yard Side Yard Rear Yard ReqUired Provided Req�uircd Provides Rec wired-7—provided DINIENSI ON 'umber ol'Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTI-,S and DNI A—(1,or clepartment use) 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 • Debris Removal Form Workers Comp Affidavit • Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work AdditionO r Decks ❑ Building Pen-nit Application ❑ Form U ❑ Surveyed Plot Plan . ❑ Debris Removal Fonn ❑ 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) New Construction (Single and Two Family) ❑ Building Pen-nit Application ❑ Form U • 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 a Mass check Energy Compliance Report In all cases if a \ariance 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: IONA ,SER\ICES DF.P.\R"I'\IE�'f:al'FOR\IUS Location -3 0/w ° No. Date r I To, TOWN OF NORTH ANDOVER t HOR O•• No .•'�O /0 s 9 Certificate of Occupancy $ S E< Building/Frame/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �'< Building Inspector NORTH ` � F TO" o t over No.sdo(4 Ar T �Q - LA E dover, Mass., AWE a COCHICHEWICK y�. AQRA-rE D PPS` '`C:) `s BOARD OF HEALTH PER T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... .....COWI..*..... ..........-Q&�N............................................... .................. Foundation has permission to erect........................................ buildings on. ...ifl� �.r .. � .............. -Rough to be occupied as.., ' i '�.... .... ..../#. �' ,.I .. Chimney �� �► Ch' e provided that the person accepting this permallSn every respeo�`co orm to�fe terms oft application on s� in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration d Construction of Buildings in the Town of North Andover.IIID%•• PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ��✓► Rough • PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TARTS Rough ................... ........... �"Aa Service L IN SP final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i .j �.� FD A--)EmgtJT (UNF(NlJliib) lu is �.1. �� � i � •�'1 c✓ �l�'��'�..v`• tit• �;i'r S >> I 1 r• is _ �1_ �•( �ii1�y '1-,:5}�0��' rp9flRC. DTENW(s 5ASEMENT ? LAN L� } 12 OPEAJ(46: pit f-0 QjQ D A 7-,v 40 re lk. All L 06- ON TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT � 400 Osgood Street f Nort�ltAndover, Massachusetts 01845 Telephone(978)688-9545 Gerald A. Brown Fax (978)688-9542 Inspector of Buildings HOMEOWNER LICENSE EXEMPTION I C Please print DATE: 70 �� r JOB LOCATION: Number Street Address 'Map/Lot HOMEOWNER J�+"kP V Da V A Name Home Phone WorkThone lid -3 � �)d PRESENT MAILING ADDRESS A) - A-),jj 0�VCA 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 require is and that he/she will comply with said procedures and requirements. ' HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homcowners Exemption