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HomeMy WebLinkAboutBuilding Permit #63 - 35 OLD FARM ROAD 7/22/2009BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued:' IMPORTANT: Applicant must complete all items on this Daae LOCATION 3-5-01d (; l� i;( /v-�t�eo �e •N\ ? • O o 4 not PROPERTY OWNER G VA t P cc Oyc- 190,,,1 /l/ Print MAP NO: 35PARCEL: �Q ZONING DISTRICT: Historic District yes n Machine Shop Village ves no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Others: Repair, replacement Assessory Bldg Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer utacrcir 11UN Ul- VVUKK TU BE PREFORMED: 6o fru ✓� ���� 2 4' (-Uv�l Identification Please Te or Print Clearly) OWNER: Name:-'Gv\,P C, ►-a IQCiv< 70► ,Al d\ - Address: 3 �— ©J Fi(vvk CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: ARCHITECT/ENGINEER Phone: Address: Reg. No one: q -7Y -7O 4 DOD Lf FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ �;�o FEE: $ 9 0 - ---- Check No.: r Receipt No.:�2 ?7 NOTE: Persons contracting w' h unregistered contractors do not have access to the guaranty fund signature of Agent/Owner I ignature 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 COMMENTS CONSERVATION COMMENTS Jk�/ HEALTH -Reviewed on Signature r Reviewed 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 DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes, Located at 124 Main Street Fire Department signature/date COMMENTS t_ocatea 364 Usgooa Street no Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes 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 2009 IM 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: Building Permit Revised 2008 Location M/,/ No. tog Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check# 30 419 22 2.:)7 Au(Iding inspector �I 0 w o w v cn � a o w o aG ^c U x O a a o w G w 0 U � w o oG c� c w pG o o4 c ii z c rA o Z cn o cn dl zip y C 0 cm o: cm m 0 cm _c �C N m Z O z O 8 cm U O O Q� .T -T 04 O O O Z CLo O y D C IO Om 0.— y OCD m m CL Z O � CD L eov o a CLCID c Q c 'a. o ,C; c Z CL V H O C � C cc CO3 0 G U) uj U) 19W W 19 W U) c CD �. 3 m� a _ co �. y 0 j A- y A- Ce c o a� = o :CLQ :l dC.0 \ m 0 � �Z CL N a m o C 'm y mCL- os3 C 0+=+flt uiW a:H 4D C H L.2 4D C. COD O .0 -a:02 -m dl zip y C 0 cm o: cm m 0 cm _c �C N m Z O z O 8 cm U O O Q� .T -T 04 O O O Z CLo O y D C IO Om 0.— y OCD m m CL Z O � CD L eov o a CLCID c Q c 'a. o ,C; c Z CL V H O C � C cc CO3 0 G U) uj U) 19W W 19 W U) FORM U.- LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** -Fr APPLICANT ,r!'C+Vh1E' ,i�r Oct ll (0vvV7 PHONE g7ir- _744-- )-004r. LOCATION: Assessor's Map Number PARCEL_ SUBDIVISION �� �� `" % LOT (S) STREET '"y,\ ST. NUMBER 3S l ATION COMMENTS *************************************OFFICIAL USE I OF TOWN AGENTS: DATE APPROV9D DATE REJECTED_ TOWN PLANNER DATE APPROVED DATE REJECTED COM FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMME DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED_ PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT jyfL7?q—_4 RECEIVED BY BUILDING INSPECTO Revised 9\97 jm o Z DATE I North Andover MIMAP 35 Old Farm Road July 21, 2009 035.0-0008 035.0-0107 035.0-0104 035.0-0002 035.0-0056 035.0-0063 035.0-0 64 32W 284' Old Farm Road 15-1, /801 146' 163' 035.0-0097 035.0-0067 fD 035.0-0068 035.0-0069 035.0-OVO 035.0-0096 -.n 035.0-0071 7 . .... . . . .... . . .... 035.0-0095 Aw. ........ 0350-0076 4' w i,035.0-0075 035.0-0074 035.0-0072 035.0-0073 035.0-0094 4. 148 035.0-0093v. 154' Rall Line Interstates Interstate Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83, Major Roads Roads Easements NORTH a 0 Meters Data Sources: The data for this map was produced by Merrimack Valley Planning Commission (MVPC) using data provided by the Town of North Andover. Additional data provided by the Executive Office of Environmental Affairs/MassGIS. The Information depicted on this map Is for It be for legal Trails Streams planning purposes only. may not adequate boundary definition or regulatory Interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING E3 MVPC Boundary 41 THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY E] Municipal Boundary 4 • 41 OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT 0 Percale ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION Hydrographic, Features Wetlands Exempt Lands 1"=115ft FRANK S Cqi.pq p t .,q ,I" OF M40 NT ATTC, FRANsycS t'0Tr I j p'L. vii ES VD A XTV NO 4 9 1 ILI, LMLES SSIO SURWVO QURVEYING id QrALP. Of T)PPR-M-PALDOIX P C) 411 ii Wit -N -- I NT01. Al TDCOVER, MA 0 1 'A i tg 7R j Atica TNT 6- ?()()2nc ko V k -,u -Cvi TWIP AN - \V 111 MIAP 35, PkRCEL-i7o DEED E;K. -- - a 9, FG - 240 PLA 35 OLD F-kR-A4 ROAT—) V'D /#A A CRT TLT T NORTH -AN!)(-)VI4,R_ MA DPEP-ARE—T) FOR DAVID & j j3ko� TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 01845 Gerald A Brown ` Telephone (978) 688-9545 Inspectpr of Buildings Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: o JOB LOCATION: � f, w� Number Street Address HOMEOWNER I-vm\e � Ooa 6 (b v -1A- � 7�- 7QCr ovo o � ? i y- r a r j4Y 7 Name Home Phone work Phone PRESENT MAILING ADDRESS 357 o (d 61-&-, rd, City Town State 61 �x(f Zip Code The current exemption for "homeowner" was OMMUM to include Orw- neF-occupieddwell-opto two un= or less and to allow surds homeownors to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code motion 108.3.5.1) DEFINMON 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 is a two-year period shall not be considered a homeowner. The undersigned '"homeowner" assumes responsibility for WmPlb = 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 rapirements and that he/she will comply with said procedures and 12 HOMEOWNERS SIGNATURE_ APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Foim Homwwnw Edo TIOARD OF �PPE:1I_S 699-9541 CO3%SER1'.VTI0\ E88-9530 ITE.�1 TIi oxg_9;4p PL.L\SIING 6gg-9535