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Home My WebLink AboutBuilding Permit #236 - 360 WINTER STREET 9/26/2006 TOWN OF NORTH ANDOVER %%ORTH APPLICATION FOR PLAN EXAMINATION o`tt�t° �616AV t Date Received 2�- O(`p 4 Permit NO: ® y�9Ssac Husr`�� Date Issued: '® IMPORTANT: Applicant must complete all items on this page LOCATION O ��1✓��►°/L !� ) Print---� _ PROPERTY OWNER I/C�1 / L',�D�!yA Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building M70ne family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: Ci�<epair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Aall mcic� I (Aluannum) /2oof dentification Please Type or Print Clearly) Phone: c17$ I�k�- ail d 0 OWNER: Name: -7%0 M�n�•,�� I � / Z Address: �v6D �,► �`n �2 �( CONTRACTOR Name: Phone: - Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date. ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON 5125.00 PER S.F. Total Project Cost :$ iS.t)UO,— 30,00 FEE:$_ U Check No.: 1190 Receipt No.: o� Page Iof4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ 11Tanning/Massage/Body Art ❑ g Public Sewer Well 11Tobacco Sales ❑ Food Packaging/Sales 11 Permanent Dumpster on Site ❑ Private(septic tank,etc. L�( Electric Meter location to project NOTE: Persons contracting wA unregistere4ontractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waved ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no 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 Required-T— equired Provides Required Provided- Dimension rovidedDimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA-(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 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 ❑ 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 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORMO_5 Page 4 of 4 Location �D No. Date -01 NORTh TOWN OF NORTH ANDOVER 4 � A Certificate of Occupancy $ �'�s'•^°• MUE<� Building/Frame Permit Fee $ ACS Foundation Permit Fee $ ' t Other Permit Fee $ TOTAL $ Check # /Mb 19624 Building Inspector Andover Town of No. CO2 3 0 LA dover, Mass., COC H CHEW1 ORATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System % q BUILDING INSPECTOR THIS CERTIFIES THAT....�;................. ..............r .0; J........................................... Foundation has permission to erect........................................ buildings on ........W ... .... ........W.11110.U.. 4411.7a Rough • Chimney to be occupied as...... ............. .... ........e.f/. A ii, s rw... provided that the person accepti this permit shall in every to the of t�e application o ilein r I i� Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construition of I Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough �v PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONS ST ELECTRICAL INSPECTOR Rough ........ Service BUILDING INSPECTOR ... .......T-' BUILDING ...am 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. F .40RT" I TOWN OF NORTH ANDOVER '< OFFICE OF z BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 North,kndover Massachusetts 01845 'A US Gerald A. Brown Telephone 9? Inspector of Buildings P (� 8)688-9545 HOMEOWNER Fax ("9;8)688-95.}2 LICENSE EXEMPTION Please print DATE: 7 g,6 a (� JOB LOCATION: Number Street Address —` — Map/Lot HOMEOWNER 17 S Name /00 9?F- 1 6 ,` 9 Q Home Phone Work Phone PRESENT MAILING ADDRESS 0 r . velz 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 Andovcr Building Department minimum inspection procedures and require ents and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE,Z1 �-i S ---- ---- .APPROVAL.OF BUILDING OFFICIAL V Rrvised 10.2005 Form Hunxuwncis Excmplinn (i.\RDOF,AFFEM.. n)- 's-`� it iticFltV.\f!<)ti,,:, _• j;U ,i5;5 �r,�-