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Home My WebLink AboutBuilding Permit #572 - 38 BLUEBERRY HILL LANE 3/2/2007 ORTH BUILDING PERMIT o -1"D "moo TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �— Date Received - 9 r ACHU`�� Date Issued: Cr 9SS IMPORTANT: Applicant must complete all items on this page "LOCATION �l%Y�2 �r. ,� p ` t1Ctt PROPERTY 0V11R: Cr >. ._ NO: PARCEL. Zt3N1NG DISTRI'GT HISTORIC t3tSTRICT yes no t TYPE OF IMPROVEMENT ED USE "ResidentialNon- Residential ❑ New Building amity ❑ Addition ❑ Two or more family ❑ Industrial 91%iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other j Ch;peptic 1t1(ell � 7 i`f "dpla n F ell, h (lfatershec! his r[ct jf •. .£j' 1 Wate� �W�rvmN , DESCRIPTION OF WORK TO BE PREFORMED: 4,2 0 v---fi I Identific ion . Please Type or Print Clearly) E l o OWNER: Name: Ju N I �9 Phone: Y Address: t �i O.NTRACTOF� me. :Phone: Iv ytkfpjf��.]�`y/{�'�/'��_+{�1 �Construction i/'� ..�'Y y ..3_ �/ l'� (� SM a Yiso Q L1V 1�ek / - �,. 'fid :E/�� `.Qat:67 y.�.n. Hoe lip o„emenf License m . ._.,w ..: p,. . )rx Gate v ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ (>D z> �o FEE: $ 60. ,0) Check No.: Receipt No.: NOTE: Persons contraci with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owne Signature of contractor Loc ation /�� No. -5 T Z Date NaRT� TOWN OF NORTH ANDOVER • ; ; Certificate of Occupancy $ CMU s Eta Building/Frame Permit Fee $ ✓ � s� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2YI-0- 2 0 G 6 '—'Building Inspector Plans Submitted ❑ Plans Waived ❑ 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 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 ❑ Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/si na tore&Date Driveway Permit Located at 384 Osgood Street EIRE DEPAR `I tEN' ' -Temp oUmpster tirl s%te yes no Located at 124 Maih'Stf et Etre '�" 'Department s gnatuii e� 'R - at COMMENTS P. 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 No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date 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 u Building Permit Application Li Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products Addition Or Decks u Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L. Licenses a Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products New Construction (Single and Two Family) L3 Building Permit Application o 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 Li Mass check Energy Compliance Report u Engineering Affidavits for Engineered products 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:BPFORM07 Revised 2.2007 NORTH Town of _ 4 L over No. S'7 Z ~ - LA E dover, Mas�s� COCMICMEWICK y1. 7,p RA'r S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System '�7 BUILDING INSPECTOR THIS CERTIFIES THAT...........��, d. .114......:.. .�i. ........... - Foundation has permission to erect...... ............... ............... buildings on.... . ............... .... .... t.40606..... Rough . . .. ...... to be occupied as...�... ... �.0. ...................................... .. Chimney .....................................:................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 34400000, PERMIT EXPIRES IN 6 MONTH - Final UNLESS CONSTRU ELECTRICAL INSPECTOR Rough .. ..... ...... ...... .. .. ........ .. ......... . Service IN BUILDG INSPECTOR 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. TOWN OF NORTH ANDOVER OFFICE OF ° " BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 vv� y �Ssgcwus�� Telephone(978)688-9545 Gerald A. Brown Fax (978)688-9542 Inspector of Buildings AFFIDAVIT FOR FINAL COST OF CONSTRUCTION In accordance with the provisions o the Massachusetts State Building Code, Article 1, Section 110.4 and 114.2, the total estimatf d cost of the construction including all related construction costs* of the building located at aK 91.v6662pc I/ 1-Lc. G-✓Owf amounts to $ 3D, voo ,being the person referred to as the owner identified below, do solemnly swear that the statements made herein are strictly true and correct and made in good faith. *Related construction costs included all work done with or concurrently with the work contemplated by the Building Permit including demolition, plumbing, heating, electrical air conditioning, painting, carpentry, landscaping, site improvement, etc. Furnishings and portable q m t are not part of the total construction costs. Signature of Owner COMMONWEALTH OF MASSACHUSETTS S.S. 20 Then personally appeared the able named and Made an oath that the above statement is true. Before, Me, Notary Public OFFICIAL USE: Final Cost: _.. Original Estimate cost of general work: - - - Cost Difference: - --- Additional Fee Required: TO AMEND FEE UNDER PERMIT NO.: -- - - Inspectional services Department 2005 F:\tinalcosta1ridaviIform SIvict code enforcement ntake.r the logien.rgJer Before hgping. renting, leasing check_oning IYARD()FA NPAIS 6l48-05 t I CoNSFRV\VION 688-0530 1IFALI'1(o88-95 ITANNIN(i 08-035 TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 "Ac U`•��tty North,kndov'er, Massachusetts 01845 Gerald A. Brown Inspector of Buildings Telephone(9?,S)6,rs4-95-. Fax (978)r;,q9-95.1 HOMEOWNER LICENSE EXEIIPTIOiv P!ru1c print DATE: 3 J 7 JOB LOCATION: C�, Number Stree address -- :�'Iap/Lot HOitiIEO�VNER (71��, �, �/1�L�2�v Name Home Phone Work Phone PRESENT MAIL INI G ADDRESS S�-� City Town State r ('r "Y`S Zip Code The current exemption for"homeowners,-was extended to include owner-occupied dwellin to allow such homeowners to engage an individual for hire who does not Possess gs to two units or less and acts as supervisor). State Building P s a license g (Cade Section - Provided tion 1 P d that OS.3.�.I) the owner DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is be, a one or two Flmily structures. A person who co • nstructs more or is intended to considered a homeowner. re that one home in a two-year period shall not be The undersigned"homeowner"assumes responsibility for compliances with the State Buil ' ,Lpplicable codes, by-laws,rules and regulations. din Code and other The undersigned"homeowner"certifies that he,she understands the Tcwn of North Andover Building Department minimum inspection procedure anat he. she equirements d that will comply with said procedures and HOMEOWNERS 'SIG,NAl'L APPROV.w.OF RLII.DIN ,t)F CIAL I. :m Hunr,�,,.r�•,L..f?,,�,r.l�iir.n