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Home My WebLink AboutBuilding Permit #574 - 40 EDGELAWN AVENUE 3/5/2007 i pORTFl BUILDING PERMIT Of TOWN OF NORTH ANDOVER �? g� �0 APPLICATION FOR PLAN EXAMINATION Permit NO: / Date Received A-° 7�A�R.{7tD 0 C3 Date Issued: IMPORTANT: Applicant must complete all items on this page -4=, ' ` firma• .� �, �� r �� yt s � ,".sem s.�r -�a .a.�� F' �..� .,e,�a��v „as� ;< �� ✓� ��t4�� '^:,: LOCATION .. Q tqua OP _1, OWNER m+ .fir m ' )�rIF1t :. �,�, ra.�, r "n°`` < ,�r �"• a, ;, MAP— PARCEI , � Olti11NG DISTRICT 1Jtt s „HIST C DISTR°I yc n M TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family Y ❑ Addition ❑ Two or more family ❑ Industrial "Iteration No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other n Septc �'U11�11� �eflapd� � filVaf�sl�ed Disfr�ct 11 DESCRIPTION OF WORK TO BE PREFORMED: New- Ci dentificat' n Please TLTe or Print Clearly) OWNER: Name ,0 Phone !Z Address: bbNTRAQTOR Name a I crne � w - �77a sk x Addresses Super�tsor's C�ahstt�.rcticnUtY'V > ' Mxp 9 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. I Total Project Cost: $ 1IDrcoo, FEE: $ Check No.: � Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own4 CCL Signature of contractor Locatio�-n - D E 0<z No. ! / Date,.., TOWN OF NORTH ANDOVER O� t.ao a','ti0 � A Certificate of Occupancy $ • 01 •.ti�s. ti• � ` ��, CNUS Building/Frame Permit Fee $ — Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 200 8 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 El— COMMENTS 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/Signature& Date Driveway Permit Located at 384 Osgood Street FIRE DE0Al0ME.Nt Temp Dump er onse ye �g no F � Located,�at 124=Majn Street er r Fire Department sjgnatureCdate ' d z COMMENTSv �. 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 ❑ 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 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) o Engineering Affidavits for Engineered products 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) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ 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 F N0RTH own of L Andover No. s- 71/ = LA E dover, Mass.,_ • s '.� COCMICKEWICK V �ADRATED C2 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............. .............................................. ...... ..l�.�A.... . i.. .�r 1/ ...................................... Foundation has permission to erect....... ................................ buildings on..... .�, . ..........gai......c. 3A...k.o.N. Rough to be occupied as..... e... ....... ..........i.. ..�.��r. ................................................................ ....................... Chimney provided that the pe on 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 a — Final PERMIT EXPIRES IN 6 MONTHS S ELECTRICAL INSPECTOR UNLESS CONSTRU T �Q� Rough .. ... Service . . .... ........................... ........ BUILDING 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. Of gORTIf TOWN OF NORTH ANDOVER �? ."';r``o �'••a°o� OFFICE OF p BUILDING DEPARTMENT �_�: 400 Osgood Street . re *-, North Andover Massachusetts 01845 CHUst� Gerald A.Brown Telephone(978)688-95454 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE:1 - ` O—4 JOB LOCATION:y Dk (SC �n.m �'�- 'Z 0 S-\1 S- Number Number Street Address Map/Lot HOMEOWNER 94 C�-,.1 "(-O. S I q,— (Vl Q-e- -`A 3 3a Name Home Phone Work Phone PRESENT MAILING ADDRESS .p �U�s n--� ►v ti� c��l 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 constricts 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 requirements and that he/she will comply with said procures and requirements. p� HOMEOWNERS SIGNATURE Q �� APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535