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HomeMy WebLinkAboutBuilding Permit #390-13 - 41 BERKELEY ROAD 11/9/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: SCV0 13 Date Received Date Issued: — IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER oCena( AL 1-10-"-4 Print 100 Year Old Structure yes n MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑•Well ❑ Floodplain ❑Wetlands ❑ Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: A A?c- S�a41E'yC o� /"1.9�Ge� /-��'��f` I/ia� � 7"� � 7�I1X�rlrL(��' � � � e .4C A2- Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: _ Phone: Address: Supervisor's Construction License: Exp. "Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Co $ S0OC, U0 FEE: $ (�J Check No.: eceipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner ^gnature.of contra e i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location N Dat//- TOWN at /TOWN OF NORTH ANDOVER e _ — Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ kv tjj ' TOTAL $ Check# 25935 Building Inspector 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 Reviewed on Signature COMMENTS HEALTH Reviewed on Signature r a COKMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments I Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW'lbw, Engineer: Signature: Located 384 Os ood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS I 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 tj ® Notified for pickup - Date f Doc.Building Permit Revised 2010 d r K.Os co-f 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 i ❑ Building Permit Application Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o 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 o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ' o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) Li 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) Li Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract Li Mass check Energy Compliance Report a 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: Doc.Building Permit Revised 2012 T - - NORTH own 0 2 t 6 ndover No. 10, ®� - y 4h ver, Mass, COC "1CMl WICK 41,9 A°R�reo ►P�`,`,�5 S ll BOARD OF HEALTH PER T T LD Food/Kitchen Septic System 4 THIS CERTIFIES THAT .............. ..... yM'�� BUILDING INSPECTOR .......... ........... ........................................................ Foundation has permission to erect .......................... bu' Ings on . .. .�...... . .. ,. .. ..... ..... ........ •go Rough • to be occupied as ......�............. .. ........... ... ............. .. . ................................................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR • S TSRough UNLESS CONSTRUService ........PN .......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost 51000.00 m $ - $ 60.00 Plumbing Fee $ 7.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 7.50 Total fees collected $ 175.00 41 Berkeley Road 390-13 on 11/9/2012 Renovate bathrooms AVN OF NORTH TO ANDOVER . OFFICE OF BUILDING DEPARTMENT S �` Osgood Street Building 20, y�ssA�H�S cts* North Andover,Massachetts 01845-te 36 Gerald A.Brown Inspector of Buildings Telephone(978)688-9545 HOAMOWNER-LICENSE EXENIpTION Fax (978)688-9542 BUIDING PERMIT"PLICATION Pleasenrint • , ' DATE: JOB LOCATION: Number Street Address Map/Lot HOMEOWNER i3ame Home Phone Work Phone PRESENT MAILING ADDRESS /© zvew'rh e? Cii�i Tn•m State ` Zip Code The current exemption for"•homeowners"was extended to iuiclude owner-occupied dwellings to two units or less and to allow such homeo�irers to en age an i�cividual.for hire who does not Possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OFHOMBOWNER Persons)who Qwns a parcel of land on which he/she resides or intends to reside,on which there is Or be,a one or two family structures. A person who cons intended to tracts more considered a homeowner. re that one home in a two-year penod shall not be The undersigned"homeowner"assumes responsibility for compliances with the State Building Co Applicable codes,by-laws,rules andregulationsde and other, The undersigned`homeowner"certifies that he/she understands the Town of North Andover Building Depattment requirements, minimum inspection procedures and requirements and that he/she will comply with said procedures and HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption 13DARD OF APPEALS 688-9541 CONSERVATION 686-9530 HEALTH 688-9540 PLANNING 688-9535