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Home My WebLink AboutBuilding Permit #389 - 416 RALEIGH TAVERN LANE 11/13/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION of No Dr;'+� Permit NO: Date Received X04✓ 3 V Date Issued: /10 V /1 d 4�7 ss 4rev IMPORTANT: Applicant must complete all items on this page LOCATION 416- AA- 1- 016t4 T'AvC—0. IV 3,,4yUL_ , `✓.AtiDoyC:�I2 Print PROPERTY OWNER /,127-H u tQ— 4, V C 14 M 7—i v 2 Print MAP NO.:IQL4 PARCEL:94 ZONING DISTRICT: 6Z Z --^ - --TYPE AND USE OF-BUILDING ------HISTORIC DISTRICT _YES _❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building XOne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: 9'Repair, replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED (ZP�,r*c4�7SIDIONJ �>00,p_,s Identification Please Type or Print Clearly) OWNER: Name:A 27-J+L- ' A., s C tom rT v f2. Phone Address: 414- AA4_all <!5i i.+ T-Au&P 2►v h✓t a- CONTRACTOR Name: vw tics te- 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$125.00 PER S.F. Total Project Cost .$ 6,000 FEE:$ Id q Check No.: 4 61.7 1 Receipt No.: Page I of 4 - J TYPE OF SEWERAGE DISPOSAL Swimming Pools 11Tanning/Massage/Body Art ❑ Public Sewer � ❑ Tobacco Sales Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Ownerp� �,je,. u Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM i --- ---- --------------DATE-REJECT-ED----SATE 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 Con nection/Shnature& Date Driveway Permit Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension 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 r — - I J 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 ConstructionSin le and Two Family) ( g Y) I I ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses I ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And I 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 I I Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 I r Page 4 of 4 TAO R T!y Town of _ L Andover No. LA E dower, Mass., d COCMICKEWICK �d AERATED APa�y,�C S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT Foundation has permission to erect....................................... buildings on.Y/ .....R�.c . .�...: �✓�iK..... � Rough to be occupied as it p ........�,�.,��l........ ..........� ... .................................................................................. Chimney provided that the person accepting this permit shill in every respelft conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Wipol- PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S` ELECTRICAL INSPECTOR Rough .................... :. ...... .................... ..... ........................ ....... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove F nagh No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 4C of ,1-- ,1 TOWN OF NO �_.� ,� v NORTH AND �' _ �� OVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 +cHu E` North,"clover, Massachusetts 01845 Gerald A. Brown Inspector of Buildings Telephone(978)688.9545 Fax (9;8)ti�s9-954? H01IEO�i'NER L[CENSE EXEMPTION !'!case print DATE: (i 113 IQ ov c, JOB LOCATION: -411r RAtGs7'6/-r- -r6ui..7 Aarv�- Number Street Address N(ap/Lot 11O,NTEM'1NER 14-M 7— sof-Cv��`}G� Name Home Phone ?n7-357/ Work Phone PRESENT MAILING ADDRESS Cit Town 1 City 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 acts as supervisor). State Building (Code Section 108.3.5.1) owner DEFINITION OF HOMEOWNER Perwm(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended t be,a one or two family structures. A person who constructs more that one home in a two-year o considered a homeowner. y period shall not b e The undersigned"homeowner"assumes responsibility for compliances with the State Buildin Code a Applicable codes, by-laws,rules and regulations. g nd other The undertii_ned• � "hom , ems ner"certifies that he,'she understands lands t he Town of,North A ndovcr Building Department rtmentminimum inspection procedures and requirements and that hetihe will com Iv with said procedures andrequirements. APPROV,\(.OF RUIr-DING OFF(C(.\L �� --- — -- I' :nt I�ninCrstb'f';f • :rq'liert li Location No. Date �oRTM TOWN OF NORTH ANDOVER ot ,,•O , ,h•0 � 9 • ; ; Certificate of Occupancy $ Building/Frame Permit Fee $ !r'� s�cMus Foundation Permit Fee $ L Other Permit Fee $ TOTAL $ Check # 19793 2 Building Inspector