HomeMy WebLinkAboutBuilding Permit #196 - 43 LINDEN AVENUE 9/11/2007 BUILDING PERMIT ~? ���;``�..,6•a"op
TOWN OF.NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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Date Received
Permit N0: o°R4reo�Pa`�4y
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Date Issued: f
IMPORTANT Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building One family
❑ Addition 11 Two or more family 11 Industrial
Alteration No. of units: Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition 0 Other
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: CI Phone: 2
Address
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ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDINGrP�ERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125 R S.F.
Total Project Cost: $ /�or�r.�4z04S Y Od FEE: $
Check No.:���//-d Receipt No.: o�oS
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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�Fg�a�ure•of�ge� ��Iner� .. .��.
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
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
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)
❑ 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)
❑ 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
❑ 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
I
Revised 2.2007
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 MENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING &-DEVELOPMENT ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ . ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
r Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/Si nature & Date
Located at 384 Osgood Street Dr' ewa Permit
erste e yep
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u �'��` "�`�'�"_ � k"�Y ? � �`r r�fit,„:;��'� ' '� �',�,?„��^�✓ �f''y��3 mob`'��� ��r��s�'r to� ,r ��3��8�� x'� „;%5, x,"i.�''�"�' ��,z�;.
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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. -
1
$100 $ 000 fine
NOTES and DATA— (For department use
❑ Notified for pickup - Date
Doc.Building Permit Revised 2007
ZZI
Location/s —(Ay��1'
No. Date
MORTq TOWN OF -NORTH ANDOVER.
+ ; . Certificate of Occupancy $
1i7-ITS E<�' Building/Frame Permit Fee $ 9
s�CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
r �y
2455
Building Inspector r'
I .
` V40RTH '9
Town of ? Andover
No. ;=
C% o '� dower, IVlasso)
COC MIC MEWICK V
ORATED PPS\ �y
S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT........ .. ................ I...!!!!. ..... ....................................................................
Foundation
has permission to erect........................................ buildings on
' ...13............:
......� Ll ..................... Rough
to be occupied as ... 44.......(Lop .........1d �44, 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
Final
��..• PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
- UNLESS CONSTRUCT
S 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.
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NORTh TOWN OF NORTH ANDOVER
: e• , • •.co OFFICE OF
BUILDING DEPARTMENT
+ ; : 1600 Osgood Street Building 20, Suite 2-36
North Andover,Massachusetts 01845
�ss�cr+ue�t
Gerald A Brown Telephone(978)688-9545
Fax (978)688-9542
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
Pleaserpt
DATE: q 1
JOB LOCATION: '-I I-t (1 A
Number Street Address Map/Lot
HOMEOWNER g�6,cAAx L a I q� eZ 056,X
` q I L 11�'IZb,5
Name Home Phone Work Phone
PRESENT MAILING ADDRESS
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-oocupied 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 Andover Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Form Homeowners Exempgon
I.BARD OF \PPEALS 688 9541 CONSFR\'AHON 688-9530 ITGALTH 688-95.30 PLANNING 688-9535