HomeMy WebLinkAboutBuilding Permit #056 - 45 BANNAN DRIVE 7/31/2006 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION O pTh qti
Permit NO: Date Received
'
Date Issued: / " �9SSACHl1
IMPORTANT: Applicant must complete all items on this page
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LOCATION �( � hi,.,�*
not
PROPERTY OWNER 6,r C 5 `7 We�Z q
Print
MAP NO.: PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑New Building 1�One family
❑Addition ❑'Two or more family ❑Industrial
❑ Alteration No. of units:
X Repair,replacement ❑ Assessory Bldg ❑Commercial
❑Demolition
❑Moving(relocation) ❑ Other ❑ Others:
❑Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
�ydof V U �/'
n� � �, Viz, � v � ��
Identification Please Type or Print Clearly)
OWNER: Name: �' ''t' T� �di Phone:
Address: L�� �o, h
CONTRACTOR Name: 'A? 0 ✓1 K 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$125.00 PER S.F.
Total Project Cost S x.70 300 a d O x12.00=FEE:$
Check No.: &Z® Receipt No.: �r
Page I of 4
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Location s h rl sn
No. ! Date 7-?/- vg4
�ORT� TOWN OF NORTH ANDOVER
10- 9 f
# •
Certificate of Occupancy $ �.—
�'�s"•n E<�' Building/Frame Permit Fee $ J,3 4), _
ACNuS
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
17292
Building Inspector
TYPE OF SEWERAGE DISPOSAL Swimming Pools 11❑ Tanning/Massage/Body Art ElPublic Sewer
Tobacco Sales ❑ Food Packaging/Sales ❑
� Well ❑ ❑
Permanent Dumpster on Site
Private(septic tank,etc. C Electric Meter location to
proj ect
NOTE: Persons contracting with unregistered contr ctors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor
XI vPlans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stampe Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING& DEVELOPMENT ❑ ❑
[]Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
i
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑� - ❑
COMMENTS
z DATE REJECTED DATE APPROVED
? HEALTH ❑ ❑
t COMMENTS
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
Temp Dumpster on site yes—no
Fire Department signature/date
I
Building Setback
Front Yard Side Yard Rear Yard
Required Provided Re uired 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)
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Doe:INSPECTIONAL SERVICES DEPARTMENT:BPFORMOS
Created JMC.Jan.2006
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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 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
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 _
Doe:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
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woRTM TOWN OF NORTH ANDOVER
=ob s?`ap N°oma OFFICE OF
p BUILDING DEPARTMENT
;a4 1600 Osgood Street Building 20, Suite 2-64
�yS AATBD.p°{t5 North Andover, Massachusetts 01845
SaCwus�
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: 7 - 31
JOB LOCATION: qS 9�+hn.? Vr
Number Street Address Map/Lot
HOMEOWNER /)-5794 179) (V9)6 55 ~ 3 7 7
Name Home Phone Work Phone
PRESENT MAILING ADDRESS 7 F-i
�GV /� hG � /� o► HCl 5
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 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 OFFIC A
Revised 10.2005
Fonn Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-
9535
XAORT
Town ofR over
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BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT...... 4:50 ........494.nJ740.0............. Foundation
has permission to erect........................................ buildings on ... /....... a Rough
to be occupied as............ 0 - 4.......a..!!...D-0-40-4-4.10........................... Chimney
provided that the person-Fc�qnj1i*V Permit shall in every respect conform to the terms of the***application"*o*"n**file'*i'n* 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
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONS S ELECTRICAL INSPECTOR
T Rough
Service
BUILDING INSP R
....... .. ............... ...............
............... ...
Final
Occupancy Permit Required to Ocatpy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
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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