HomeMy WebLinkAboutBuilding Permit #685 - 455 MAIN STREET 4/24/2007BUILDING PERMIT
TOWN OF NORTH ANDOVER
ICATION FOcPdXAMINATION
ON®,6d to
DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name:' ��� cn,(A� PJB Phone:Q-7�
ARCHITECT/ENGINEER
Address:
Phone:
Reg. No.
FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
q3qfj 'r - � I�
Total Project Cost: $ �1 �i �FEE: $
Check No.: 'a3 73 Receipt No.: O
NOTE: Persons contrkting unregistered contractors do not have access to the guaranty fund
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
Li Building Permit Application
Li Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
o Floor Plan Or Proposed Interior Work
o 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
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
o 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)
o Building Permit Application
o Certified Proposed Plot Plan
Li Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
o Mass check Energy Compliance Report
Li 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
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 SIGN OFF - U FORM
DATE REJECTED
PLANNING & DEVELOPMENT ❑
COMMENTS
DATE APPROVED
0
D EJECTED DATE APPROVED-
CONSERVATIO
y
0h1�I A%MI 0 1ITiMiilylm
HEALTH
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Planning Board Decision:
Conservation Decision:
Water & Sewer Connection/s
Located at 384 Osgood Street
0
. 1� �S urs-( Oa -r
DATE REJECTED DATE APPROVED
Comments
Comments
Zoning Decision/receipt submitted yes
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
r
Location
No. Date
1
AORTN
TOWN OF NORTH ANDOVER
n
Certificate of Occupancy
$
,Ss4CNU5Et
Building/Frame Permit Fee
_
$
4
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check #
2a'141 -e2r�
Building Inspector
MORTGAGE PLOT PLAN
E K SURVEY INC
♦ HAVERHILL, MA
Phone 976.469-1965 ♦ Fax 976-4GS-7046
MORTGAGOR LEgjff (, } DOHA 1N91084 DEED REF. _ -?ZV PG. ` y
ADDRESS OF PRINCIPLE BUILDING PLAN REF.
fISS ,h�¢�,y kyr, DATE OF INSPECTION L2i TA)K.
-6. Ak.0adWL 0A SCALE: 1' = &jo r
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CERTIFICATION TO
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AMetr'hRd„E A4tt - .tlt RUDEL �, Thetocation of the principlestructure!s
This Mortgage Piot Plan was prepared speciiclly frfaoNo. 38889
nwrtgage Purposes only and It is not intended or represented' Co�1/fl�nR
to txa Property line o'land surrey- This plan is not to be used F,t �fGt51EF�� �,�� with the local zoning bylaws in effect when constructed
to establish any of the property lines for any purpose. No sipNA! LPLAp SJ and! or is exempt from violation enforcement
responsibility` is extended to the land owner or occupant.action under Mass B.L. Tile VII, Chap. 40A, Sec. 7.
This certification is based on the location of survey marker subject building Is not in a Flood Hazard Area,
of others, O Subject building is in a Flood Hazard Area.
Flood Hazard determined from the FIRM maps!
JOB X 14 (P31t Dated
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TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
1600 OSGOOD ST
BUILDING 20 SUITE 2-36
NORTH ANDOVER MA 01845
978-688-9545
978-688-9542 Fax
HOMEOWNER LICENSE EXElYIPTiON
Please print
DATE iii/zM7
JOB LOCATION YJ n Ot '(A
Number
HOMEOWNER.
Name
PRESENT MAILING ADDRESS_ &.,, _ _ & .,,
Street Address
Home Phone
NORTq
1(p
Map/Lot
Work Phor
City/Town State Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings of
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, one or two family dwelling, attached or detached structures attached or detached structures
accessory to such use and/or farm structures. A person who constructs more than one home in a two-year
period shall not be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliance 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. �- \
HONEWOWNER'S SIGNA
APROVAL OF BUILDING OFFICIAL