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Home My WebLink AboutBuilding Permit #601 - 483 MASSACHUSETTS AVENUE 4/18/2006 1 GE NORTH,H i _ O ° 000 p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SgACHUSEt Permit NO: Date Received: Date Issued: IMPORTANT: Applicant must complete all items on this page ~LOCATION Print PROPERTY OWNER .57:5V,5_ �- /nti -Z / 2�2L1190//YZ) Print MAP NO.: PARCEL: ZONING DISTRICT: !4jj�' TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) Other f-r_K ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: Phone: 979-"T) L `� 3� 0 Signature g Address: 9`c�3 ��955 t{-✓ /✓� i � 251ip /�f} 6/�y�"^ CONTRACTOR Name OPEIFFMV _1Ni# A'15(-,754S Yi Phone do 3`532.- 3 Address: /r U-1-27WGl'-F,'CC-"" N'll 0_? Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: p p ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE.BULDING PERMIT.$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost 00 0 x10.00=FEE:$ /00 Check No.: Receipt No.: 2 Page 1 of 4 i Building Department i 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 o 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 o Copy Of Contract o 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 o 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 o Mass check Energy Compliance Report _ i 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:RPFORM05 Page 4 of 4 1 TYPE OF SEWARGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the ranty fund Signature of Agent/Owner 5c� �� . ,t M Signature of Contractor �— 1 Plans Submitted ❑ Plans Waived ❑ CertifiedPlot Plan ' _ ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 11F1 ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ COMMENTS Other DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS E HEALTH DATE REJECTED DATE APPROVED F1 � ` 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 Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 I Building Setback (ft.) Front Yard f Required Provided Required Provides Rear Yard i / 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 de artment use) I f Page 3 of Doc:INSPECTIONAL SERVICES DEPAR7'MENT:I3PFORM05 Created JMC.Jan.2006 F Location 7 No. toli'I Date j MORTM TOWN OF NORTH ANDOVER f % t + ; . Certificate of Occupancy $ bisscMus9 Buildin /Frame Permit Fee $ D t Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #t06 19129 Building Inspector 1 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Numbiq.CS, 082039 Birthdate: 12130/1977 Expires:1.2/30/2005 Tr.no: 82039 DANA M GRIFFIN 28 HIGGINS ST APT-4-1 ALLSTON, MA 02134 :�".-"',' Administrator 00-35,000 cf enclosed space (MGL C.112 S.60L) 1A-Masonry only 1 G-1 8 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. i DIG SAFE CALL CENTER: (888)3447233 t �.10RT1y q T011;M Of ----- ... * ��`' AK O dover, Mass., fait pr— COCMICKEWICK ADRA 7E D `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... .D.L. ......................................................... Foundation s .. has permission to erect........................................ buildings on.... ..��.......M. . .Arorx...... .......... Rough to be occupied as......... .. W.W.A........*.......s.�.��..•�.......................................................................... Chimney provided that the perso 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 CONSTRUCTI . ARTS Rough .......... Service ... . ...... . ..... .. .. . BUIL INSPEC Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE 1 Smoke Det. KITCHEN _ _..- S_T:E-P S--- -------- ENTRY DINING AREA iM4r ,� EWWRE. 34 7 6 ---T 28 G-R-rt C 161 1 Q1/I `e NI T I �\ 24� STEPS ALL DIMENSIONS AND DESIGN PLANS ARE PROVIDED FOR THE FAIR DESIGNED FOR BY DATE BY SCALE DWG SIZE DESIGNATIONS ]bj][MjZln rmo ah USE BY THE CLIENT OR HIS AGENT IN REV D N ,b NO. GIVEN ARE SUBJECT TO �tj$' COMPLETING THE PROJECT AS LISTED WITHIN P� L L/-t D I NO 'S o O D VERIFICATION ON JOB Bath Industry THIS CONTRACT.DESIGN PLANS REMAIN THE THE MASTER 7 E R SERVICES y=J o ] SITE AND ADJUSTMENT TO PROPERTY OF THIS FIRM AND CAN NOT BE FIT JOB CONDITIONS. USED OR REUSED WITHOUT PERMISSION. 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O T " P /9G CE�c/T�AG .sT,eEET �'AUGU.s� �Y1.4. 0 ,moo Go 90 t/DB .c/o. SPzO3 - r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .97 V BUILDING PERMIT NUMBER. DATE ISSUED: X SIGNATURE: Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: -493 MA55, #VF- Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R 'red Provided Re aired Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record ��N►�FdRt�� `�i�D �f3 /nASS. �� N Print) n Address for Service �- /03-S32- Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ I I Licensed Construction Supervisor: O License Number Address I Expiration Date ic Signature Telephone r I 3.2 Registered Home Improvement Contractor Not Applicable ❑ I Company Name M Registration Number r Address ' r Expiration Date ^ Signature Telephone I SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes...... No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other Specify 1 Brief Description of Proposed Work: elk,1.2 13/4)e 2 yX/� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beOP ICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENTORCONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Auti3eri d-Agznt of subject property Herebv authorize v /y`�"//V to act on My beh lf,in all inrs r0 a y'o work authorized by this building pernut application. U V014 (I / O Signature of Owner Date SECTION 7b OWN.ER/AUTHORIZED AGENT DECLARATION 1, �i9-/t�GJ�/ =//f� M-19,mw/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief n-/ / -,41^l Si mature of 0x%mer/A ent Date �Q NO. OF STORIES SIZE 13ASEM--NT OR SLAB SIZE OF FLOOR"17MBERS IST 2ND 3 SPAN DIMENSIONS OF SII;LS DIMENSIONS OF POSTS DiMI-NSIONS OF GIRDERS I IF'IGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL,OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE