HomeMy WebLinkAboutBuilding Permit #157 - 517 JOHNSON STREET 8/29/2006 i
TOWN OF NORTH ANDOVER NORTH
APPLICATION FOR PLAN EXAMINATION a��i�ac �6;�+0
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Permit NO: /,5-'7 Date Received
Date Issued:
�9 rSACHU`����y
IMPORTANT: Applicant must complete all items on this page
LOCATION ��1 -
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PROPERTY OWNER
/ Print
MAP NO.: 5dd!PARCEL: S ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
C New Building N"One family
❑ Addition ❑ Two or more family L7 Industrial
tA�lteration No. of units:
❑ Repair, replacement ❑Assessory Bldg ❑Commercial
E Demolition
E Moving(relocation) ❑ Other ❑ Others:
Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
!Xt mcg®tr Z.,in ISA TA C Ned rAl r' -►a.i°�r3M
Identification Please Type or Print Clearly)
OWNER: Name:
`/r V I K) 1-+,/� He �d� Phone: (21 7S9 S Z
Address: S 1 -7 014 6� 'J>Qkl ST EL�-1
n q-7 597q yloS
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CONTRACTOR Name: (� C—U l m A ii e iqdN Phone: Co I'1 ��-
Address:
Supervisor's Construction License: bG � Exp. Date: V?/.2b/0T-
Home Improvement License: /1/5 03/ Exp. Date: 6110 012
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 :$40"05&0 x12.00=FEE:$
Check No.: �—/ Receipt No.:_ Z
Page lof4
I
TYPE OF SEWERAGE DISPOSAL
Public Sewer
Tanning/Massage/Body Art ❑ Swimming Pools ❑
❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
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
r
Signature of Agent/Owner / 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 REJECTED DATE APPROVED
PLANNING& DEVELOPMENT ❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
Zoning Board of Appeals: Variance,Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer connection/Sianature&Date Driveway Permit
Temp Dumpster on site yes no_ Fire Department signature/date
Building Setback (ft.)
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)
Page 3 of 4
Doc:INSPECTIONAL SL RVICLS DUARTMENT:I3PLORM05
O ealed.].MC.,Ian'006
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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.
f
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)
�r
❑ 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 In
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
Doc:INSPECTIONAL SERVICES DEPARTMENTMFORN105
Pnu 4 44
Location ✓�� 7 �t
No. I,S'Z f Date Ia S/o
�aRTM TOWN OF NORTH ANDOVER
O#, aao ,a,hC
+ ; , Certificate of Occupancy $
Building/Frame Permit Fee $ �
swCHus
e
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # ggll
19527
' Buii)#1 g Inspector
Remodel exsisting Bath kitchen I rr FAMILY
and bedroom. I E
UP
14'3
X � 24'5
BEDROOM Walk In closet
o
FLI
0 H
BATH F ss 2'a
KITCHEN -
O
i -82 _
15'11
O�
6'2
UP
PD a
S ORAGE Kevin Aheron
,_j Window Seat
BEDROOM ENTRY ---- 517 Johnson ST
3'8
North Andover,
UP
MA 01845
.... .. :. 2u. :. Q
UP
LIVING AREA
1999 sq ft
µORTH N TOWN OF NORTH ANDOVER
0*
OFFICE OF
° BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-64
North Andover Massachusetts 01845
�SSACHU5ES
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: ll
JOB LOCATION: 7 JCXNhI IU ! :E INPIII�o,Z f�
Number Street Address 94ap/Lot
HOMEOWNER &11n1 ^1E 0a' 617 733
Name Home Phone Work Phone
PRESENT MAILING ADDRESS S AUS
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 OFFICIAL
Revised 10.2005
Fonn Homeowners Exemption
BOARD OF APPEALS 683-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-
9535
,(yORTH
Town of
No. f
�,o -= LA dover, Mass., �' Q
COCMICMEWICK
AoRATE0
S BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT....... ..... ..rrer�.....44ee-o-ov. ...........................:. :.
•.• Foundation
has permission to erect........................................ buildings on ........� �..7........ �,�►.s�/>~.Sf. Rough
to be occupied as.. .........it... 6# f • Chimney
thprovided that the ers accepting this permit shall in eve00� &r'm to the e f o e application on file in Final
is 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
�Q PERMIT EXPIRES IN 6 M014THS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIO STARTS Rough
Service
BUILDING
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.