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Home My WebLink AboutBuilding Permit #160 - 52 MARBLEHEAD STREET 8/30/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION 0-futo 061 9tio �? o..::.'• 6 OL 0 A Permit NO: v Date Received Date Issued: O'� �9SSAC HU`�� IMPORTANT: Applicant must complete all items on this page LOCATION ^S oZ 1441k-A 0L(e/716Ce-Ad Print PROPERTY OWNERS/rC,.n kA14 C- Q Print MAP NO.: PARCEL: /.3 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑One family ❑ Addition )?I Two or more family ❑ Industrial ,'Alteration No. of units: 02 ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED *tC(a- 0,Af 1 T- Identification Please Type or Print Clearly) OWNER: Name: gety c,6�- S'%J&4164 du C- Phone: Address: 1'11�A ae-k J1,6M S/T CONTRACTOR Name: Lf 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$125.00 PER S.F. Total Project Cost ..$ P 0,0 ox a �1nb`� FEE:$ 92 Check No.: Receipt No.: Page 1 of 4 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 Doc:INSPECTIONAL SERVICES DEPARTMENTMFORM05 Pane 4 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools El Art Elg Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting wit{ unregistered contractors do not have access to the guaranty fund i Signature of Agent/Owner 15�7 Signature of contractor Plans Submitted ❑ Plans Waive Certified Plot Plan ❑ Stamped 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 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/Signature& Date Drivewav Permit Temp Dumpster on site yes_no Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required 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 SERVICES DEPAR7'MENT:BPFORM05 Created 1MC.Jan.2006 1 Location No. 1 loo a Date iY - HpRTq TOWN OF NORTH ANDOVER .�, fit," O '•.�ti0 3: � • of Certificate of Occupancy $ ;�SS�cHusE�A Building/Frame Permit Fee $ CLQ Foundation Permit Fee $ E Other Permit Fee $ TOTAL $ t2- Check # 19531 r Building Inspector NORTH Town of Andover ja "H •.4'" • l40 _ LA o lover, Mass., Lo COC MICMEMCK ^ �ADRATE D BOARD OF HEALTH PERMIT T Food/Kitchen i Septic System ' . BUILDING INSPECTOR THIS CERTIFIES THAT.... �1��i14! .r........... .1�.�. .L.rA ... ........ ............................................. Foundation has permission to erect... .................................... buildings onn. 4?v......I..�01.�. ....116111:011114...... Rough to be occupied as... . .. ..4.....Cow. .lz^....�......b.at.®.a w..0.............................. 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-taws 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 sow PERMIT EXPIRES IN 6 MONTHS 1 ELECTRICAL INSPECTOR UNLESS CONSTR . �1 STARTS. Rough Service 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. a ptORTH TOWN OF NORTH ANDOVER & + a0`},�so ."etioofi OFFICE OF 0 o k BUILDING DEPARTMENT / , 1600 Osgood Street Building 20, Suite 2-64 ' North Andover,Massachusetts 01845 � SaCHU`+Et d Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print I DATE: JOB LOCATION: i�0 -S ��-k � /J -f/�• 8 3 Number Street Address Map Lot HOMEOWNER 4/�VC�16 S/,Earl AV/Nc_-,' 9S b Name Home Phone Work Phone PRESENT MAILING ADDRESS 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 omeowner: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 requiremen 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 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688- 9535 f ' i i 1 I �1 i6 v - i All Ig w(/V Z 5,t