HomeMy WebLinkAboutBuilding Permit #853-14 - 53 SPRING HILL ROAD 5/13/2014TOWN OF NORTH ANDOVER
` APPLICATION FOR PLAN EXAMINATION
Permit NO: �J/ Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
PROPERTY OWNER VA f Q 1n - - __--
Print ' V 100 YearOld Structure yes o
MAP NO:� PARCEL 5 ZONING DISTRICT: Historic -District yes no
Machine Shop Village , yes no
.TYPE OF IMPROVEMENT.
PROPOSED USE
Residential
Non- Residential
❑ New Building
� One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
0 Floodplain, ❑ Wetlands
❑ Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PERFORIVIEU:
( vto Q ✓� M 909 )1
v % f RO4)ard'
ir 004 denti ication Please Type or Print Clearly)
OWNER: Name: ayi6 "f Phone:
Address: `� C` l s
CONTRACTOR Name: Phone:
v3 1-91v
Address:°?
Supervisor's Construction License: Exp. Date:
Home Improvement License:
ARCHITECT/ENGINEER
Phone:
Address: Reg. No.
FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
...,� g�j= �2.
Total Project Cost: $ �; l FEE: $
Check No.:�-3 Receipt No.: 0�2
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent%Owner a Slg iature:,of cdntFactor
Plans Submitted ❑ Puns Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
- -Plans-Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans F1
-TYPE-OF SEWERAGEDISPOSAL '
Public Sewer ❑
Tanning/Massage/Body Art ❑ ...
S" ming Pools 0�
Well ❑
Tobacco.Sales ❑
Food Packaging/Sales ❑
Private: (septic ta*, etc:_ .
Permanent D"uinpster on_Site ❑
THE- FOLLOWING SECTIONS FOR OFFICE USE ONLY �
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE:APPR:OVED
PLANNING & DEVELOPMgNT F1❑
COMMENTS
CONSERVATION
COMMENTS
Reviewed o
l\,-" o
0
/HEALTH Reviewed on c3�aQi Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Com
Conservation Decision: :Comments
Water & Sewer Connection lSignature � Date Driveway Permit
t
DPW TowO Engineer: Signature:
Located 384 Osqood Street
FIRE D`IE
PA AT. - Temp Dumpster on site yes no .
- Located'at 124 Mair, Street
-Fire Departme�ifsignture/date
COMMENTS r .
Building Department
--`- The fol?owing is-''alist of.the required.forms to be -filled outfor:the appropriate permit to' be obtained.
Roofivg, 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
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster:permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
o Certified 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)
❑ 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)
❑ 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
❑ 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 apw• al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submAted with the building application
Doe: Doc.Buiiding Permit Revised 2012
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North Andover MIMAP
Interstates
—1
— SR
Roads
i; rEasemenls
❑MVPC Boundary
OParcels
1" = 161 ft
May 13, 014
Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83,
Meters Data Sources: The data for this map was produced by Merrimack
f �QRi►( Valley Planning Commission (MVPC) using data provided by the Town of
Q, ."So ` ® North Andover. Additional data provided by the Executive Office of
3,2. se a Environmental Affairs/MassGIS. The information depicted on this map is
_ for planning purposes only. It may not be adequate for legal boundary
F o definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER
MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING
i _ • THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY
,f $ . ♦ OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT
W f ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
THIS INFORMATION
TO" OF NORTH ANDOVER.
OFFICE OF
BUMDING IDEMTMENT
:1600 OB90od Street Building 20, -Suite 2-36
North Andover., Massachusetts 01845
Gerald A. Brown Telephone (978) 68$-9$45
TnspectorofBuzildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
B DID]NG PF—RW ` APPLICAZTOIIT
Pleas�iinf .
- DATE:
JOB LOCATION:
Number StreetAddres9
' - •
Map/Lot
' 7ZOME
O�
INNERJ 4A
Name.. Home Phone
WorkPhone
PRESENT NAILING ADDRESS
-------------
Sfwf� Zip Code
The current exemption for "-homeowners" was extended to
to allow su:h homed: r - �Glude owner -occupied dweIlings to Uvo units -ox less and
eels to engage an iudividual.for hire wbo does not possess a license, provided that the owrter
acts as supervisor). stateBulding (Code Section 108.3.5.7)
DEFINITION OFHOMEOWNER
Persons) who gwns aparceI ofland on which he/she resides
be or intends to reside
a o on
one or which (here "s
two faintly structures. A person who constructs more that one IlOme in a twoyearperiod shall n be to
ude
considered ahomeowner.
The undersigned "homeowner" assumes responsib
Applicable codes, by lawsrules andzegalationsility for compliances with the State Building Code and other
, . t
The undersigned "homeowner" cera a -es that he/she tmderstauds the Town of North Andover Building Department
minimum inspection procedures and re
requirements, quirements and that he/she will comply With,said procedures and
'
HONMOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Foran Homeowners Exemption
•BOARI)OF APPEALS 688-9541
CONSERVATION 688-9530
r• •
DEALTH 688-9540 PLkXNING 688-9535
Location
No. e,7e D a t e
1-7 �
Check # �
2Y612
TOWN OF NORTH ANDOVER ,'
Certificate of Occupancy
Building/Frame Permit Fee'
Foundation Permit Fee $
Other Permit Fee $-
TOTAL $
Z-� -
Building Inspector