HomeMy WebLinkAboutBuilding Permit #746 - 54 MILK STREET 5/2/2006Permit NO:
Date Issued:__L_z
LOCATION
PROPERTY OWNE
MAP NO.:
TOWN OF NORTH ANDOVER
,APPLICATION FOR PLAN EXAMINATION
IMPORTANT: Applicant must
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Print
PARCEL:
TYPE AND USE OF BUILDING
TYPE OF IMPROVEMENT
New Building
Addition
Alteration
Repair, replacement
Demolition
Moving (relocation)
= Foundation only
DESCRIPTION OF WORK
Date Received: V_�
lete all items on this p
6nd
ZONING DISTRICT:
HISTORIC DISTRICT
PROPOSED USE
Residential
One family
= Two or more family
No. of units:
Assessory Bldg
- Other
BE PREFORNIED
YES ❑
Non- Residential
= Industrial
Commercial
Others:
Identification Please Type or Print Clearly)
L_ U�/�' d
OWNER:'dame: D rn £ ey� -Po a)`� Phone
Address: V_1-,0
IN=
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CONTRACTOR Name: � � Phone:
;address: VL' milk )
SuperN isor"s Construction License: Exp. Date:
Home Impro%ement License: Exp. Date:
ARCHFITCT. E"N'UNEER \.amc: Phcne:
address:
Reg. No.
FEE SC HEDC LE: Bt LDL%G PERMIT. S10.i10 FER : 400.00 OF TIME TOT. IL ESTIMATED COST IASED JN V -'5.,10 °£R S. F.
Total Project Cast :$____ %3� Ody
x 10.00= FEE:$
Check �l s�
Receipt No..
—
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
a Building Permit Application
j 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
:3 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 In
Sprinkler Plan And
Hydraulic Calculations (if Applicable)
Copy of Contract
> Mass check Energy Compliance Report
to all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of
%ppeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One cop) and
proof of recording must be submitted with the building application
I, sl•:N1 1( G5 &T `R'I SIF' 1:31'FOR"05
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TYPE OF SEWARGE DISPOSAL
Public Seer _
Well _
Private (septic tank, etc. _
Tanning'Alassage Body .art Swimming Pools
Tobacco Sales Food Packaging Sales
Permanent Dempster on Site _
Electric deter location to
project
NOTE: Persons contrtrctin with unregistered Yntractors do not have access to theguarunty.fund
Signature of .Agent, O\sner Ih-2�Signature of Contractor
Plans Submitted s Waived Certified Plot Plan _ Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
DATE REJECTED
7
❑Water Shed Special Permit
1-1 Site Plan Special Permit
] Other
DATE APPROVED
DATE REJECTED DATE APPROVED
J .�
DATE REJECTED
HEALTH
CONI- IENTS
Luning Board of Appeals: % ariance. Petition No:
-_,ming Decision receipt �ubmittcd :,,,s
P';Inning, B,)arcl Comnic
C•.unments
DATE :APPROVED
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Building 0crrnit Appro%cd Lind l5sucd by:
-Building Setback (ft.)
Front Ward
Side Yard
Rear Ward
Required
Pro% ided
Required
Provides
Required
Provided
DIMENSION
?umber of Stories:
Total land area, sq. It.: _
Total square feet of floor area, based on Exterior dimensions.
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Location 17)
No. `f (i Date 69.
NORTM TOWN OF NORTH ANDOVER
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+ ; ; Certificate of Occupancy $ '
Building/Frame Permit Fee $ . a
s�CHU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # _
dbilding Inspector
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TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 01845
Gerald A. Brown Telephone (978) 688-9545
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:
JOB LOCATION:
J�Number Street Address �Map/Lot
HOMEONER-t�6ZC�K5 ��d �6� / �LW-6 F
W
Name Home Phone Work Phone
PRESENT MAILING ADDRESS 6Y n� //k-
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 11 comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL 6 L,4��
Revised 10.2005
Form Honiwwners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 088-9530 HEALTH 688-9540 PLANNING 688-
9535
The Commonwealth of Massachusetts
North Andover
( City of Town )
Department of Fire Services
Office of the State. Fire Marshal
P. O. Box 1025 State Road, Stow, MA 01775
PERMIT
A Atra
(If Applicable )
In accordance with the provisions of M. .Q 4 8 Chapter -1Q as provided in section -5 7 CMR 34
This Permit is granted to: /%7 ' �(,r/ f'r f
Date: "a !
Dig Safe Number
Start Date
Full name ofperson, Firm or Corporation
Permissionto locate dumpster for construction/renovation/demolition of building.
Comments: dumpster must be 251 from structure if unable to place with required
Restrictions: clearance dumpster must be covered with plywood or tarp end of work day
at `S'y 1o;71/,e Si,.� f� ;
( Give location by street and no., or describe in such manner as to provied adequate identification of location )
Fee Paid$ 50:00- /t'l Fire Chief
�--
- GThis Permit will expire 7� (Signatureofoffcal granting permit) Ofiica granting permit ( Title )