HomeMy WebLinkAboutBuilding Permit #516-12 - 54 PHILLIPS COURT 5/1/2018 tt t&ORTOI
BUILDING PERMIT O`�SLED ,6 91•
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
Permit NO:
Date Received
ACHUS
Date Issued:
IMPORTANT:Applicant must complete all items on this page
PR®PERRTRYi®WNER �_ �.�
�P int ;
I � �
_ Pnnta �
- 1
lop, 1PARCEL �-— ZONING _®IS±��RICT _ 3Histonc(Distnct
—
iMacfainefShUilla a es ono.;
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition eTwo or more family ❑ Industrial
❑Alteration No. of units: 1 V6 ❑ Commercial
Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
Septr_c, (Well: ❑Irk
oodplan DWetlands ❑41Natershe�dstncf:
Water/Sewer a. ::
� ��� -
DESCRIPTION OF WORK TO BE PREFORMED:
Nem ,
Identification Please Type or Print Clearly) q--
OWNER: Name: (R yG l p. �h��q� Phone: O FF'P�'
Address:''
C�O:NTRACTO,R fName . Tr = _ Phone4
�. .�
.ti
Address-'
i
SupervsorKsCoaft ctionAfLitd_
ense ._r Exp fDate; _
I
fHomelin rovementLicense . _-fExp irate
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ lo, t�1® FEE: $
Check No.: ' Receipt No.: '9 �2 7
NOTE: Persons contracting with unregist red contractors do not have access to the guarantyfund
u
Sgnatur_etofAgent/Owner ,Sigriatureof co trn actors ]
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
u Building Permit Application
o Workers Comp Affidavit
a Photo Copy Of H.I.C. And/Or C.S.L. Licenses
u Copy of Contract
o Floor Plan Or Proposed Interior Work
u Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
u Certified Surveyed Plot Plan
u Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
u Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Mass check Energy Compliance Report (If Applicable)
o 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)
o Building Permit Application
u Certified Proposed Plot Plan
u Photo of H.I.C. And C.S.L. Licenses
u Workers Comp Affidavit
u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable) +'
u Copy of Contract
a Mass check Energy Compliance Report
o 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 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 DEPARTMENTMFORM07
Revised 2.2008
%AORTH
BUILDING PERMIT ofst�Eo ,bgti
TOWN OF NORTH ANDOVER F
APPLICATION FOR PLAN EXAMINATION _
4
Permit NO: Date Received
Oreo�
SSACHUS�
Date Issued:
IMPORTANT:Applicant must complete all items on this page
tL<<OCATION'� 6T J
PF2®PERT�Y0INNERY _ � �� -
Pflnt�
4�_.
Q-
iMAP1N0P`ARCL_ _fZONINGDISTRICT HistoicFDis"tact yes, ono
z - -
�Macfine¢Shop Village yes, ;no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition I/Two or more family ❑ Industrial
❑ , Iteration No. of units: l was ❑ Commercial
r Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
FSeptic, dDWell+ ❑#Floodplan �Wetlands, tlNatershed District.
Ne�r k` � DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: IR` O A Phone: 0il-M M
� a -
�1 cF
�.. I � l s
Address. � � � P
IC.ON'TRACTtOR
!S"upervisor'sC;onstructi-on�j License
IHomeIrrpro�emeritafLicense ._ _ -_ r,_a. n �_. _ _._:dExp.. ate; �
- - ----_A
ARCHITECT/ENGINEER 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: $ /0, QgO FEE: $
Check No.: -Receipt No.: �2
NOTE: Persons contracting with unregist red contractors do not have access to the guaranty fund
Signature�ofYA"ent/®wnerc g `
_ �g_�
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
o Building Permit Application
o Workers Comp Affidavit
u Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
o Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
o Certified Surveyed Plot Plan
L3 Workers Comp Affidavit
o 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)
u Mass check Energy Compliance Report (If Applicable)
o 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)
o Building Permit Application
o Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
u Mass check Energy Compliance Report
o 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 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:BPFORM07
Revised 2.2008
I
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
i
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
_ Located 384 Osgood Street
;FIRE DEP-RTMENT _emo ®um step on J ite es
�Located,tat�1241Marn[Street a
[Fire epar#ment�srgnature/dater _ _
�C®MIVIEN�T�S
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$10041000 fine
NOTES and DATA — For department use
❑ Notified for pickup - Date
Doc.Building Permit Revised 2008
i
Location
No. 2 Date
NORTH TOWN OF NORTH ANDOVER
O � L
A
• i ; , Certificate of Occupancy $
HusEt�' Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
24925 � Building Inspector
F j1°RTH TOWN OF NORTH ANDOVER
0rf- OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
r7 q�A�nc.aa`.y
9SSgc►+us��c North Andover,Massachusetts 01845
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER-LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE:
T
JOB LOCATION: 5q=
Number Street Address Map/Lot
HOMEOWNER �y�� Nr� �,Z e✓�al�r `�7� ��G�� 6g��'y
Name Home Phone Work Phone
PRESENT MAILING ADDRESS
A/ 40
City TovM S+Mre. Zip Code
The current exemption for"•homeowners"was extended to include owner-occupied dwellings to two units-or less and
to allow such homeovrners 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 Qwns 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 o1h
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONTSERVATION 685-9530
HEALTH 688-9540 PLANNING 688-9535
Qii
0 of over
.1 .
0
No.
L A K E fl . lover, Mass.,
�A COC MICM_.C'K\��•
%SDRATED PPG-1
U BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
�! �7. S G l/-tee,rv��
BUILDING INSPECTOR
THIS CERTIFIES THAT.......... . .......................................�...................................................................... Foundation
has permission to erect..........:.::... g Al . ..................... Rough
. ................... buildin son .........�..........:.....�. ..........................
to be occupied as...................... .. �,�� G.G �C` ....... .. .. ..r, 1 ............................................. 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-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 CONSTRUCTIO ARTS Rough
e Ilf. . . .... Service
BUILDING 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 (Nall To Be Done FIREDEPARTMENT.Until Inspected and Approved by the Building Inspector. Burner
- Street No.
SEE REVERSE SIDE Smoke Det.