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HomeMy WebLinkAboutBuilding Permit #004 - 55 FOXWOOD DRIVE 7/5/2006 TOWN OF NORTH ANDOVER OORT1i APPLICATION FOR PLAN EXAMINATION o`tt, o quo FO 2 Permit NO: (7 Date Received 7.S 'O �-' io e Q11.. 1 ` 'Is9ss Oreo�5��49 Date Issued: �- "� Y ACHu IMPORTANT:Applicant must complete all items on this page LOCATION SS Fzxkva1 Or._ OJ. 4n n01A. 0 In-E- t nEt PROPERTY OWNE - Print MAP NO.:_L S— PARCEL: AAR ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building )(One family Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessomy Bldg ❑ Commercial ❑Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED c t r Identification Please Type or Print Clearly) OWNER: Name: �• yJt,(�► Phone: 1_x__k __L'7 0 Address: 5__S7_ Fx(,v0oc.� bit. 4J, 41y )AAA. OMIL S CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ x,1.5M. FEE:$ 30 Check No.: Receipt No.: ©1 Page Iof4 TYPE OF SEWARGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public Sewer ❑ Tobacco Sales Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site ElPrivate(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner ;Signature of contractor -, Plans Submitted Plans Waived ❑ ertified 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 ElOther COMMENTS s ,� - - !•, ,, DATE REJECTED. .-D TE APPROV } s CONSERVATION ' ❑ r ' , COMMENTS i DATE REJECTED r DATE APPROVED H LTH ❑ ❑ i W,MMENTS ZoningBoard oa d of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Si2nature&Date Drivewav Permit Temp Dumpster on site yes_noFire Department signature/date I ' Building Setback Front Yard Side Yard Rear Yard Require= Provided Required Provides Required Provided DIM ENSION 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 DEPARTMENT:BPFORM05 Created JMC.Jan.2006 I, I 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 DEPARTMENT:BPFORM05 Pave 4 or4 T Town of MIE21i t o dover, Mass. • ' a O C �C 1. 1 C OC MIC ME WICK AORATED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.............��1.h. ...........9A.U.t. . :Z.. �.......................... . i Foundation has permission to erect........................................ buildings on ... ..... .......4 .... .................... Rough tobe occupied as....j.0,Gtr......A.hA.....r. PT....................................................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in p 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 PERMIT EXPIRES IN U MONTHS Final V / ELECTRICAL INSPECTOR UNLESS CONST'RUCTTI® TS Rough ..................... ........... ....... ............ .... ........... .............. Service BUILDING INS CTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done, Until Inspected and Approved by the Building � Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det. KOHrN TOWN OF NORTH ANDOVER j OFFICE OF ° BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 4SSACHUS�'t Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 5 0 JOB LOCATION: S h6 Number Street Address • ap/Lot HOMEOWNER �- — _ _ 13V I_ me Home Phone Work Phone i PRESENT MAILING ADDRESS �oJrc.load r r` . S' 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. IIOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Honwowners Exemption t BO. APPEALS 633-9.541 CONSERVATION 033-0530 HEALTH 688-9540 PLANNING oi8- 0535 i O/8/4 Sll-�S/1�d3"Sb'!y `.Y.r,.t00/Yd'I ` .L..��.�1S �3'd'bo/ 99 � ,�sd'a'o».�' �ni1s✓x3 wva� �Y.�,rv1 iror�c� c700,44 X Oj ;>LaV 860052 e� a'CJ /Y.H6'�'4 dna a- drd'z,*w aav75' 1or►'si sLyrTl3t+vd riyt 1rH1 .a.�/1y�.� 3�•�v/!�Z •SS dfjy /�9•r GY1/Yd/ /�'.1 e'�'G� r S'.i/r/�'y/G*7 j S,L.7�eYlt'iYG2�S,Y�Y9.L,�S' .`�'1'/OJ'Y'9:�Y SYCYYJv7W93i'' 2)U toV"e 0/Y,�O S3od.1/1rh'-1 7/YA, /Y.WaVS', 107 9//1 / /� /YO d�lb'J07 1'r OW177-.wd. -WZ ZO&Z.'wyt"O ..L V Bi4'L Ql 4 • } n f �S Y \ t f 1p V\ ms's 04 '/0 n' E 97 .flooz.� r w - 1r' L•� Ma- PAP �.. �, q Qr, d!:Yi'�✓ Ai�:^u���F�+Abi, 5� y .n2" .ta�s�'.:;;e �.. � ; � �^ �I $ ..• :� - fi16lN.7�,gtC�''yylldMYi�r�q�IIIIyL�"G¢µpl g���p4'�♦A'{ EWMAN&AUIMMMEN mm"— '&itM�,l1SS.fIEIRk'� 'id"i>AI.•Y A" k�i.4 — a!b � so 111 I At r i� I� 4 } _ i m 14i now,it Mill AMONOWWASM 10 L r • r. 3 wxM ^h"Y Y1.7 �d ' 14 ' "r 'y y +y "AyE � FR �a P '"ky��� 1 * '�s•?} 'gr(a.. t {t1 "'� r c# •e�i� �}A." .f:T1�5Fr`ti i•.wiS.n7f� �`.. �.J�. ^-.rs4 - .�j�i'4%�' - � .'.fin: 14 A` .'�i