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Home My WebLink AboutBuilding Permit #506 - 55 Peachtree Lane Lot 7 1/27/2006f NORTH , TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION y Sg1CMU5Et . Permit NO: S-0 Date Received: Date Issued: 2 IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNE -PA-k) L - MAP NO.: PARCEL: TVPF. AND 1J9F. OF Ri1ii,11iNC. Print Print ZONING DISTRICT: i 1QTnDi1'i 1QTDir9r vrc n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building D Addition Alteration 0 One family 0 Two or more family No. of units: D Industrial D Repair, replacement D Demolition 0 Assessory Bldg 0 Commercial 0 Moving (relocation) 0 Other 0 Others: 0 Foundation only 1Jr;!A-M1r I WIN Ur W UK1L I U 13t YKrt'UKNILD S I TT -i yCi G ,A 94-fvt, 6��' �oIdentificationon Please Type or Print Clearly) q -7OWNER: Name: Phone: Address: -5 Signature PLSc`�z z N� CONTRACTOR Name: Address: Supervisor's Construction License: Phone: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. F f FEE SCHEDULE: BULDING PERMIT: 510.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. ,?000o c7 Total Project Cost : % x10.00=FEE:$ %30 Check No.: Receipt No.:_1n, P TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art ❑� Swimming Pools Public Sewer Well F]Tobacco Sales —� Food Packaging/Sales ❑ Private ❑ _ Permanent Dumpster on Site (septic tank, etc. NOTE: Perso►rs contracting with whregisteret contractors do not have access to the guaranty fund Signature of Agent/OwnerTnature Si of s.,. g Contractor Plans Submitted ❑ Plans 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 DATE APPROVED ❑ ❑ ❑Water Shed Special Pen -nit ❑ Site Plan Special Permit ❑ Other DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED HEALTH ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Water & Sewer connection signature & date Temp Dumpster on site yes—no— Fire Building Permit Approved and Issued by: Comments 4 n e Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided V 11V1 11!11 k'pty Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. NU FF"S and DATA — ( For department use) Doc: INSPEC`IIONAL SERVICES DE'PAR'I'MEN I':BPP(.)RMO5 Cmited JM(Jan.10m f D 9 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 ❑ Debris Removal Form ❑ 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 ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Form ❑ 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 r. ❑ Form U ❑ Certified Proposed Plot Plan s ❑ 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 —R-- -- — -- Locatione- N A✓ No. �%r,., Date NORTq TOWN OF NORTH ANDOVER. � 9 + ; : Certificate of Occupancy $ Building/Frame /Frame Permit Fee $ CHU 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 18946 LOU ing "spec 01 a M W M tv � A a a a W a � W A � a s a cn c' w° U G w a a �° w w n°' U ao' w a w rA o. z � cn o cn o m c .cam O ti C O lb • V CJ dC cc ea - 1=0 C o � m �> E a 4a i Q ; rct D C O CL� �. Qo 0 CD �0 Q� c �N � $ * 2t► m c %mjh l � .mm h C C � m SO € .o CDC m o ph CL or •� o Z CD F— a' m h C O dmw H ' ' m WCO) CO . 4::s ui..C y.+ �- •dZ A C W EN� COLS CD.y COD d 4DO -0 dts m O z O U e-�cm UCLMW000Loo Q. O 'S w Z w CL O CO) I O �_ U3 m m � O O 3� O G O .mO � CIL cmQ O }� c ev a CD CO) COCL cc ) zCD w vs O c C CL W W N I - 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: 7 0 jb JOB LOCATION: /Number Street Address Map/Lot HOMEOWNER /"qW- DIEM 0 AJ -/— 9 - 3 - O 1 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 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 SIGNA' APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption .n Location No. `d Date Check #4 1847 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ e) Q,� ?:-,� G% 'Building Insp&r Of NORTH 1 p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,Ss�cNuse� Permit NO: ` o y Date Received:/' Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION P�, �—1% se�C L r4 n/L /fin , I — (Print PROPERTY OWNER /1`j'�J _��l oYc� Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF R1JI1.DtNG A14;.TnVJ n1CTA19'T VrQ rl TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 0 Addition ❑ Alteration 0 One family 0 Two or more family No. of units: C Industrial 0 Repair, replacement 0 Demolition 0 Assessory Bldg 0 Commercial ❑ Moving (relocation) ❑ Other 0 Others: 0 Foundation only LJLN—KIF I WIN UP W UKK I(-) BE FHEI, UKMED ° $fntT 4koo nn Identification Please Type or Print Clearly) 7 OWNER: Name:F—po..A-tQ� e ot- M Phone: 1' e G 55Y111 SignatureAddress: l / z&� L i4r/ CONTRACTOR Name: Phone: Supervisor's Construction License: Home Improvement License: ARCHITECT/ENGINEER Exp. Date: Exp. Date: Name: Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. ni Total Project Cost :$ �� e� x10.00=FEE:$ Check No.: /r3G `✓ Receipt No.:—