HomeMy WebLinkAboutBuilding Permit #733 - 56 GLENWOOD STREET 5/25/2006o TOWN OF NORTH .kNDOVER
e MPLICATION FOR PL kN EXAMINATION
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Permit NO:
7� Date Received:���
Date Issued:
66
IMPORTAM:Applicant must complete all items on this page
LOCATION ' G�er,���� sj'T
Print
PROPERTY 0WNER___b v is n L A 0�f
Print
IMAP NO.: PARCEL: ZONING MiTRICT:
uieTnoir niCTRirT VFR n
s i lr W 11111% V va %_FA -- a
TYPE OF IMPROVEMENT
__ _ - -- - -
PROPOSED USE
Residential
Non- Residential
New Building
.W One family
Addition
= Two or more family
- Industrial
Alteration
No. of units:
= Assessory Bldg
Repair, replacement
_ Commercial
*-Demolition
Moving(relocation)
-Other
Others:
= Foundation only
DESCRIPTION OF WORK TO BE PREFORNIED � �� �� (Ae"A n-+A�c
I
Identification Please Type or Print Clearly)
OVN'NER: Name: t)6 A n L A nA
address:
CONTF_-kCTOR dame: As n.6�, Phone:
address:
Supery isor's Construction License:
I ome Improvement License:
Exp. Date:
Exp. Date:
:\RCI II-I'E-C f EINC:I LER Vimc: I'hcne:
v,ddress: Reg. No.
FEE SCHEDL I_E: U LDIAG PER,111• S10.0 PER ar 000.110 GF THE TUT IL ESTI.t1. I TED COST BASED OA 5125.00 PER S- f.
Total Project Cost :$.. __-��� 7, x10.00= FEE:S � ^�
(: hcck No.:
_Receipt No.:
TYPE OF SEW ARGE DISPOSAL
Public Seiner
Well
Private (septic tank, etc. _
TanningAlassa;e Body .art
Tobacco Sales
Permanent Dempster on Site
S"imming Pools
-- Food Packaaina Sales
Electric Meter location to
project
MOTE: Persons contracting wil 'unregistered contractors do not have access to the gur►runty�.J'und
Signature of Agent Owner � Signature of Contractor
Plans Submitted Plans Waived Certified 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
1J Site Plan Special Permit
Other
CONINIENTS
CONSERVATION
COMMENTS
HEALTH
C O,%v I -Nv I EN T S
DATE REJECTED DATE APPROVED
iJ i ]
DATE REJECTED DATE A. PPROVED
Luning Board of ,Appeals: % ariance. Petition No:
Zoning Decision receipt submitted � es
Nimning 9 -mrd L?cci.ion; lnnununts
Co,oscn,uicn Doci:rion: Cimuncnts
So ,cr xrnection J,Inaturc &- date.
icrnp DUmpster cn sile ; rs_ no _ Fire Department si! nature gate
Building Permit Approxcd and ISSLIcd by:
Building Setback (ft.)
Front Yard
Side Yard
Rear Yard
Required
ProN ided
Required
Provides
Required
Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
r— --
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Poofing, Siding, Interior Rehabilitation Permits
Building Permit Application
«'orkers Comp Affidavit
Photo Copy Of H.I.C. And/Or C.S.L. Licenses
Copy of Contract
Floor Plan Or Proposed Interior )kork
Addition Or Decks
Building Permit Application
Surveyed Plot Plan
o Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydrai.
Calculations (If Applicable)
Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
a Building Permit Application
• Certified Proposed Plot Plan
a Photo of H.I.C. And C.S.L. Licenses
Workers Comp Affidavit
a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
La Copy of Contract
j 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 o
appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One cop3 an(
proof of recording must be submitted with the building application
Nit: 1`'NPI.("1'1111 11. "FRN I('b:'i 01CP'.R'I �IF ' 11114-011,MS
µORT" TOWN OF NORTH ANDOVER
OFFICE OF
00 "1
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: e C `o I t�_Yl woo � S4
HOMEOWNER
Number
p
P(1AV1r�
Name
Street Address
Home Phone
PRESENT MAILING ADDRESS SG
City Town
Oen wo a
014
State
Map/Lot
Work Phone
61�Ll
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 SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Foran Homwwners Exemption
BOARD OF APPEALS 688-9541
9535
CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-