HomeMy WebLinkAboutBuilding Permit #744 - 56 GLENWOOD STREET 6/1/2006TOWN OF NORTH ANDOVER
got APPLICATION FOR PLAN EX:AAIIN:ATION
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Date Received: d
Permit v0:
Date Issued:—6.:. O
IMPORT ANT• Applicant must complete all items on this page
LOCATION TION l� I �.�1)()CA 4"
Print
PROPERTY OWNER �'�ISA' t
-7Print
�,I,Ap NO / PARCEL: ZONING DISTRICT:
TYPE AND USE OF BLiILDING HISTORIC DISTRICT
TYPE OF Ih1PROVEMENT PROPOSED USE
Residential
New Building ?SOne family
Addition - Two or more family
Alteration No. of units:
Repair. replacement Assessory Bldg _
aulic Demolition
Moving (relocation) = Other
Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
'e", b V I'd
OWNER: '.Mame:
.Address: S C
Identification Please Type 6 Print Clearly)
6 l fl,n LF
a)e-ntN-X51 A
YES 0
Non- Residential
= Industrial
Commercial
Others:
C'ONTR.ACTOR Mame: C) W r Phone:
Address:
I of Supern isor's Construction License:
Ind
I tome Improvement License:
Exp. Date:
xp. Date:
1RCI-11'1'1-C F I;\CINLER \.lmc: E'hcne:
\ddress:
Reg. No.
FEE SCHEDULE: BL LDIAG PERMIT:.510.30 FER S;00.00 GF THE TOT IL E'STIM I TED COST 3. ISE aN S125-00 PER S. f"
Total Project Cost:$_„__-- / /� , i�� P> xlO.W FEE:$
Check No A Receipt No.:-�
Location t) b Qen c,) 0 a - 5 7—
No. 7 i Date tom' ' 6
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
o ci
Check #
19226
Building inspector
.p
TYPE OF SE XARGE DISPOSAL
_
Tanning Alassage Body .art _
S" immin, Pools
Public Sewer _
—
Vv el l _
Tobacco Sales
Food Packaging Sales
- -- -
-
_
Permanent Dumpster on Site _
PriNate (septic tank, etc. _
Electric deter location to
project
NOTE: Persons controcting with unregistered contractors do not have access to the guurunly.14nd
Signature of Agent; Owner 4Signature of Contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
DATE REJECTED
❑ I
ElWater Shed Special Permit
�J Site Plan Special Permit
J Other
DATE APPROVED
CON-INIENTS r
CONSERVATION
COMMENTS
HEALTH
CO3MMENTS
DATE REJECTED
1-1
DATE REJECTED
Zoning board of Appeals: � ariance, Petition No:
Zoning Decision receipt submitted N es
'I;nmin!; 13r,ird L�ccisiun: C�muncnts
incl w S,:VLr :Crnection i ,naturc Jatc
ntp �umpstcr ce eco
--- Fire Department si`natur,� .iatc --
Building Hermit .lpproied and lssmd by:
F ve.'--(tl
- - _
DATE APPROVED
!J
DA'L'E .APPROVED
Building Setback (ft.)
Front Yard
Side Yard
Rear Yard
Required
ProN ided
Required
Provides
Required
Provided
DIMENSION
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq, ft.:
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
a 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
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydr
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
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o 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
%ppeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One cop3 o
proof of recording must be submitted with the building application
)1u: 114 )\ U sVRN R P:'4 Df,I `RI1IP,':JI'PAV105
I'.1"c 4 1 1 1
a NORTH
O`sitto
TOWN OF NORTH ANDOVER
;6 e"�G
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: Co , l r 0
JOB LOCATION: 56 C) G n W o O a 7/ (37
Number Street Address Map/Lot
HOMEOWNER -96") C� JG) Ar) �A Y?�i'rn
Name Home
PRESENT MAILING ADDRESS 5(�
6)eY1 Wood S4�
A-OAOv(u- f Y) or
City Town
State
Work Phone
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
Fonn Honwowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 6380530 HEALTH 688-9540 PLANNING 688-
9535
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