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HomeMy WebLinkAboutBuilding Permit #178-2012 - 56 HUCKLEBERRY LANE 9/1/2011 TOWN OF NORTH ANDOVER . APPLICATION FOR PLAN EXAMINATION Permit NO: 2- Date Received I Date Issued: �/V,// DRORTANT:Applicant must complete all items on this page L OCATTON �� a & �f d Ln Print PROPERTY OWNER- Print MAP NO: _PARCEL:�ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resi ential Non- Residential [INew Building One family ❑Two or more family 11 Industrial [I Addition j ❑Alteration No. of units: ❑Commercial El Repair, replacement � ❑Assessory Bldg 11 Others: ❑ Demolition _ ❑Other _ -e li -.:. � I_ ,151 odplainl4_,_ DiWetlands�, •, "�❑-iWatershed�Dlstrlct - i r t S eptic, ®Well V AT DESC1T_TON Obi V1ORKTO BE P ERiiOR -ED: e (Identification Please Type or Print Clearly) OWNER: Nam.e: Phone: -3/ _SDG c7 Address: J_ ( - r n—,h� ` c�<�JeiL- �1 A © l 1 CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULD/NG PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 3 d � Total Project Coat: $ a� FEE: $, -... Check No.: -�/q 9 Receipt No.: 07 '�S NOTE: Persons co tracting with unregistered contractors do not have access to the guaranty fund - fu-:e.ofcontractor^-<.==•��= `_`—•tu�e�of• ertt/,Own erg .:=.<..J .......� ,�_ - -- --- T L 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit. Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Pian ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Con•iracf ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign oft from Fire Department prior to issuance of Bldg Permit 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 ❑ 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 CIerks 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: Doc.Building Permit Revised 2008mi Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, toast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use I ® Notified for pickup - Date r � DomBuilding Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art El Swimming Pools ❑ Well ❑ Tobacco Sales ❑ . Food Packaging/SaIes ❑ 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 Zoning Board of Appeals:Variance, Petition No: Zoning Decisionfrecelpt submitted yes Planning Board'Decision: Comments Conservation Decision: Comments Water& Sewer ConnectioniSignature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT •-Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Location v C F 7//r No. /7,—/2— Date r �o 0 TOWN OF NORTH ANDOVER 3? O �. • F R 9 • s Certificate of Occupancy $ Building/Frame Permit Fee $ _ tACNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # .L/ 2 4 5 � L Building Inspector NORTH 0 0Andover ., o , dover, Mass., - LAKE COCKICMEWICK %SORATED BOARD OF HEALTH Food/Kitchen PERI 11T T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ ... .: ... ...... ...f. ........................................... Foundation p buildings on / v� 1E6 ��� .... .....�Y.:................. Rough has permission to erect.......... ............ 9../.. ........ . . ... . . .. `...... to be occupied as Chimney Vic.. ,sf ... . C.......... 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 CONSTRUCTION S TS Rough Service G 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 Wall To Be Done FIRE-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. I BUYM AW Yuan Yuan Ding and >vli P Chen Lee I I - I - I ! i N h . � N 1 b /L 22,mol * 'E-1- indicates �5' Sy required L if no Variance a and w violation exosts ¢� 45% s� -- =_ t-A.- , %ZvAD Wells Farpo Baru, U M!p"E RraR ' MORTGAGE;INSPECTION PLAN �ocATm n�. I CERTIFY 7HAT RIE BMDiNGS 6HOWN DB( )CGNF77Rb1 70 SETBAQC RFAVR6Etn3 �Q. A ..�N r`►{`. LE (FRONT.SIDE @ REAR SETBACK @B.Y)(wm dOV@r 4 4�•[.J�/ V'METI CONSTRUO'IED.OR ME EXE'],�T PROM NOlAlidll�NFO7RE�CO,_kNT ACTON IRBB:R PASS.6l 7n7E vR OEIAPTER 4oA SEO770N r,IRLIESS° Ncile'a c�teidA MASSACHUSEM FURTHER YER7IFY THAT THts F7tOPER1Y IS AOt tncnTED N THE ESTABUSHED FLOW HAZgDARE OOMMUNITY PANEL NO.; 25OD96 00070 DATE &-2-93 DEED �}` 9 IMS COMPANY IS NOT RESPONSIBLE FOR ANY DIDENTURES MADE SUBSSQUENT 70 7W REDORDED BOOK BATE OF THE LATEST DEED OF RECORD. - PAM 2 . "VENEVER BUIDRMS ARE SHOVIN LESS IMAM ONE FOOT FROM THEPROP ADVISED CERT NO. �TTARE A MOPRECISE SURVEY BE MADE 7D VERWY 7HESE MEASURFM , IMS CERIEICATIOM IS BASED ON IME LOCATION OF SURVEY M RAN BK. PACE REPtffSEtiY A PROPERTY SURVEY.VEWCA710M OF SURVEY AND 0 ORM, 172579 MAY BE ALOCONM�P�USHFD ONLY BY AN ACCURAIE MSMUMENT jp ICTED PLAN f IRO71MCATION TO BE USED FOR MORTGA POS NCY. AT RI(,. OFFSETS AS SHOWN ARE NOT . ` i-- USED USED FOR THE ESTABLISHMENT OF PR IJP BRADFORD , ' ENGINEERING CO. P.D.BOX 1244 JAMES W. BOUGIOUKAS R.L.S. #9520 �/97a,373 D2396 a� No Tit TOWN OF NORTH ANDOVER �: r •'.�°oma OFFICE OF } p BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 „,;;:� 41 North Andover,Massachusetts 01845 SswcNus� Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: 0,:[jZ`/�� JOB LOCATION: Number Street Ad re Map/Lot HOMEOWNER Dr✓l a �I� ?a9_,>6�` !72—31 7-10 d,0 ,A ame j 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 SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 3 _ t I' y -- "-°--`moi A(�1`-•:.:-.^----��----d..� s I f ' G I f + I lid i {{ '"1 k i �So4'