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Home My WebLink AboutBuilding Permit #94 - 573 MASSACHUSETTS AVENUE 8/6/2008BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: 0 IMPORTANT: Applicant must complete all items on this page LOCATION P.nn -1 Lo /, I T4,13 Print' �GDISTRICT-- MAP'NO: PARCEL: �ZONIN 4istoric; gistnct 'Machine Shop, Villa! yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Al!q�� . No. of units: Commercial -R �air �relaqe�� Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer' DESCRIPTION OF WORK TO BE PREFORMED: -/T 011(� F/c, 0 / -( /zq OWNER: Name: Address: 5,7,3 06 /;-,) Identification Please Type or Print Clearly) I- I ZA(Ar--� (n, - 1 -he . ? 70- r-�& �? W30 ARCH ITECT/ENG I NEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 9so, 00 FEE:$ Check No.: Receipt No.:-QJ29 NOTE: Persons contracting * h unrepAtered contractors do not have access to the guarantyfund nature of Aaent/OWner V'V\ Y71�x--, 11 S-ianature,of, contractor 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 zi Building Permit Application L3 Workers Comp Affidavit Ej Photo Copy Of H.I.C. And/Or C.S.L. Licenses u Copy of Contract L3 Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Ei Building Permit Application L3 Certified Surveyed Plot Plan ci Workers Comp Affidavit u Photo Copy of H.I.C. And C.S.L. Licenses L3 Copy Of Contract ci Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) L3 Mass check Energy Compliance Report (If Applicable) Lj Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application Li Certified Proposed Plot Plan Li Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit L3 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 Lj 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 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 DEPARTMIENT:BPFORM07 Revised 2.2008 Di-mension Number of Stories: Total square feet of floor area, based on Exterior.-,,,Oimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector . Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21 A —F and G min.$100-$1 000 fine NOTES and DATA --(For department use) 13 Notified for pickup - Date . . . ..................................................... ... . . .......... . ........ . . . .. . ...... ... ............ . ................................. . .......................................... . . . . . .. . .. . . ........ . ......................................................... . ........ Doc.Building Permit Revised 2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/S`iileg Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY . INTERDEPARTMENTAL SIGN OFF - U. FORM DATE REJECTED DATEAPPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: --Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con nection/s 1-q nature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREDEPARTMENT -TempDumosteron-sitq, yes 'no Located at 124 Main Street Fire Department signatureldate COMMENTS Location 5 7,3 No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Mu Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #6t3l-�- 2,,391 Building Inspector Gerald A. Brown Inspector of Buildings Pleage print DATE:. JOB LOCATION: HOMEOWNER TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION Number Street Address I � A?" D, Name Hoiie Telephone (978) 689-9545 Fax (978) 688-9542 &.� yod� MAP/Lot Work Phone PRESENT M[AILING ADDRESS 523 Aq City To" State Zip Code The current exemption for 4'homeawnert" was extended to =In& owner -occupied dwellings to two units or lea and to allm such homeowners to engage an individual for hire who does not possess a license, prdvided that the owner acts as supervisor). State Building (Code Section 108.3.5. 1) DEFINITION OF HOI�IEOWNER Person(s) who owns a parcel of land on which helshe resides or intends to reside, on which there is, or is intended to be, a one or two %mily structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeownce' 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 inspection procedures and requirements and that he/she will comply with said ptocedures and requirements. z? HONIEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Reviwd 10.2005 Fom Hommmm E=mptkm 110ARDOF \PPFA1.S6?P)541 C0NSERV.V1'10N(,X8-953() ifE.u..'rii 688-9540 PLANNING 688-9535 CO) m m X m m m CO) m CO) a m CA Cl) 10 0 CD a Z CD 0 CL r— CA CD cm CD CL r.r CD Er CD 0 CD w w a CD W CD CL ca tp Cos 0 10 CD z CD CD 0 19 Lw FA F� cn cn n 0 z cn M ol w C/) 0 rD 0 CD cr C/3 91 r- CA Ix 0 QS CD ICIDL a 0 m 0 n :7- CO2 0 C2 C -J ITI 8 0 CL so 0 m cp a a. n cn (D 0 rL eD cm c Q w to — 1-0 a cm :�i =r =r CL .* = co =r Im Co m CO) CD --1 CD CA 0 0 0 a. SE Go co , CO 31. 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