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Home My WebLink AboutBuilding Permit #245 - 59 PADDOCK LANE 9/29/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION O Nu oT 6;�tio O — A Permit NO:� / � Date Received `0 Date Issued: /g flof �9SSACHUS��y IMPORTANT: Applicant must complete all items on this page LOCATION PA p 0 C`� Z/V Print� PROPERTY OWNER �- II,, Print MAP NO.: U� PARCEL: D ZON G DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ATne family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: epair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED ns�� (� �� sof old �d 7 l 7� Identification Please Type or Print Clearly) OWNER: Name: !Ch q-e F/?!} df! .v Phone: Address: -S-1 A4,0b dc /`1 6-01 903 00 CONTRACTOR Name: `— ax/-e — Phone: S? R612 Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: 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 1 3 0 0 0 FEES !,6 C Check No.: 5�-5 Receipt No.: 33 Page Iof4 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ , Public Sewer ❑ Well F1Tobacco Sales ❑ Food Packaging/Sales 11 Permanent Dumpster on Site ❑ Private(septic tank, etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no F&V Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature& Date Drivewav Permit l Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required j Provided Dimension Number of Stories: f Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) Page 3 of Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created IMC.Jan.2006 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 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 ❑ 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 ❑ 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 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 DEPARTMENTMITORM05 Page 4 of 4 Location 5 66" Z e" No. -?�/� Date �/ �f 6 } �oRTN TOWN OF NORTH ANDOVER 0 w 9 • i ; , Certificate of Occupancy $ s' Building/Frame Permit Fee $ 00 'Its C"Us Foundation Permit Fee $ Other Permit Fee $ ? TOTAL $ Check # CM3 /Building Inspector NORTH Town of N0% o. A060 ., 0 or dover, Mass., 2 OCMIC ti A. C �A�RATED pP�\ C IS � BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.............. . .. ........ .Orel a.0440y ....................:.......................................... Foundation has permission to erect........................................ buildings on . .. ..... .....�� 0.61f...A .............. Rough to be occupied as................ .. � �..... ... �.�.. ............................................................to provided that the person acceptinspermit shall in ve respect conform to he terms of the application on file in Final g thi 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 CONSTRUCTIO TARTS Rough Service .............. .......... ............................................... UILDING 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. IF_sEE REVERSE SIDE Smoke Det. NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: Ue W V'fc 4-4 �✓l ��J (Location of Facility) Signature of Permit Applicant Fire Department Sign off: Dumpster Permit Date +ONT" TOWN OF NORTH ANDOVER I " Z ,JF ,_ o •4,y i 4 OFFICE OF BUILDING DEPARTMENT r„ 1('00 Osgood Street Building 20, Suite 2-64 ° 1F North.kndover, Massachusetts 01845 Gerald A, Brown Inspector of Buildings Telephone f978)688-9545 Fax MR)688-9542 HO-MEOWNER LICENSE EXEMPTION Plcasc print DATE: V �j JOB LOCATION: 4 u t(,l Number Strcet;Address t (� Map/Lot HOMEO'W'NER MtClnUp� v��Horlhi SIS �� g6Name Phone Work Phone PRESENT MAIL[NG ADDRESS MA 0 9 Lt� City Town State I /-!p 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 Ire,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. HONlEO1VNERS SIGN ATL'RE ___jf�& APPROVM.OF RUILDING OFFICIAL �. 1:ed n uu -. :III llmlio)snrrs li. mpli,:n l;..fliC.F