HomeMy WebLinkAboutBuilding Permit #164-11 - 68 LINDEN AVENUE 8/24/2010 BUILDING-PERMIT of µoRTy
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: �j Date Received
Date Issued: �lr/ �SSACHus���
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more.family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition_ Other
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DESCRIPTION OF WORK TO BE PREFORMED:- �^
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Identification PIease Type or PrintCIearIy)
OWNER: Name:_ ��i ,t7 �p_�aL.lL-"}, Phone
Address:
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ARCHITECT/ENG INEER
Phone:
Address: Reg. No.
FEE SCHEDULE:BULD/NG PERMIT-'M00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $ 2:a
2
Check No.:
Receipt No.: o;
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
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Building Department
The following is*a fist 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 Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
n 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 off from Fire Department prior to issuance of Bldg Permit
----New Construction (Single and Two Family)
❑ Building Permit Application
❑ Ceiified Proposed Piot Flan.
❑ 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 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:Building Permit Revised 2008
Pians Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tann ing/MassageBody Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales
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
i
CONSERVATION Reviewed on
Siriatu
g re
l�Vf1%IiVICI�I I J
I
i
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance Petition No:
P Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/signature& Date Driveway Permit
DPW Town Engineer: Signature:
_ Located 384 Osgood Street
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Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
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 21A—F and G min.$100-$1000 fine
NOTES and DATA— (For department use)
iJ I
a
i
❑ Notified for pickup - Date
Doc.Building Permit Revised 2010
j
1
Location(ak h de, j
No. Date
u
MORTq TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $ �✓
r
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
533 S7
237 3b
Building Inspector
NORTH
Town of Andover
0 . Wto ;
_411--. ..
No.
over, Mass., —l0
'+r O C LAKE
COC MICME WICK �
ADRATED PPf'
S U BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
h
THIS CERTIFIES THAT................................ �/.vt..( .k�.�/.1. —
......®......................................................................... Foundation
11
has permission to erect........................................ buildings on ... .......... .1X04 ... ................................... Rough
to be occupied as... .3....IS-w°! .o�^ s N 'r�,�o ti- �": VI n �. + � si J(' Chimney
..... ... .. . .. .
provided that the p rson accepting this permit shall in every respect conform to the terms of a 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 Permiir- Rough
Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION TARTS Rough
................................................................................................... Service
BUILDING INSPECTOR
1 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 S 1 D E smoke Det.
TOWN OF NORTH ANDOVER
i
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL C. 142 A requires that the"reconstruction, alteration,renovation,repair,modernization,
conversion,improvement,removal,demolition,or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units...or to
;fires which are adjacent to such residence or building"be done by registered contractors,
with certain exception,along with other requirements.
Type of Work: viny'�'w Pwnt-der 's um—ema�,w�,eet o ons Est. Cost 1000.00
Address Of Work 68 Linden Ave.Norffi Andover,Me.01845
Owner Name:Erin<wumow
Date of Permit Application:8/24/10
l hereby certify that
Registration is not required for the following reason(s): For office Use Only
Work excluded by law Permit No.
ob under$1,000 Date
Building not owner-occupied
ner pulling own permit
Other(specify)
Notice is hereby„oiven that
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION
PROGRAM OR GUARANTY FIND LINER MGL C.142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the owner:
8124/10 Erin Cournoyer,providing own labor
Date Contractor Name Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a permit as the owner of the above property:
B124no
Date Owner Name
Scope of demolition/repair to be done at 68 Linden Ave.North Andover, Ma.01845
1) Remove Sheetrock on interior of front three season porch.
2) Remove vinyl siding
3) Repair/replace cedar shake shingles existing underneath.
A) Replace shingles where holes were previously drilled to blow in insulation
B) Shingle wall where two windows where removed during a previous remodel.
4) Paint exterior of house
5) Debris to be removed to offsite dumpster and transfer station.
A) Homeowner own a utility trailer for transport
Total cost under$1000.00
R
Town of Worth Andover poRTk q
014 SSLeoab� ��
Building Department ��1,�.- ►. 6 oL
1500 Osgood Street
North Andover MA 01845
Tel: 978-588-9545 Fax: 978-888-9542 -
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DFMOLMON OF BUILDING AFFIDAVIT 0 rev
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DATE
OWNF..R'S NAME&ADORES ,
LOCATION OF PROPERTY TO DEMOLISH�e��' 1 Pam ���e a Al AAdiv-c- N. Ulbyrs
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CONTRACTOR'S NAME&ADDRo w K r-c
DEPARTMENT SIGN-OFFS
DEPT.OF PUBLIC WORKS -WATER: SERVER:
DEPT OF CONSERVATION HEALTH DEPT: Septic Well
HISTORIC COMMISSION
GAS
ELECTRIC
TELEPHONE
CABLE
TAXES '
POLICE '
FIRE
gXTERMINATOR
DUMPSTER—ONIOFF STREET
DIG SAFE NUMBER
DATE REC'D BLDG. INSPECTOR
ioo form demo tton of bvffft affidavit
f posrp TOWN OF NORTH ANDOVER
OFFICE OF
_
.. 9 BUILDING DEPARTMENT
�► 1600 IOsgood Street Building 20,Suite 2-36,
` -•�" ' North Andover,Massachusetts 01845
,SSAGWUst
Gerald A.Brown Telephone(978)688-9545
Fax (978)688-9542
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:8/24/10
JOB LOCATION:68 Linden ave. N. andover Ma. 01845 210/045.A-0021-000.0
Number Street Address Map/Lot
HOMEOWNER Enn coumoyer 508-265-0438 N/A
Name Home Phone Work Phone
PRESENT MAILING ADDRESS 68 Linden ave.
N. Andover Ma. 01845
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