HomeMy WebLinkAboutBuilding Permit #810 - 69 PROSPECT STREET 6/16/2006Permit NO: �?,, v
Date Issued:
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received A�'z�
IMPORTANT: Applicant must complete all items on this page
LOCATION h I !►� S�iCi� �� 1�
Print
PROPERTY
MAP NO.: V49 PARCEL
rrVPTi ANTI TTQF n1P RTFU UNC:
ZONING DISTRICT:
IIiCTCIRIC D1V%TRIC'T VFC n
Of NORTH qti
O T
9'SSACNU`�E4
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
One family
❑ Two or more family
No. of units:
❑ Industrial
U/Repair, replacement
❑ Demolition
❑ Assessory Bldg
❑ Commercial
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED &2mg v-,
AX )710W
Identification Please Type or Print Clearly)
OWNER: Name:
Address: /4 iffz
CONTRACTOR Name:
Address:
Phone: of77-ali'b��
Phone:
Supervisor's Construction License: Exp. Date:
Home Improvement License:
Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address:
Reg. No.
FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost :$ 20 0,0,r? x10.00=FEE:$ 9,0
ry
Check No.: Receipt No.:
Page I of 4
TYPE OF SEWARGE DISPOSAL
Tanning/Massage/Body Art E]
Swimming Pools 11Sewer
Public
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc. ❑
Permanent Dumpster on Site ❑
Electric Meter location to
project
persons contracting ttn unregister contractors of have access to the guarantyfund
Signature of Agent/Owner Signature of
Contractor
Plans Submitted ❑ ins give Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
f CONSERVATION
I COMMENTS
HEALTH
COMMENTS
DATE REJECTED DATE APPROVED
❑ ❑
[]Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
DATE REJECTED - DATE APPROVED
❑ ❑
DATE REJECTED DATE APPROVED
❑ ❑
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer connection/Signature & Date Driveway Permit
Temp Dumpster on site yes_no Fire Department signature/date
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required
I Provided Required
Provides RequiredProvided
/
/
ION
Number of Stories:
Total land area, sq. ft.:
NOTES and DATA — (For department use)
Total square feet of floor area, based on Exterior dimensions.
Ld tl ti-� "
Page 3 of 4
Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created JMC. Jan.2006
DIM
ENS
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 DEPARTMENT:BPFORM05
Page 4 of 4
Location Ady/1,-? I,"—
No. Date
r`
NORT#j TOWN OF NORTH ANDOVER
9
o •; Certificate of Occupancy $ L
"„•O'�t� 9
Buildin /Frame Permit Fee $ QL0 4)_
s�cNuse
Foundation Permit Fee $ t
Other Permit Fee $
TOTAL $
Check # 3 Z
194Y
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Fe: AI sIi de Supply Manchester 603 669 6319 To: WO01753/PETER/JEFF/ATLANT IC HOME I M (17815947615) 14:27 06/14/06 EST Pg 1-1
6/14/06 123 MANCHESTER POO: 123-01753
14:22:59 WINDOW ORDER Page: 1
------------------------------------------------------------------------------------------------
Customer: 09901 Job name: Ship to:
ATLANTIC HOME IMPROVEMENTS JEREMY YOUNG 123 MANCHESTER
PO BOX 17505 111 ZACHARY ROAD
ESMOND RI 02917 METHUEN MA MANCHESTER NH
(401) 270-2220
Given -by Cust-POO Tax Ship -by Install Measured -by Authq By Job -pack Ordered
Y OT CMH 6/05/06
Ln. Qty --Width-- X -Height- Model Description Color Set Pos Price Extended
1. 1.0 46 1/ 4 X 50 0202 EXCALIBUR 2 -LITE ROLLER WHITE
41-8004-01 0202 2SL UI 101 182.39
41-B1A2-00 CLIMATECH 17.99
41-B5A1-00 FULL SCREEN 7.75
41-B901-00 HEADER EXPANDER .00
Window total 208.13 208.13
Ln. Qty --Width-- X -Height- Model Description Color Set Pos Price Extended
2. 4.0 27 l/ 4 X 52 l/ 2 0201 EXCALIBUR DOUBLE HUNG WHITE
41-A002-01 0201 DHG UI 83 141.40
41-AlAl-00 CLIMATECH 8.89
41-A3P1-00 COLN CONTR FULL 21 21 01 16.54
41-A9D1-00 HEADER EXPANDER .00
Window total 166.83 667.32
Ln. Qty --Width-- X -Height- Model Description Color Set Pos Price Extended
3. 7.0 30 1/ 4 X 44 l/ 2 0201 EXCALIBUR DOUBLE HUNG WHITE
41-AO02-01 0201 DHG UI 83 141.40
41-AlAl-00 CLIMATECH 8.89
41-A3P1-00 COLN CONTR FULL 21 21 01 16.54 r
41-A901-00 HEADER EXPANDER .00
Window total 1666.83 1,167.81
Total windows ordered: 12
Total windows 2,043.26
Amount due (PLUS TAX) 2,043 26
ATTENTION
I have reviewed this order and certify that it is correct. I understand that
this order is noncancellable, nonreturnable and nonrefundable.
n By Authorized Representative
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TOWN OF NORTH ANDOVER
to P
APPLICATION FOR PLAN EXAMINATION - •
,SSACHUSEt
Permit NO: Date Received A,
i
Date Issued: C116-
IMPORTANT:
/%
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
MAP NO.: PARCEL:
TYPE AND USE OF BUILDING
ZONING DISTRICT:
HISTORIC DISTRICT YES n
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
One family
❑ Two or more family
No. of units:
❑ Industrial
VUepair, replacement
❑ Demolition
❑ Assessory Bldg
❑ Commercial
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
J
dJJ h4/OkO <
Identification Please Type or Print Clearly)
OWNER: Name:
Address: A fiv
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License:
Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL EST/MATED COST BASED ON $125.00 PER S.F.
Total Project Cost :$ x10.00=FEE:$ 00
/,,
Check No.: A L-�9�' Receipt No.:/�_
a roHrH 1
TOWN OT-N0RTH ANDOVER
OFFICE OF
040
M-. BUILDING DEPARTMENT
r �'Z 400 Osgood Street
North Andover, Massachusetts 01845
Gerald A. Brown
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: 0 z //�4� 4
JOB LOCATION: n Pte,
Number Street
HOMEOWNER --1
r
Name H me Phone
PRESENT MAILING ADDRESS
Telephone (978) 688-9545
Fax (978) 688-9542
Map/Lot
fr/ -.5 7Y- 3;
ork Phone
.0 �d MA nl(3 �
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 tie/she understands the Town of North Andover Building Department
minimum inspection procedures andrequirements and that he/she will cpnipI with said procedures and
requirements. J / J�
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING
RrvisL�d 10.2005
Form Homeowneis Exemption
BOARD OF :APPEALS 683-9541 CONSERVATION 038-9530 HEALTH 6,"-9540 PLANNING
0535