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Home My WebLink AboutBuilding Permit #871-11 - 70 SALEM STREET 6/20/2011C" 4 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 1S %/ _ �� Date Received Date Issued: /�0�� IMPORTANT: Applicant must complete all items on this page LOCATION `%D 9Q- IRA S41 Print MAP NO: PARCEL: d ZONING DISTRICT: Historic District yes QQ Machine Shop Village yes eo TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building VOne family 0 Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial 0 Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic'? ?Welly +Flog o plairn (] Wetl ndst - ' �(®F�Wat�� e shedD► i°str ct y .®i,Wafer/Sewer ._: �h .:.:�x`�,:.�.� . .� _.� - - # k . _`�Y `_:. DESCRIPTION OF WORK TO BE PERFORMED: Please Type or Print Clearly) OWNER: N Address: -4O CONTRACTOR Name: o Lk)"Z Phone: Address: -40 (S Supervisor's Construction License: Home Improvement License: ARCH ITECUENGINEE Exp. Date: Date: Phone: qz9 -,�?L�- 5Z -3z Address: Reg. No. FEE SCHEDULE: BULDING PERMIT7$^12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: 06, FEE: $ Check No.: 7 Receipt No.: NOTE: Persons contracting wit&,ghr gist�ered coi W�� have access to the guaranty fund 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 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) ❑ Muss 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 ❑ .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 III cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals Chat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording rnust be submitted with the building application Doc: Doc -Building Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ O s ?' vy Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on S9nature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments 11 Water & Sewer ConnectioniSignature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT r- Temp D ster on site yes `� no Located at 124 Main Street - Fire Department signature/da COMMENTS 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.$10041000 fine Doc:.Building Permit Revised 2008 Location No. Date — C A Check # ///7 24� b3 1116 14W. / " Building inspector TOWN OF NORTH ANDOVER AL Certificate of Occupancy $ F S 4'Argo *TS CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ///7 24� b3 1116 14W. / " Building inspector U) m X m CO) m EP mm v y 'v C � Poll. �. 'v O CD SCz y CD O 'v CL c P.O. o Or CA CD CD O CLQ CD CD CD CD W W c CD y C. v y O cc CD I � v CA O 'O Z CD O CD O CD I I Cn �° z C_ C = mw c =r_ '�C �' 71 w O —• CAO cr H rf jJ ac a' r� 71 P3 a p do CD 'i7 � CL W d Cn �^ n 0 � mC h Cl n n m Z =r= N 9� H w w O H T � CL C m � ,•, CD ... m H y CD CD o..=: o —1 o mm : o a > > N ' CD ..�. -00 O _ O p OZ y C2 • m cc a = om CL� m '^ VJ co O � . m y� CDRCD m CD �jca. C _ 1 c J N O � CD CD FJ .�• {D w � o -� o CD CD CD cn CD c J CO) CD 0 o C m CA) o 'o nom• n cM O - CO) C O CD Cn �° z 'rl w '�C �' 71 w Cn r, 1,0 oGn rf jJ ac a' r� 71 P3 (� El 0 11Z aq ;:r" 'i7 � CL W d Cn �^ n Q. x � 9� H C � 0 y 0 9 Town of North Andover Building Department 1600 Osgood Street Bldg 20, Suite 2-36 North Andover MA 01845 Tel: 978-688-9545 Fax: 978-688-9542 // DEMOLITION OF BUILDING AFFIDAVIT DATE �P r OWNER'S NAME & ADDRESS: `?D S�F 1ee � �, /Uo 14),1 - VV./ - LOCATION OF PROPERTY TO DEMOLISH `70 S4" d7 , DESCRIPTION: (3/>z-lf � N t%0RTh '9 O 16 G O �wnE coc641c«ewic. 1 7 A°RArEo 0a`y(5 �SSACNUS�� CONTRACTOR'S NAME & ADDRESS: ) 2 DEPT. OF PUBLIC WORKS - WATE DEPT. OF CONSERVATION X HEALTH DEPT: HISTORIC COMMISSION PLANNING GAS �LECTMC . TELEPHONE CABLE TAXES POLICE: FIRE: EXTERMINATOR: XDUMPSTER - ON/OFF STREET _ BUILDING INSPECTOR: DEPARTMENT SIGN -OFF g+1 SEPTIC WELL DIG SAFE NUMBER NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordanc with 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 115 S 150 A. - Also, note Permits are required under Fire Prevention laws Chapter 148 Section l OA. The debris will be disposed of in: (Location aFacility) Signature of Permit Applicant Date 1�1 .� ` e -) c� his % ss �r ;z --fAej Gerald A. Brown Inspector of Buildings Please print DATE: TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2=36 North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Telephone (978) 688-9545 Fax (978)688-9542 JOB LOCATION: �Zo -SG � 't Number Street Address Map/Lot HOMEOWNER [/C�Or7� . 1�� Z ?� �i L S��l Name Home Phone PRESENT MAILING ADDRESS City Town Qt„ to Work Phone Zip Code r 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 Awns 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 fancily 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. 11 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 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535