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Home My WebLink AboutBuilding Permit #611 - 701 WAVERLY ROAD 3/31/2006f NORTH a 9 SS�cHU Permit NO: Date Issued: 6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received: IMPORTANT: Applicant must complete all items on this pate LOCATION % 01 I Print PROPERTY OWNER kc� Print MAP NO.: PARCEL: �j ZONING DISTRICT: TVPF AND TTCF "F RTT11.DTNf_ ArC'r"D110 nremnrrm vna m 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 ❑ Demolition ❑ Moving (relocation) ❑ Other ❑ Others: ❑ Foundation only TTfY !'IT r LLU Vl�tl 1lvt� vi' vvvix-� iv Dr, ricr,rllitNir,u v,)G D �A cal, Identification Please Type or Print Clearly) a a OWNER: Name:_ r: olia.ks \1-0 A Phone: (178� (o8k~a30 Sign ture Address:_ `?01 GJgVt2.(y - AD d), An ovte,,M# �lg4 T CONTRACTOR Name:— 5. -n -R cfJ A bo -e. C o,,v ) Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: s Address: Reg. No. FEE SCHEDULE: BULDING P�MIT.• $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON 125.00 PER S.F. Total Project Cost :$_ J�,, 000. 0o x10.00=FEE:$ ./' L7•.v a Check No.:Receipt No.: / D% Page I of 4 TYPE OF SEWARGE DISPOSAL Art ❑ Swimming Pools 11 Public Sewer Public ❑ ❑ Tobacco Sales Food Packaging/Sales ❑ Well Permanent Dumpster on Site ❑ Private (septic tank, etc. ❑ Electric Meter location to proj ect NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner `�� V;ASignature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS N CONSERVATION COMMENTS HEALTH11 COMMENTS Zoning Board of Appeals: Variance, Petition N Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: ! Water & Sewer connection signature & date DATE REJECTED ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE APPROVED DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED Comments Comments Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 Q DATE APPROVED Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total land area, sq. ft.: NOTES and DA 1A—(ror Page 3 of 4 Doc Created 1MC. Jan.2006 Total square feet of floor area, based on Exterior dimensions. 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 7tWI)ao, 1, 1,41 No. C// Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 0.0 Foundation Permit Fee $ Other Permit Fee TOTAL Check # /6�6 91'7 4 Building Inspector v n � LL v 51" 24" f 27" r �J ..vUMI-PSL. � Wftre.r h t' ie( k)O' I --800-3Z 3 w 40 CL w 0 FM4 O z moo. H o w° •a Cf)w° w A � � � a°' � U � w � go A" � cw°' � w F a W � a°' •u � w � `� � a°' � w w w w G r� � v o cn 0 FM4 O z moo. H F W z� O O E � � U z ti OC rrl Ze F•V U !' Y cm U) cm W 0 cm S c N m _ O Z 0 I -.- :000 p O v O O c c : N C Ma C ti O ` O N C ci v :,a= CL A A C :t O O � m 16- 4D D C MA 0 a. f/1 O m v o" mm oCD hIs 3: C C ..1 � m a O � N R .�' to Cci y O ? CLc= C=2 ` o a ►- m • v, c = o 03 H o �� W o �=..'0= •40 c •- Cc f.. 'a- CL= C V C2 V CD c S � y a mO� Z � rO. N 7 F— a.- Cc F W z� O O E � � U z ti OC rrl Ze F•V U !' Y cm U) cm W 0 cm S c N m _ O Z 0 I -.- :000 p O v O O Gerald A. Brown Inspector of Buildings Please print TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION Telephone (978) 688-9545 Fax (978)688-9542 DATE: 3131 /06 JOB LOCATION: 701 wAve.4�y r�I� Number Street Address Map/Lot HOMEOWNER 4,, &, JA Vco'A g7e,- � q' 9,30 298 - YY7-5-5(a Name Home Phone Work Phone PRESENT MAILING ADDRESS 0L�. Avy MA- Ufs45 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 `�� V.4 - APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Fonn Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688- 9535 Gerald A. Brown Inspector of Buildings Please print DATE: 3131 TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 HOMEOWNER LICENSE EXEMPTION Telephone (978) 688-9545 Fax (978)688-9542 JOB LOCATION:—'? D r WA V,1V � 49,-U Number Street Address Map/Lot HOMEOWNER & 4 ,, t d 00' [a x%78' 68 9 - 9 78 - 557 -,5_3 Name Home Phone Work Phone PRESENT MAILING ADDRESS -70I WAwe2(y 6a 00A LAnytci M4 0j 8 4-S' 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 Foran Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688- 9535