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HomeMy WebLinkAboutBuilding Permit #184 - 71 ELM STREET 9/11/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONof NO°T a 11' ? o o `� Per►nit NO: Date Received � o Date Issued:- 4SSACHUS��� IMPORTANT: Applicant must complete all items on this page LOCATION 12 -Oe�< l9Print PROPERTY OWNER U GH e-l? Print MAP NO.: PARCEL: ZONING DISTRICT: �C TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building One family ❑ Addition Two or more family L Industrial Alteration No. of units: F] Repair, replacement C Assesso Bldg g C Commercial Demolition Moving(relocation) ❑ Other C Others: C Foundation only DESCRIPTION OF WORK TO BE PREFORMED fl! /P/ Identification Please Type or Print Clearly) OWNER: Name: r'49-oKee Sel-171df a-�l�i�w Phone: 60pr 6�?"Ov Address: 122 MC-6 /P 0��v/o 6 CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT1NGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PE VIT.•,512.00 PER,51000.00 OF THE TOTAL ESTIMATED COST BASED ON$125S.F. .00 PER S. Total Project Cost :$ &o©D — FEE:$__ Check No.: v'`°- / Receipt No.: -,7A7-3 Paige loft Location No. Date NORTH TOWN OF NORTH ANDOVER O 3? OL F 9 a � r nc + ; . Certificate of Occupa y $ nog 'ss�cMusE` Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # � 19563 - , { U Building Inspectof� TYPE OF SEWERAGE DISPOSAL Swimming Pools Tanning/Massage/Body Art — ublic Sev r To Sales J Food Packagin&Sales Well Permanent Dumpster on Site Private(septic tank,etc. Electric Meter logon to proj(:c--. NOTE: Persons contracting with unregist ed co h actors rlo not have access to the guarmhry 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 ❑- U []Water Shed Special Permit Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APP ROVED HEALTH COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision;receipt submitted yes— Planning Board Decision: Comments Conservation Decision: _Comments Water&Sewer connection/Si nature& ateDrivewav Permit Temp Dempster on`site ycs_–no Fire Department signatureidate Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of Floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) r Page ;of l Doc:L`1SP(C I-10 a;A1_SI4RVICLS OEP;\R'I MI.:N 1':13PFo>RMi)i Craved AIC.bn_u06 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 j 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 00„•:INSPECTIONAL s6RVI ES nr;i.�k r�rn;ti'r:eiruitn�os oar"O oT 6"ti TOWN OF NORTH ANDOVER o m OFFICE OF A BUILDING DEPARTMENT 1600 Os good Street Building 20, Suite 2-64 �4SS^CNU5E�Sy North Andover, Massachusetts 01 845 Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: / C Number Street Address Map/Lot HOMEOWNER_ Gx �✓ O Name H �© •me Phone Work Phone PRESENT MAILING ADDRESS 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 considered a homeowner. Y period shall n er. P of be • The undersigned"homeowner"assumes responsibility for compliances with the Applicable codes,b -laws ru State Building Code and other Y les and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirem s and that he/she will co ply with said procedures and requirements. HOMEOWNERS SIGNATURE .APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Holneownem Exemption B30ARD OF APPEALS 088-0541 CONSERviA'rION 0,"-9530 0535 HFAI_'rH r,,Y$_9540 PLANNING 688- of y.AORTy Town Airidover 0 ro o o lover, Mass., •L A CGCMICHEWICK I A°Rq r e o Ppm\ •(Cl S BOARD OF HEALTH Food/Kitchen IMT 0 Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....:...............i....... ............ ................................... Foundation .... ...................... / has permission to erect........................................ buildings on .....�... .................................... ......................... Rough s y to be occupied as Chimney .................................................................................................................................... 4 provided that the person acceptile permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions 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 CONSTRt1 r ?NT�R�'S Rough ,............ ervice BUILDING OR 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 SIDE Smoke Det.