HomeMy WebLinkAboutBuilding Permit #661 - 71 PLEASANT STREET 4/12/2007BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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Permit NO: Date Received
Date Issued: O
IMPORTANT: Applicant must complete all items on this page
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QESCRIPTION QF WORK TU tat rKL1-U cmtu:
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Identification Pease T pe or Print Clearly)
OWNER: Name:��c'`� C ����/J�r Phone:
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ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ AQ I 10OC2 FEE: $ /y
Check No.: 02 ( Receipt No.: rJ Uf
NOTE: Persons contractin 'th unre, i ered contractors do not have access to the guaranty fund
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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)
❑ 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
❑ Certified Proposed Plot Plan
o 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body 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
e e
Zoning Board of Appeals: Variance, Petition No:
Planning Board Decision:
Conservation Decision:
0
1-
DATE REJECTED DATE APPROVED
DATE REJECTED DATE APPROVED
❑E
DATE REJECTED DATE APPROVED
Comments
Comments
Zoning Decision/receipt submitted yes
Water & Sewer Connection/Signature & Date Driveway Permit
Located at 384 Osgood Street
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
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
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NOTES and DATA — For department use
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❑ Notified for pickup - Date
................................................................................................................................................................................................................................................................................................................................................................................................. ..
...................................................................................
Doc.Building Permit Revised 2007
Locaiion-24 A*� f- S I Date
N o. //C//
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
MU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
20 1 '16
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
1600 OSGOOD ST
BUILDING 20 SUITE 2-36
NORTH ANDOVER MA 01845
978-688-9545
978-688-9542 Fax
Please print
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JOB LOCATION _ �� 4 .,Pd�s/�•.�, 7`
Number Street Address Map/Lot
Name
Home
PRESENT MAILING ADDRESS
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City/Town
State
66pc�__
Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings of
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, one or two family dwelling, attached or detached structures attached or detached structures
accessory to such use and/or farm structures. A person who constructs more than one home in a two-year
period shall not be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and
other Applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that helshe understands the Town of North Andover Building
Department minimum inspection procedures
procedures and requirements. /
HOMEWOWNER'S SIGNA
requirements and that he/she will comply with said
APROVAL OF BUILDING OFFICIAL
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