HomeMy WebLinkAboutBuilding Permit #981-16 - 71 REGENCY PLACE 3/17/2016V%ORTH
ED 6 'N4,
BUILDING PERMIT
TOWN OF NORTH ANDOVER 011
e��4,APPLICATION FOR PLAN EXAMINATION 41
Date Received
Per it No#: CHO
Date Issued: I t 11 'terns on this pa ge
MPORTANT: Applicant must corn - e- e a 1,
LOCATION -7 1 k- L-:& C int
/-% ILI
PROPERTY OWNER \—[: g�)( - T I
Print 100 Year Structure yes Inn
,MAP —PARCEL: ZONING DISTRICT: Historic District yes � �no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
Ei New Building
Ei Addition
El Alteration
El Repair, rep6cement
Ej Demolition
—.7— - 7-11-11.1n. � -
A-9
OWNER: Name:
17 -
Address:
Contractor Name:
Email:
Address:
PROPOSED USE
Residential
0 One family
El Two or more family
No. of units:
El Assessory Bldg
0 Other
Non- Residential
El Industrial
Ei Commercial
El Others:
DESCRIPTION OF WORK TO BE PERFORMED:
fidt 0 (2 k -J C E— 7-0 CS
cation lease Ty�e !�rPrint �Che�a�rly
Phone:
- t, 41 VA
Pho
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGI NEER Phone:
Address: Reg. No._
FEE SCHEDULE. BULDING PERMIT: $12.00 PER $10Aq-00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ FEE: $ X
Check No.: eipt No.:
NOTE: Persons contracting ith u egisteref contract do not have access to the guarantyfund
a irsnnfi inn nf r-nntrnr-fr)r
r-
. Plans Submitted -0 Plans Waived 11 Certified Plot Plan 11 Stamped Plans F1
OF SEWERAGE DISPOSAL
FTYPE
_r
Pubhlic Sewer El
Taming/Massage/Body Art El
Swinnning Pools
Well El
Tobacco Sales 0
Food Packaging/Sales El
Private (septic tank, etc. El
Pennanent Dumpster on Site El
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On Signature'.
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Com
Comments
Water & Sewer Con nectionisignature & Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
RNRKIDW�; � _71�1 ''I'll'',
fWAR rff
VLs Le'
L,d_-6—gLte:dj4t'4,_1r ".4,
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.sloo-woo fine
No
Doc.Building Pennit Revised 2014
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
4. Engineering Affidavits for Engineered products
10TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
4� Building Permit Application
.,4 Certified Surveyed Plot Plan
• Workers Comp Affidavit
• Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
Floor/Cross Section/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
IOTE: 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
2012 IECC Energy code
Engineering Affidavits for Engineered products
10TE: 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
Doe: Building Permit Revised 2014
Location
No. Date /I /-
Check #
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Building Inspector
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
1.5,3000.00
m
$ -
$
180.00
Plumbing Fee
$
22.50
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
22.50
Total fees collected
$
325.00
71 Regency Place
981-2016 on 3/17/2016
finish basement
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t%ORTII TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street, Building 20, Suite 2035
North Andover, Massachusetts 0 1845
Gerald A. Brown
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please pri
DATE: 75-J7-� �
JOB LOCATION: 7 / ///�
Telephone (978) 688-9545
Fax (978) 688-9542
Nuniber StrR�Address
Map/Ldt--
HOMEOWNER CALL,_ 7�_/
Name Home Phone Work Phone
PRESENT MAILING ADDRESS //0 _/ 0 LO lt�:) A-4
ZY 11 91 ate / " — Z� =_
The current exemption for "homeowners" was extended to include owner occupied dwellings of one or two family
dwellings and to allow such homeowners to engage an individual for hire who does not possess a license, provide
that the owner acts as Mervisor.
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 dwelling, attached or detached structures accessory to such use and/or farin structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. (780 CM[R
Section I I O.R5.1.2)
The undersigned "homeowner" assumes responsibility for compliance with State Building Code and other applicable
codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies
minimum inspection procedures and req
requirements.
HOM[EOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 8.2015
Form Homeowners Exemption
Jerstands the Town of North Andover Building Department
that jie/she will comply with said procedures and ___
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 BEALTH 688-9540 PLANNING 688-9535