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Home My WebLink AboutBuilding Permit #673 - 73-75 MAIN STREET 4/19/2007i Permit NO: 6 V `? Date Issued: Z �f �7 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received d / p' SSLED �6*'ryO\ L Po TYPE OF IMPROVEMENT ❑ New Building ❑ Addition VKI'teration ❑ Repair,- replacement ❑ Demolition ?, otl o c& / PROPOSED USE Residential ❑ One family Vwo or more family No. of units: ❑ Assessory Bldg ❑ Other Non- Residential ❑ Industrial ❑ Commercial ❑ Others: DESCRIPTION OF WORK TO BE PREFORMED: 01 <f'e;l , . ,�� Identification Please Type or Print learly) OWNER: Name: Phone: 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. all Project Cost: $ FEE: $ .;-, 0` Check No.: Receipt No.: �2, 01 " `1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED ❑ ❑ Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments 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 No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — For department use ❑ Notified for pickup - Date ....... ....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Doc.Building Permit Revised 2007 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) Li 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In alp cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apifeal 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 Locations r �� No. G7 Date MOftT1y TOWN OF NORTH ANDOVER Ot�•.a° ,a,h Certificate of Occupancy $ Building/Frame Permit Fee $ d ^GNUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # a2 G r 20129 Building Inspector HOMEOWNER LICENSE EXEMPTION Please print// 10 7 DATE!f / JOB LOCATION 73 '% / l j Number Street Address Map/Lot HOMEOWNER Q 1(),Al 6� 0 Name Home Phone / Work Phone PRESENT MAILING ADDRESS % �s� . —fi`j c �itj City/Town State N 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 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. HOMEWOWNER'S SIGNATURE % APROVAL OF BUILDING OFFICIAL Q MONTH 1 Oaa*�tD yea 1'O �'�q`°•,.,°��°"�g* TOWN OF NORTH ANDOVER SSACNUSE'� BUILDING DEPARTMENT 1600 OSGOOD ST BUILDING 20 SUITE 2-36 NORTH ANDOVER MA 01845 978-688-9545 978-688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print// 10 7 DATE!f / JOB LOCATION 73 '% / l j Number Street Address Map/Lot HOMEOWNER Q 1(),Al 6� 0 Name Home Phone / Work Phone PRESENT MAILING ADDRESS % �s� . —fi`j c �itj City/Town State N 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 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. HOMEWOWNER'S SIGNATURE % APROVAL OF BUILDING OFFICIAL CA M x M M M M W C � 01 � CO) .n Z Co 0. O C2• O d y aCc CD o p C� O Cr CD CD 0 CD C CDCD y� �■ CL O CO) C I a p y O -v z o � CD 0 0 It M m G� E m r4 o m n� O o z CZ t=i rT, rA .rt N 0 im Or = o C,.: .0 ti m:� . M y��c 3 M COL ,+ a m ?o m: • 2 =• o� Z °1 o� �o m so C po CL N all y CL vi CL a g- ccIv O rA Cos cc •% CD z O !:-.! o 0 omh , za G M r ]' r � a a a! . O V