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Home My WebLink AboutBuilding Permit #642 - 75 DUNCAN DRIVE 4/4/2007BUILDING PERMIT o`t,�o ,6 +0 TOWN OF NORTH ANDOVER c� APPLICATION FOR PLAN EXAMINATION ,. Permit NO: Date Received �SSAc aus�� Date Issued: ' O IMPORTANT: Applicant must complete all items on this page LOCATION r)GvLC c. j� Print , PROPERTY OWNER Print MAP NO: .PARCEL: ZONING DISTRICT: HISTORIC DISTRICT yes no 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 ❑ Others: ri Demolition ❑ Other u Septic ❑ Well [ 1 Floodplain 0 Wetlands tj Watershed District L Water/Sewer RIPTION OF WORK TO BE PREFORMED: I Gk -LA ICx.mu Type or Print Clearly) OWNER: Name: `1 a\.0 1 J?a Address: 9 S ll ONA c-cK CONTRACTOR Name: Address: 1 Supervisor's Construction License: Exp. Date: ~ Home Improvement License - ARCH ITECT/ENG I NEER icense: 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: $ ) 1� , 0 tl Q FEE: $ Check No.: Receipt No.: NOTE: Persons contra in A una 'stered contractors do not have access to the guaranty fund Signature of Agent/Own r ld:k Signature of contractor. '7 Location No. 61 ze_-R—_ Date L/ TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ "us Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Build g Inspecto, Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools C7 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 Is DATE REJECTED DATE REJECTED DATE APPROVED 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 FIRE DEPARTMENT - Temp Dumpster on site yes o Located at 124 Main Street Fire Department signature/date COMMENTS 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 LI 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 ❑ 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 ❑ 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 m 0 ou0 � Q h O.L O O E04 O O ` c y V V •dam CLCM M <a CO c s o `o 16. V Ea L ym, c m 0 ID •� o n EIA :,moo m c� 0 0 msC CL.C_ N o mm • m m ,�•m 3 m m 0 a mCD m is .moa m • m � o • �� A o Z co ao m m c = m :m.- 3 W W c •- E!:uiemit CL �° 5 W �E v�� G ti a m� �S z = .os= E- z $ a � m r U) /l cn o w w oG U w a w a xr, a a n: O U w" oo w w a� Oq cn 0 cn m 0 ou0 � Q h O.L O O E04 O O ` c y V V •dam CLCM M <a CO c s o `o 16. V Ea L ym, c m 0 ID •� o n EIA :,moo m c� 0 0 msC CL.C_ N o mm • m m ,�•m 3 m m 0 a mCD m is .moa m • m � o • �� A o Z co ao m m c = m :m.- 3 W W c •- E!:uiemit CL �° 5 W �E v�� G ti a m� �S z = .os= E- z $ a � m v I COD y E FL O c 0 as U a CO2 O CL COD O cc V C cc COD D W CM C O C D� m m �p A 3� a� L o a. CL cna c � C ev 'C O Z s CDCLC43 C r U) /l E 4/ N c o ' c �z v) �.w O U CD ac c U) w m a� 0 v I COD y E FL O c 0 as U a CO2 O CL COD O cc V C cc COD D W CM C O C D� m m �p A 3� a� L o a. CL cna c � C ev 'C O Z s CDCLC43 C HOMEOWNER LICENSE EXEMPTION Please print DATE JOB LOCATION J D I—) Vim- V_ o, I 1 YI ✓ HOMEOWNER Name PRESENT MAILING ADDRESS w, A�� jo I Citv/Town Street Address Home Phone State Map/Lot Work Phone ofg K 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 nc�requirem is and that he/she will comply with said procedures and requirements. I HOMEWOWNER'S SIGNATURE tv APROVAL OF BUILDING OFFICIAL f No oTN 1 TOWN OF NORTH ANDOVER S 1CNUSE 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 DATE JOB LOCATION J D I—) Vim- V_ o, I 1 YI ✓ HOMEOWNER Name PRESENT MAILING ADDRESS w, A�� jo I Citv/Town Street Address Home Phone State Map/Lot Work Phone ofg K 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 nc�requirem is and that he/she will comply with said procedures and requirements. I HOMEWOWNER'S SIGNATURE tv APROVAL OF BUILDING OFFICIAL