HomeMy WebLinkAboutBuilding Permit #508-2011 - 75 GRANVILLE LANE 12/28/2010TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: 5—o 4 + ;20 Date Received
Date Issued: 022� w
IMPORTANT: Applicant must complete all items on this nage
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MAP NO: 1� L PARCEL: 00 ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Assessory Bldg
❑ Commercial
❑ Others:
D<P,epair, replacement
❑ Demolition
❑ Other
{❑ Sit phc3 ®Well' v
_
�p�F 'odplain f®.Wetlands] ^s ;�``®� Watershedt�D�ist�rict�
DESCRIPTION
OF WORK TO RR PF.RFnRMRn-
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Type or Print Clearly)
OWNER: Name:
Address:-1���LI.�C
CONTRACTOR Name:
Address:
Supervisor's Construction License:
Home Improvement License:
Exp. Date:
Exp. Date:
ARCHITECT/ENGINEER Phon
Address: Reg. No
Phone:
FEE SCHEDULE: BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total Project Cost: $ J 6 ;QM , Cwt FEE: $__ %,Op —
Check No.: � 22 t Receipt No.: 2,3 (2 2 -
NOTE: Persons contrac ' ith unr g t6d contractors do not have access to the guaranty fund
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17118 —A tic � C�------
Building Inspector
Location
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No. J5 a 3
Date
NpRTM
TOWN OF NORTH ANDOVER
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9
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Certificate Occupancy
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of $
s�1CHUSE
Building/Frame Permit Fee $ Q 9 O
Foundation Permit Fee $
-4
Other Permit Fee $
TOTAL $ 7 O +`
0
Check #
17118 —A tic � C�------
Building Inspector
Location 7r
No. SD �? -2 Date
NpRTN TOWN OF NORTH ANDOVER
L
•
e •; , Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee
Other Permit Fee
TOTAL
Check # 3;221
23822
wilding Inspector
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools D
Well ❑ Tobacco Sales ❑ Food Packaging/Sales 0
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
Reviewed on Siqnature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Water & Sewer Connection/Signature & Date Driveway Permit
Com
Comments
DPW Town Engineer: Signature
Located 384 Osgood Street
FIRE DEPARTMENT -Temp Dempster on site yes no
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
Doc:.Building Permit Revised 2008
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
o Building Permit Application
o 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
o Building Permit Application
o 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)
o Mass check Energy Compliance Report (If Applicable)
o 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
o 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
MOTE: 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
:hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
nust be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
Gerald A. Brown
Inspector of Buildings
Please print
DATE: l Z' Zi5 - I (D
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
North Andover, Massachusetts 01845
HOMEOWNER LICENSE EXEMPTION
BUIDING PERART APPLICATION
Telephone (978) 688-9545
Fax (978) 688-9542
JOB LOCATION: -7�;" (,�Vj\ Nd� N,_j�,ckj tAN�-
Number Street Address Map/Lot
IJOMEOWNER ��� 1"1 i�1V�� 1-7 9 -1
Name Home Phone
>7•5�33 c
PRESENT MAILING ADDRESS �?S G-12t.IV lUtz
City Town
Hk Otq-S
$tatwr, . .
Work Phone
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 period shall not be
considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other
Applicable codes, by-laws, rules and regulations. 11
The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department
minimum inspection procedures and requiremend that he/she will comply with said procedures and
requirements. / //
HOMEOWNERS SIGN
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
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