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HomeMy WebLinkAboutBuilding Permit #618-12 - 75 WINDSOR LANE 2/27/2012TOWN OF NORTH ANDOVER //�� APPLICATION FOR PLAN EXAMINATION Permit NO: (D �r/2 Date Received Date Issued: 2 7 IMPORTANT: Applicant must complete all items on this naLre LOCATION 7U;, W t N b soo-_ uA tj�iso11r` ��.•��`tt Print PROPERTY OWNER Unit # v Print v MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure 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: ❑ Demolition ❑ Other aAc ` ® Septic ® Well _� � !75 � x yJs .s r ! '*� 5 "i'Ir* e� E � �F�ioodp t©�We�lands �� � rfi�'1� � Watershed stnct �. E (] Water/Sewers ' t 3 =. !t:� a- 4 e� - . �_ 2._.: a.��-�:=arrL4� _.�_.a.�:.�..za �,. m'.itl .. .. J6....�•ri:_ ' y.,.„ C0 t w 1 lvl'4 Ur w UK& 1 U bh FhKt KMEI): I v ` ,;nll Lq\A&,"n CIAO r M� v -� w�b� . 6A �y tA,. k QIvv,ISS (TdPntifieniinn Plaaea `Tann nw PA-* 1ry1---]d A OWNER: N Address: WINS sem— CONTRACTOR Name: Q' �v Phone: Address: Supervisor's Construction License: Home Improvement License: Exp. Date: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ p (o D FEE: $__ d Check No.: 67 IF Receipt NOTE: Persons contracting th un gistered contractors do not have access to the guaranty fund _OT;;7 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 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 D Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town ]Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dunipster on site yes no Located at 124 Main Street Fire Department signature/date rC)T%/ 4P'KTTC 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 DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine Doc:.Building Permit Revised 2011 June/mi 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 x ❑ Workers Comp Affidavit , ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses A ❑ Copy of Contract ,r ❑ 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 MOTE: 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 Ira 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: Doc.Building Permit Revised 2008mi Location /V a rol- No. 6 a Date r - Check # QCefl::' 25048 TOWN OF NORTH ANDOVER �-M Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL Buhdin6lnspector $ _S7 4; cd lV l �Jui O z r�i O U O � w o o w a v cn w° b a°' U �� w + � ° w �-1 W a�' cn w C noco � w z cn Q a, cn a o G4 m c U� *_' : U N C42 : C� G O vv '(.7 CL ' d C O W 'Q L GO E e C/) H _ O o. .z. E=CD W z "03 CC" L. MoN ``•cc)�3p z Co N WC Em W <: ®mo H m ' � CJ z = O V �cm a,. -a CDJo r- 0 P-4 l O to .c C n 0 �'a .CD 5 C Q .O C •O = m Cw="� N ~ 2 N W O= Hwy .. c •• •«- .N Co .D cc cc m C Z UA •E V v N O V m O m= c COD d coCc CaMI) CD O E F- t :.52 G all, 2 ai • O �• s 0 0 Z o. O y � C I c C CD ®'O yO O CDC3 m m aD CL F-- O Lft? 0 eOv o O- CL C � CM cco .v J .0 a O o CO2 Z CD CL V CO) O C CL C . � C — y cm TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT .600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 01845 Gerald A. Brown Telephone (978) 688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER -LICENSE EXEMPTION BITIDING PERYHT APPLICATION Please print DATE: JOB LOCATION. Number HOMEOWNER Name PRESENT MAILING ADDRESS City _ * Town Street Address Phone Map/Lot Work Phone Zip Code The current exemption for"homeowners" was extended to include owner -occupied dwellings to two units or less anrt to allow such homeovmers 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 Awns 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. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and(quirements and that he/she will comply with said procedures and requirements. ` Yl A„ HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption 0 BOARD OF APPEALS 688-9541 COTQSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535