HomeMy WebLinkAboutBuilding Permit #062-13 - 790 DALE STREET 7/25/2013 C,0
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BUILDING PERMIT txORTH
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received ArE
Date Issued:: AC U
IMPORTANT:Applicant must complete all items on this page
IXOCATION
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PrR%0FPEA,
RT E'R,
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Altera ion No. of units: Commercial
Alte=
Re-'pair, replacement Assessory Bldg Others:
Demolition Other
At&she 7 istric '-.,
At
3
DESCRIPTION OF WORK TO BE PREFORMED:
std kq-, L40ihouse W� -,Zvec- S 0
"A
-�Oeoq� Of Out-
Identification Please Type or Print Clearly) Phone:
OWNER: Name: CAZL �,J kGAPY'Kk-)-1— Cq
Address: 4RO AL ST ST, AIV OVeZ M/t
--rr '-, I I
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,GONTR-A TQR?`Na&e Phone
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2'"V-Ft:S
Wb
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'bf'v1§b1, c6de nd 9
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�Home Improvement n11sb1* XP -a.
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OFTHETOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
is,—, FEE: $
Total Project Cost:
Check No.: Receipt No.:
NOTE: Persons contracting with
contractors do not have access to the guaranty fund
Signature.of Agent/Ovvner._ 1. Si nature OTc6ntracor,,-- -..*-
Location
No.06 -13 Date
. = TOWN OF NORTH ANDOVER
e yN
- A
Certificate of Occupancy $
Building/Frame Permit Fee $ �
Foundation Permit Fee $
Other Permit Fee $ ,�
TOTAL
Check#
25541 VBuilding Inspector
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: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature&Date- Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT Temp'Dumpster on site yes "' . . r�'no '` , `
4 •0 Zr i YY �3 � ..
4,
Located`�at 1�24•Main Street ��- ,�' �� {�� f`� `�->~� � �` `��' � � ��� i�' �;
�. to
Fire�iDep,.,armensignure/date
r r-Y -.: �a4-� �i
tt at �
4i�i} � t -:T. •FSS. ��. ♦t �Si.! `�4�, a o.r, ��y �,�} r�,',i P i�i�v r� yr s ,�. .Y j i�rZ fis;� ✓~ ){t`. �i yy� .'
COMMENTS, tom-�� r` ,
�' f S`.�'+.. "k, . +i �1.�'., :w_ .a`� A.� .d rs. .t +.� +a .;e:` v,. s '• '.
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)
U Notified for pickup - Date
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
❑ Building Permit Application
- ❑ Workers Comp Affidavit
-� ❑ Photo Copy Of H.I.C. And/O C.S.L.' icenses
-��❑ 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 DEPARTMENTMFORM07
Revised 2.2008
NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
at: 710 ba(If Sf is that the debris resulting from this work shall be
disposed of in a properly licensed solid.waste disposal facility as defined by MGL
c 11, S 150 A.
Also, note Permits are required under Fire Prevention laws Chapter 148 Section
I 0A.
The debris will be disposed of in:
LLQ s ��� �� Lr well ;�� ��, N7V- 0307
(Location of Facility) -
Sig r f Permit Applicant
Date
,Qe 3� his 5sae-
WN OF NORTH
o��r�eo ,bsy TO ANDOVER
0= 6E'�-��T`0°, OFFICE OF
s BMDING DEPARTMENT
f7 o P, y* ::,1600 Osgood Street Building 20,-Suite 2-36
sSq�nos North Andover,Massachusetts 01845
Gerald A.Brown
Inspector of Buildings Telephone(978)688-9545
Fax
HOMEOWNER-LICENSE EXEIVIpTION (978)688-9542
BUIDING-PERMIT A ppLICATION
Please print
DATE:
1 .
JOB LOCATION: �'
/Number Street-Ad cdl,,.s,.
FJOMEOWNER L-!.0 Map/Lot
Name ome Phone
Work Phone
PRESENT MALING ADDRESS
Ale Y�
Citi Tn�=fin
5L.+e. Zip Code
The current exemption for thomeowners"was extended to include owner-occupied dwellings to two u '
to allow such horrmeoti= ers to engage an individual-for hire who does not possess a 1 cense,provided that the owner r1
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,oris intended to
be,a one or two family structures. A person who constructs more that one home in a two-year period shall not e
considered a homeowner.
be
The undersigned"homeowner"assumes responsibility for
Applicable codes,by-laws,rules and compliances with the State Building Code and other
regulations.
The undersigned`homeowner,,certifies that he/she understands the To of North Andover Building Department
minimum inspection procedures and requirements and that
requirements, e co . y with,said procedures and
HOMEOWNERS SIGNATURE �
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530
HEALTH 688-9540 PLANNING 688-9535
l '
NORTH
own o s E : ,. ndover
No.
oh ver, Mass,
COCKIC"RWICK �1'
A04ATED
S V
BOARD OF HEALTH
Food/Kitchen
PERMIT T Septic System
THIS CERTIFIES THATC'.'. / "'`".r�' BUILDING INSPECTOR
....... .... ...... ...........................................................................................
l
has permission to erect ...........:............:. buildings on ............................................ foundation
to be occupied as dKF .. - ���=-� g C�a'w. �kta .�.. :'f!� ur ^C� .
Rough
........,�.... .............-...... :s. .............. .. .�.�►............... ......... ..... ...... Chimney
provided that the person accepting this per It shall in every respect conform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR'
UNLESS CONSTRUCTION STARTS Rough
...................... Service
.................... .��� ....... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
SEE REVERSE SIDE
NORTH
own of
t E : 1, ndover
0 .
- �
No. 4."L.K.t _
oh ver, Mass,
COCNICNl WICOC ��
p�R-ATEo 0'��.(5
S U
BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT /....�i:;: `.�'. ®'.. .................................. BUILDING INSPECTOR
....... .
/ Foundation
has permission to erect ...........:.............. buildings on .79!!2A?/ ............................................
to be occupied as ... �.a :.. < nt :: S C 'itG�k .f.. '�;1� �>� "��'c;.,c ^�� ....... Rouen y
.. .. !•.41....... Chimne
provided that the person accepting this per It shall in every respect conform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR'
UNLESS CONSTRUCTION STARTS - Rough
..,........, Service
.................... .��:-90,................. Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
SEE REVERSE SIDE