HomeMy WebLinkAboutBuilding Permit #023 - 83 OLD FARM ROAD 7/20/2006 TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION 0f 14
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Date Received �PermitNO:
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Date Issued: 7:7 � �SSAeHus��
IMPORTANT: Applicant must complete all items on this page
LOCATION 1: 3 0! o/ /?
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PROPERTY OWNER J Oh h IN/' e
Print
MAP NO.: PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition - Two or more family - industrial'
Alteration No. of units:
Repair, replacement - Assessory Bldg Commercial
Demolition
Moving(relocation) L Other Others:
Foundation only
DESCRIPTION OF WORK TO� PREORMED
Identification Please Type or Print Clearly)
OWNER: Name: j C1 "N Phone:
Address: e :7 (Do'� ^ tea" /1 1-2, t,/.,p v r/ 10,119
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Ilun►e ltllpr01,cmcnt License: Exp. Date:
: RCI-IITECT. ENGINEER Namc: Phone:
Address: Reg. No.
FEE SCHEDULE:BLZDLVG PER, /T /0.00 PER.51200.00 OF THE TOTAL ESTIAM TED COST BIS DOS�125.00 PER S.F.
Total Project Cost : �� �1 x 12.00==FEE: 4 -
Check No.: Receipt No.: C 10
Pa'-'e Io1 4
TYPE OF SEWERAGE DISPOSAL _ -
Public Sewer
_ Swimming Pools
X TanningiMassage;Body Art
Tobacco Sales Food Packaging/Sales
Well _
_ Permanent Dumpster on Site
Private(septic tank, etc. Electric %{eter location to
project
NOTE: Persons con ac•li g with unregistered contractors do not have ae to the guartuiti filar!
Signature of Agent/O j gnature of contractor
Plans Submitted Plans Waived ertifie Plot Plan ❑ Stamped Plans
THE FOLLOWING SE FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF- U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
OMN TS
ATE REJECTED DATE APPROVED
CONSERVATIO
J
CONIMENTS ILA-)
DATE REJECTED DATE APPROVED
HEALTH J .J
C kBoardol'Appeals:
ENI
>-
130
g Variance. Petition No:
I_oninu, Decision:receipt submitted %.cs
I'lanning Board Decision: Comments
Conservation Decision: Comments
1,1 ater,',� Sewer connection.Signature& Date Driveway Permit
Temp Dumpster on site yes_no_A Fire Department signature date_ _
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required Prox ided Required Provides Required Provided
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
NOTES and DATA—(For department use)
i(-IS UI_PAKI VILV
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
Addition Or Decks
❑ Building Permit Application
❑ Surveyed Plot Plan
❑ Workers Comp Affidavit
u 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)
New Construction (Single and Two Family)
o Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
zi 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
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
Poc:J\srix HONA .SLR: R ES DEPAirrw:vr:ni1roiiNws
Location R-zj 0/a tai si r✓� ��
No. 02- 5 Date
MaRTM TOWN OF NORTH ANDOVER
Certificate of Occupancy $
�ssAC11tI5Et� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 1
Buil 'ng Inspector
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FROM ED-BORTOLINO&SON PHONE NO. 6039265809 Jul. 17 2606 03:38PM P1
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07-17-2006 14:31 TOWNS AUTO BODY 9789751340 PAGE!
F OORTH TOWN OF NORTH ANDOVER
R
�rpts1 OFFICE OF
° BUILDING DEPARTMENT
sof = 1600 Osgood Street Building 20, Suite 2-64
94�'�wTED tPP`.�5 North Andover, Massachusetts 01845
�SS"�CHUS�j
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:
JOB LOCATION: 0` �J T� l`~
Number Street Address Map/Lot
HOMEOWNERj
Name Home Phone Work Phone
PRESENT MAILING ADDRESS F _? 9/1) �Tfi� " /� d
wG � �2_ �0,, � dr\? � c)IeF �� �—
City Town State 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.
The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department
minimum inspection proced and requirements and that he/she will compl aid pr ures and
requirements.
HOMEOWNERS SIGN
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Fonn Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-
9535
i N0RTH '9
Town of 19Andover
0
No. v 29,35
dover, Mass.,
0 LA
Ifs COCMICKEWICK
ADRATE D
`s BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT... r1 V�
� Foundation
has permission to erect........................................ buildings on .......................U',3.....+0..14 .. ►4I'A.. G� Rough
tobe occupied as............ r..M. i. ...... •�...o.r.rpok...♦..................................................................................... Chimney
provided that the person ccepting this permit shall in every respect conform to the terms of the application on file in Final
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
dop PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRU S
ELECTRICAL INSPECTOR
T
- Rough
............. .. ..... Rtwo
.. .... . .... .... .. ......
UIL INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal
No Lathing or Dry Wall To Be Done
FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
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07-17-2006 14:31 TOWNE AUTO BODY 9789751340 PAGE1
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07-17-2006 14:31 TOWNE AUTO BODY 9789751340 PAGE1
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entire street line.
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areaa where side let lines intersect
street line. OLD FA?Af QOATJ
TO THE( ASSURAncs Roam aDEr�uTza RlCA MORTGAGE INSPECTION PLAN
AND ITS RTLE KNSURFRi ) N 0 8 LOWED IN !T D O V E A
1 CERTIFY THAT 1 HAVE EXAMINED RPREMISES AND 71E 9UlDRTi.S STIor/DO( )
K�roAK�LAW AND AME100HPj L•(ERaNt 9oE•RE/IR YARD seTFAE2E D1R.7� MASSACHUSETTS
ENFORCEMENT ACTON tMEN NASO O.L. WEN R7� ODNSR 1XD.OR ARE 17EIWT RTOM VTOLATTCH
VR CHAPTER 4011.SECTD/7.,MESS OTERYIISE NOTED.
I FURTHER CERTIFY TNAT THIS PROPERTY IS nor LOCATED N THE ESTABLMH D iL00D
HAZARD AREA.CWA"TY PANEL No- 25rot98 DEED
ETIAMNARON OF T� o DATE 6-15-93 am 1917
LATEST OEED ANO OOES�SjpT NpJI EyE�yY►HO T TO BE RECORDED DALE OF THE
PREVKM To TS PATE OF REODIRO. ACOIIftACY THE DEED DESCRIPTION PAGE—261
HMS COMPANY K NOT RESPONSIBLE FOR Airy INDENTURES MADE SIMSEOUENT TO THE RECORDED CRT.N0.
DATE OF THE LA7FST 0®a RERECORD.
IgT*NATIEAVFRMOReRtDNECS AIE OVLESS THAN ONE FOOT FROM THE PROPERTY LRE IT 15 MMED PLAN SK PAGE
PRECg SURVEY MI HE MAGE 70 VERIFY THESE LEASU EINEM
TM 8926
A CERTIFICATION yygVBASED F� .-9JRVEY MARKERS OF OTHFRS�AND DOES NOT PLAN{ —DATED
MAY lE ACCQREIs♦ED ONLY OY AN ACCRA USED AND OFFSEIsv AS�W. January 26
THIS CERTIFICATION To 9E USED F � --
To OSES ONLY. SCALE: t•.11nr
USEFOFPEEE EsATABUSE �so
re LINES
,�� 7j BRADFORD
ENGINEERING CO.
P.O.90X 1244
JAMES W. 8000t0UKA5 R.LS. /9529 PAL
MD.Ot631
TEL(SDR)373--2396
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