HomeMy WebLinkAboutBuilding Permit #701 - 85 PUTNAM ROAD 4/30/2007n
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BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO:--kDate Received "7 - 3 `) —e 7
OWNER: Name:
utsL;rur iy UP wvRK TO BE REFORMED:
Please Type or Print Clearly)
t
ARCHITECT/ENGINEER Phone:
Address:
Reg. No.
FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ ad FEE: $ &o
Check No.: Is- � Receipt No.: .C9 () l& d'
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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
PLANNING & DEVELOPMENT ❑
COMMENTS
COMMENTSATE REJECTED
CONSERVATIO��� — gri
� 1,
HEALTH
COMMENTS
DATE REJECTED
El
DATE APPROVED
DATE APPROVED
El
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes _
Planning Board Decision: Comments
Conservation Decision: Com
Water & Sewer Connection/Signature & Date
Located at 384 Osgood Street
FE
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 2 1 A —F and G min.$100-$1000 fine
Doc.Building Permit Revised 2007
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 2 1 A —F and G min.$100-$1000 fine
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
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E K SURVEY INC
4 HAVERHILL;`MA ,110
Phone 975469-1985 6 Fax 978.4Wma
MORTGAGOR 21t : Sr P�4 Difji&
ADDRESS OF PRINCIPLE BUILDING r
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lot 3
DEED REF, _ 795 - PG. _zie,
PLAN REF.
DATE OF INSPECTION
SCALE. 1'= $1o' .
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CERTIFICATION TO:LI.Al /.e„& RUDEL N
-$r4 hr
Lo'r to
This M' prep PecF� for No. 34t3tSa The location Of the principle structurds
ortgage Plot Pian uuaa arod s Aa rtion of
mongepe purposes only and it is not Intended or represented 'f 'prClSt « with tha local toninAd
to les a property line or land sunray. Thts plan is rot to be used ✓� 9 bywm In effect When con9mcled
to establish any dthe property lines for any purpose. No h`�#N U 10 S and/ or is gL4npt from violation entorcamtenl
responsibilAy is Wended to the land owner or owupant salon under Maas B.L. Title VII, Chap, 40A, Sec. 7.
This certification is based on the location of survey marker �Subjeat building is not in a Flood Hazard Area.
Of Others. O Subject building is In a Food Hazard Area.
Food Hazard delennined from the FIRM rrtapo.
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of *CRra 1�c TOWN OF NORTH ANDOVER
;o� OFFICE OF
p BUILDING DEPARTMENT
,o �+1600 Osgood Street Building 20, Suite 2-36
�►. �:,;.o :�� North Andover, Massachusetts 01845
Gerald A. Brown
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
Please print
DATE:
JOB LOCATION:
s f --G -T-;� G
Number Street,
0
Telephone (978) 688-9545
Fax (978) 688-9542
Map/Lot
HOMEOWNER men QS^ Q Q E; Cl Y3 O r5�
NameHome Phone Work Phone
PRESENT MAILING ADDRESS PC' 7`n G
,/"f
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 procedures and requirements and that he/she will comply with said procedures and
requirements. �--,
HOMEOWNERS
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Form Homeow" Exemption
BOARD OF APPE :\LS 688-9541
CONSERVATION 688-9530 HEALTH 688-9540
PLANNING 688-9535