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Home My WebLink AboutBuilding Permit #Exception - 85 PUTNAM ROAD 5/14/2009BUILDING PERMIT TOWN -OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received - s --)/C//,-) Date Issued: IMPORTANT: Applicant must complete all items on this t)age LOCATION 6 �J r U I F W K(,k rin PROPERTY OWNER r UP' " rt Pdnt MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT 0 Residential Non- Residential New Building 11 -Ir -17,11" __00ne family 'y Additio ltt�ioorn T� wo or more family TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building 11 -Ir -17,11" __00ne family 'y Additio ltt�ioorn T� wo or more family Industrial No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer OWNER: Name: Address: DESCRIPTION OF WORK TO BE PREFORMED: 3's x Yee or Print Clearly) CONTRACTOR Name: Phone: Address: Phone:'� Supervisor's Construction License: Exp. Date: Home Improvern Exp. Date: ARCH ITECT/ENG I NEER Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000-00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F Total Project Cost: $ FEE: $ _ �00 Check No.: Receipt No.: C� 0 NOTE: Persons contracting with unregisteg?d contractors do not have access to the guarantyfund Signature of AgipnVC6._n.r;02M__, _Wg_j� nature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF -SEWERAGE DISPOSAL j�ubli:cSe�wer 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. PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on COMMENTS T, HEALTH COMMENTS DATE REJECTED DATEAPPROVED Reviewed on Signature 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: LOcaiea ozs4 usgooa ,jtreet FIRE DEPARTMENT - Temp Dumpster 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 MGL Chapter 166 Section 21 A —F and G min.$100-$l 000 fine Im. NOTES and DATA — (For department use) LJ 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 Li Building Permit Application Li Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses Ei Copy of Contract ci Floor Plan Or Proposed Interior Work 13 Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Li Building Permit Application Li Certified Surveyed Plot Plan L3 Workers Comp Affidavit • Photo Copy of H.I.C. And C.S.L. Licenses • Copy Of Contract Lj 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) Lj 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 Doe: INSPECTIONAL SERVICES DEPARTNIENT:BPFORM07 Revised 2.2008 n Location oe 4 No. Date 7�f 40RTN TOWN OF NORTH ANDOVER 4L Certificate of Occupancy $ Building/Frame Permit Fee $ S CMUO' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22Ub'I Y_*-�� Building lnspe(�t—or 6 z N a a p 0 E 0 E-4 u w z 0 R, u w o u t 0 2 'n >, C/) u C/) .4 5 m Or- - z as '1� -a to Z :U>l r. E -C u ci r. x., co r. X to z 0 co r. S. :J 0 8 b C/) o E C/) ui am CD 02 0 C.3 CLC c D CC2 cl) CIO E CO CF co 0 CL E E C2 ts cm I- E Ma cl) 4D ca cm co C=, 0 C) e COD u 73 cm CD C/) C/) cm cm -a go .5 CL 4D.e Co c 0 cc 0 cm 0 4D 'CD L:5 1-4 =.S CD C4 CD ui M CC E CO LU Cs CD CL CD C* 0 ca .0 2.LOS CD ZZ CL:s Cl F. 0 10. "It N E co cr- -Ito j CD z CL 0 COD CD cm CA Ca -g cm CIO Q3 0 CD L - It. co CL.) en 0 L- C:L cc 0 CL m: CMCZ CA *-0 C cqo —J co GO z CD CL U CO) cc CL CO2 w uj U) ce LLI w W uj LU U) -Z C) lu -i La 7A E K'SURVEY INC 0 HAVERMILL,:MA 0', PhORG gn469-1085 4 Fax 979489.7M MORTGAGOR jLgiegit.) pjfj�& DEED REF, PG. 2J& ADDRESS OF PRINCIPLE BUILDING 65" - PLAN REF. im, AdIzIge, DATE OF INSPECTION A-ra, gypaf- SCALE: 1. - 3144 Em. &rmm 7C. 76 4r 10,11rO q1 I 1JL t T - CERTIFICATION TO: 00" AVDEL This MMgaga Plot P Ian was prepared 8 p" No Ths 10caft Of the Principle' st'ructurwa "10119ago Puqmft only and 4 113 not intended or reprewntd to be a property lins or land survey. This plan b not to be used Wt% with th to establish wyor the : 6 local zoning by*m In effect Wtien cmetrucled PrOPOrtY Itnes for MY purpose. No 0 rKV Or 13 exMPt IrOm Violation entotrengni responsibility is aWandad to the land owrw or occupant C1101"I under Was B.L. Title V11, Chap. 40A, See. 7. This certification is based on the location Of surfty mariker wsub)W building it not Im a Flood Hazard Area. of oth". 10 Subject lbulldlng is In a Flood Hazard Area. Flood Hazard determined from the FIRM rhap# JOR Dated�� Ranins *M'.3 w ULD:01 so 02 60 Je . W` Gerald AL Bruwn Inspector of Buildings Please mint TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 North Andover, Massachusetts 0 1845 HOMEOWNER LICENSE EXEMPTION DATE:� ba /0� JOB LOCAMN: ufn uk Number Street Address HONEOWNER, Name Home Phone PRESENT MAELING ADDRESS City Town State Telephone (978) 688-9545 Fax (978) 688-9542 MR" (0 /(,,1 - 5 q'�? -() 'Work Phone Zip Code The mr= =Whon for "homeowners7 was odended to include owner -occupied dwellings to two units or less and to allow such hDmeowners 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) DEFINMON OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on winch 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. Ile undersigned "homeowner" assumes responsbilitY for compliances with the State Building Code and other Applicable mks, by laws, rules and regulations. The undersigned "homeownce certifies that lidshe understands the Town of North Andover Buildmg I)Wtment inspection procedures and requirements and thathelshe will comply with said procedures and requirements. HOMEOWNERS, SIGNATURE APPROVAL OF BUILDING OFFICIAL Revind 10.2005 Fam Homwwom E=,Wfio, ROARD OF \PPE, U. S 6X8-9541 I CONSERV. MONO 48-9530 HEALTH 688-9540 PLA-N-NING 688-9535