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Home My WebLink AboutBuilding Permit #789 - 87 BUCKINGHAM ROAD 6/4/2010BUILDING PERMIT TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION I- Date Received 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 Septic VUeI, a Floodplarn Watersyhetl District` ¢ rkWetlaniis .� 1JZbk;K11- i 1UN OF wUKK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: -t � -� -`�' � a " �`^�..�',�" � �.z, �;r �. ,r`^ � -�.. ria r.3 ,� ✓�" '� Ec � -ki "5L' ' -' R °r-�' -�'- '� ""�'i, � - „rk�c ,� - a ff t "`✓ '� � .xi 7. €� x � _. �A. -�*" -'e°p .3+ _ ; � as "'`L ,�" h "�.K .k�� ,, t`! 'c ter_ * Q s xfYx �uLj CONTRACTOR -Name -411- � = ��Phonewr� �"s j •s-,'d'.e4' Yom''.-� �- �� AEI t ��_ -i-5s t ✓+ rli �� •• ro.. w r Addressz �� rµ F b ahs a Y ` r " ''- .. Ss .g,.'` -3 t � ARCHITECT/ENGINEER 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: $/G�� FEE: Check No.: 6�1 Receipt No.: t NOTE: Persons ontractingl with unregistered contractors do not have access to the guaranty fund Signature of Agent/OwaPSignafure of _i Location ✓ �� _ Date No. , TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ e Other Permit Fee $ TOTAL $ Check # 2 3 Building 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 dI%C�r iAll %O7- 'n S -e C/1 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS Reviewed on Signature HEALTH Reviewed on Signature CQMMENTS, 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: 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 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 117 - 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: Building Permit Revised 2008 E QI v 11 * O C O T yW . �� C 7: y Cm C m� CoIA CD �. y R H m :mo _ dV i y O m CI p C t' C y Q d C t O :m�Z :ono m no C = m :moo �V _ y O~ COD C OC -.m= Lu I.- •CHCL O C W .E V 'p v • V O V CD Cm GCLti d m .fl O CR CAO F- L $ CL Cc J CD 1 zoo a w z 0 L) I U O ICD Com_ Ca Q H O O 'E Co m CL CD � .o O � CD CDQ c_va o a a Ca � = c o +r cc C3 i d O CD Ca Z 15 C Co CL V w O C waft c _c a CO2 D u°. Cf) (f) w o 0 w° toQ a�G U _to w w • C2 x. a in - u cn w a to w z a rA z cn v cn 11 * O C O T yW . �� C 7: y Cm C m� CoIA CD �. y R H m :mo _ dV i y O m CI p C t' C y Q d C t O :m�Z :ono m no C = m :moo �V _ y O~ COD C OC -.m= Lu I.- •CHCL O C W .E V 'p v • V O V CD Cm GCLti d m .fl O CR CAO F- L $ CL Cc J CD 1 zoo a w z 0 L) I U O ICD Com_ Ca Q H O O 'E Co m CL CD � .o O � CD CDQ c_va o a a Ca � = c o +r cc C3 i d O CD Ca Z 15 C Co CL V w O C waft c _c a CO2 D F µoRTH TOWN OF NORTH ANDOVER ot�s�eo Fb�tio o� OFFICE OF BUILDING DEPARTMENT 1600 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 Please print DATE: D! �X� JOB LOCATION: HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Number HOMEOWNER &e,,90 V,3 Naffie PRESENT MAILING ADDRESS A191,�V ,06110 Street Address Map/Lot Home Phone GSI Work Phone 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 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