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Home My WebLink AboutBuilding Permit #416 - 871 FOREST STREET 11/21/2006 — e TOWN OF NORTH ANDOVER RTh APPLICATION FOR PLAN EXAMINATION 0* p10IAO o qti o ° OL z 'A Permit NO: Date Received o ey ,> 9q<xKK w.wKw� Date Issued: Ar 0 ssgc►+rJs�� IMPORTANT: Applicant must complete all items on this page LOCATION re PROPERTY OWNER ArJ 2 >- Print MAP NO.: )05'D PARCEL: ZONING DISTRICT: ' 1 TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family K Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OE WORK Tq.,B E PREFORMED , f Identification Please Type or Print Clearly) OWNER: Name: p14,J i£ /d•l Phone: Address: CONTRACTOR Name: STC A,,J C &ri N Phone: 7 7S -360 - /�6 Address: 143 �6 ,� &� �J!� �� 03Q6 Supervisor's Construction License:_ G'504431 c8 Exp. Date: 1a111 job Home Improvement License: 141 a�o Exp. Date: 16107 ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PER /T.•$12.00 PER$1000.00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 5,000 FEE:$ '#60 Check No.: & Z Receipt NoA Q d L I Page W4 4 Location t No. Date ,.ORTst TOWN OF NORTH ANDOVER Certificate of Occupancy $ •O� sr�r�. 4 �7s''•a°•Eta' Building/Frame Permit Fee $ �� sACMUs Foundation Permit Fee $ Other Permit Fee $ , TOTAL $ a Check # 19821 (� Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art ❑ Public Sewer Well F1Tobacco Sales Food Packaging/Sales❑ [I 1Permanent Dumpster on Site Private(septic tank,etc. ;� Electric Meter location to ` project NOTE: Persons contractinpansWaivc istered contractors do not have access to the guaranty fund Signature of Agent/Own89Signature of contractor Plans Submitted ❑ d CertifiedPlot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS TE REJECTED DATE APPROVED CONSERVATION `2a7 c COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ ' c COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes bn Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Sip-nature& Date Driveway Permit Building Setback(ft.) Front Yard Side Yard Rear Yard RequireC Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: i NOTES and DATA— For department use) I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPART MENT:BPFORM05 Created JMC.Jan2006 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 ❑ 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) ❑ 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 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:BPFORM05 Page 4 of 4 F '''Kr„ TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood• g Street Building 20, Suite 2-64 �cHU�,t,�h North,\ndover, Massachusetts 01845 Gerald A. Brown Inspector of Buildings Telephone(978)688-9545 Fax 19;8 j 6,S8-9542 HO:�IEOw'NER L[CE'VSE EYE;�iPTION DATE: 11111 d JOB LOCATION: f lyres. Number Street:Address ti[ap/Lot — HO,NIEOVVNER_ 1, M i`E I _i�- R Y-W 9 7S-6 f- tll NameHome Phone 9 79 4,01-366 Work Phone PRESENT MAILING ADDRESS S 1ar�•� 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 acts as supervisor). State Building (Code Section 108.3.5.1) p d that the owner 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 i be,a one or two family structures. A person who constructs more that one home in a two-year mended to considered a homeowner. y period shall not be 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 Andovcr Building Department minimum inspection procedures and requirements and that he.'she will comply with said procedures and requirements. p HO-N[EOw-N'ERS SIGN,111RE 1PPROV.M.OF RCILDING OFFICI,kL k rm Hnmur.it rs I :,rq iir.n (.. I;i?CF.tFF ,.i.. NORTH Town Of odover, Mass., . p A_O COCMICHEWIC ' 7d ADRATED is BOARD OF HEALTH i Food/Kitchen PERMIT T D Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT .f .,r.. ...•...........................:.................................................... .....EXVZFoundation has permission to erect........................................ buildings on ..:..> .. ........r1��T......,. .. ............... Rough to be occupied as......�.�...A...�.......6r4k.s............................................................................................................ Chimney provided that the person accepting 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 Cao PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUr AtTS %tm� Rough Service BUPECTOR i Final Occupancy Permit Required to Ocmpy Building GAS INSPECTOR 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. 1{ SEE REVERSE SIDE Smoke Det. 1 ��R p°�� $ Rro�►r i of I kll J a/ 9r (17' $)off 7 CP rwo A I I tt i, GAG SUA Po 91 A " r= ly/�0 - A t /6'f.cF Prx-) Q L L am P it ) T T v G 8 � 9 � � I r s / El V/j - ' -- ;rN + 9. X. �I = � ,