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HomeMy WebLinkAboutBuilding Permit #142 - 89 LISA LANE 8/22/2006 L TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION 0 -t 20 61�0 m Permit NO: Date Received �9SSACHU5�t�y Date Issued: IMPORTANT: Applicant must complete all items on this page I.,OCATION 41 A L,41v Print PROPERTY OWNER ��'QK iGKS Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING -- - HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential New Building Ione family L dition Ell Two or more family =' Industrial ✓,�Iteratior. No. of units: epair, replacement ❑Assessory Bldg u Commercial Demolition Moving(relocation) _ ❑Other _ Others: __ Foundation only DESCRIPTION OF WORK TO BE PREFORMEDII 26�evv G ,e rn� �By�h/loam N 0 �7 A24 e/1 Identification Please Type or Print Clearly) R��m OWNER: Name: t��'�IC� �� YC Phone: X78-258'32 2— Address: 8'S L.1SA r CONTRACTOR Name: Phone: Address: � Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: 1 ;-kRCHITECT;/ENGINEER Name: Phone: i address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 167400 x12.00=FEE;$ _ Check No.: �'i /nr Receipt No.: Pace 144 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 Pen-nit Application ❑ Workers Comp Affidavit ? ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses . -2 ❑ 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) o 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 Dor.INSPECTIONAL SERVICES DEPAR MEN'HIPFOR 105 i I i TYPE OF SEWERAGE DISPOSAL F--, Tanning/Massage./Body Art Swimming Pools Public Sewer Well Tobacco Sales El Food Packaging/Sales Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to prgject NOTE: Persons contractingwit a ire ' tered contractors do not have access to the guarantyfund v'k- Signature of Agent/Owner—W Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM -.-.------------ ----DAT-E-REJECT-ED ----- -DATE APPROVED PLANNING& DEVELOPMENT ❑Water Shed Special Permit ❑ Site Plan Special Permit Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ 1' COMMENTS DATE REJECTED DATE APPROVED HEALTH (] G1 COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision!receipt submitted yes Planning Board Decision: Comments Conservation Decision: —Comments Water& Sewer connection/Signature& Date Drivewav Permit Temp Dumpster on site 'yes_no_ Fire Department signature/date Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided __Require 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 I I I i 7 Page 3 44 Doc:INSPEI`HONAL SI.RVICL'S DEPARI'MEN FBITORM05 i I { Location t(j�q No. �7Date MORTM TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ �.�5',^°•'<� Building/Frame/Frame Permit Fee $ 7� s�CHusa 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r' Building Inspector XAORTH Town of 4Andover _ ,, 0 No. 1410 _ ti _ . o z= A E dover, Mass., COCMICKE WICK DRATED PPa\ -`C2 '9S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT....... 5. ......... I.. .. lC. ... ............................................................................. Foundation has permission to erect........................................ buildings on .... .......... .4A.............N....a.......................... Rough to be occupied as.Dt rnv....��O.k.,mmi..�....... 0A... .... .:MAL 4�..... ....I .... j•ifrl Chimney provided that the person accepting this permit shall in every respeIR 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI � 7'S_ Rough .................... ...... .................. ... ... ................. Service BUILDING INSPECTM Final Occupancy Permit Required to Occupy 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. SEE REVERSE SIDE Smoke Det. NORTH TOWN OF NORTH ANDOVER �=0y OFFICE OF ° .BUILDING DEPARTMENT 1600 Osgood Street Building - g g 20 Suite t 64 Sys�ATFo rY"t1y North Andover, Massachusetts 01845 Sq 5� CNU Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: Lz Z ©(v JOB LOCATION: $R Number Street Address Map/Lot HOMEOWNER rS DICKS, 979'25'8-3212. `/'7�-861L-6, Name Home Phone Work Phone PRESENT MAILING ADDRESS g9 /SA 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 requiremens and that nhe will comply with said procedures and requirements. HOMEOWNERS SIGNATURE evkl APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 68$0540 PLANNING 688- 953.5 f