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HomeMy WebLinkAboutBuilding Permit #454 - 9 ELM STREET 12/6/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 01 ftA `�`O or 6!6 0 tio r0 to Permit NO: J Date Received rc'(O r Date Issued: CHU IMPORTANT: Applicant must complete all items on this page LOCATION g CSM'[ �� Print,�" PROPERTY OWNER JAf- �1�/tC A /�SSO 9- Z4WI-) �- � /al t SSD Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) X Other FA*xy A/#t 1,(/ 45&-A� ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Fit cLy ao©/k HA2 �3/J-.S6-AJt-:A7- Identification Please Type or Print Clearly) OWNER: Name: 5'r�}LV/ MkZ- '�- LIOVhA- kkSS'O Phone: 779-2S?'-'1p2S Address: ? E2-Ot i'7��T CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 $10 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 600,00 00o FEES (0 — CI Check No.: /al d Receipt No.: / kk3 Page I of 4 Location) No. Date HQRTq TOWN OF NORTH ANDOVER f .; A ` Certificate of Occupancy $ Building/Frame Permit Fee $ sACMUs Foundation Permit Fee $ *— Other Permit Fee $ �— s, TOTAL $ Check # tit y Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public SewerV- ❑ Tobacco Sales Food Packaging/Sales ❑ Well ❑ 11Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered con ractor do not have access to the guarantyfund Signature of Agent/Owne Signature of contractor Plans Submitted ❑ P s Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS j FIRE DEPARTMENT - Temp Dumpster on site yes no 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/Signature& Date Driveway Permit Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Re uired 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 NOS O Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan.2006 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:BPFORNI05 Page 4 of 4 „'"r" TOWN OF NORTH ANDOVER ��� ' �'• OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 ' '•^ A " .AA`'I North.\ndover, Massachusetts 01845 Gerald A. Brown Telephone(9?5) [nspector of Buildings 68,9-9545 Fax 1978j 6`s4-9543 HOMFO%'NER LICE\;SE EXEMPTION P!case print DATE: j 2 ,M JOB LOCATION: _� Number Street;Address Map/Lot — HO,NIEO'%NER � ' - Ll., �A_ f�tfSsa _ Mame Home-PhoneLSA 4 9LSr17�X40 1x43 Z Work Phone PRESENT MAILING ADDRESS_ - -yj 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 t b e considered a homeowner. no The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws,rules and regulations. The undersigned"homcoi ner"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. IIO'•IEO ERS SIGN;1'1-LRE -- ---- ------- —.fir._ _ •��� \PPROV\I.OF RCI(.DfNG 0FFIC'f.Q I rm Hnnr" ina�•f� r,r;��iini i• ,. Iii IL. ,� •l. ,. it Town of Andover 0 No. 7 over, mass. 0 46 C�- _ _ _r - L f A. IE COC IC WICK ORATED BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT........Sectets....AN-& ......... BUILDING INSPECTOR ..................... .. .............................................................. Foundation has permission to erect........................................ bui;1d&11non .7........ii f-7o....... ).r.......................................... Rough to be occupied as...00.d P.W4 0%'.. ......... ................................................................ 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 Final • PERMIT EXPIRES IN 6 MONTH V ELECTRICAL INSPECTOR UNLESS CONSTRU T Rough Service ...... ... ..................... ............ ......... ............................. ....... ..... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place an 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. A MORTGAGOR: PAMELA L ORLANDELLA DEED REF: 5418/248 LOCATION: 9 ELM 5TREET PLAN REF: 3819 CITY,5TATE: N. ANDOVER, MA 5CALE: 1 "=20 DATE: 8/19/OG JOB #: 20G.0395G 8� 7g LOT 39 13, 192 5F± u� J W cD DECK 6> GAR 42.3 I ' 57.69' R=GG3.7G' ELM 5TREET CERTIFIED TO: WA5HINGTON MUTUAL BANK Flood hazard zone has been determined by scale and is not necessarily accurate.Until definitive plans are issued by HUD and/or a vertical control survey is perjbrmed,precise elevations cannot be determined. 5, Rork This mortpa" Inspection was propared i.x� rhis »wri t ton wm rod in a000rdatwe rift-u r�oltsd upon Pew only and paps n+P� Pa as a land or p vpelly Y (t�OF A1q ��Y with the Technical Standards �r Yostyayv Loan lin. survey used )Or rocand preparing deed t�� �� Inspections w adopted by the jbaachusetts Board o1 -- _-- -- __-- __wdinq._ �a �•r\ Registration of ProAssional Rhaimwm and Land C-;Q5 rir16- DECK EXESTIuG' x €ECL Arfl- GAR ,k- 11 N 1- M Po T-E" )T i A L 42 . 3 1 ` 57 . 69` R= 663 . 76' 9 fI M 5TREET I I NGTON MUTUAL bAN n determitwd by scale