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HomeMy WebLinkAboutBuilding Permit #453 - 90 LANCASTER ROAD 12/6/2006 TOWN OF NORTH ANDOVER NORTF/ APPLICATION FOR PLAN EXAMINATION 0.1%..o 16.6 10- ti A Permit NO: 5 3 Date Received Date Issued: �� SSACHUS� IMPORTANT: Applicant must complete all items on this page , - LOCATION A _5 Prin PROPERTY OWNER AK41-1,4/14 .ZfD�ro va��LS '-Oe7FJC>,© Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building )40ne family ❑ Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED 4 aa 7- Identification JPleeaase Type or Print Clearly) OWNER: Name: � Ls��L T�4'!5, Phone: 7-,_2-;� 77 Address: �Pr �4eo CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: f Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL EST/MATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ ©O FEE:$ Check No.: /D�� Receipt No.: rq 2_ Page W4 4 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 Inall 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 TYPE OF SEWERAGE DISPOSAL Swimming Pools 11Tanning/Massage/Body Art ❑ g Public Sewer x ❑ Tobacco Sales Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered c ntractors do not have access to the guaranty fund 11 Signature of A ent/Owne g g Signature of contractor , Plans Submitted ❑ Plans 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 FIREfDEPARTMENT - Temp Dum ster on site es - P Y � n 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 i Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required 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 Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 Location hf J am- It No. - -3 Date f - MORTM TOWN OF NORTH ANDOVER 3? i OL 16. s ; ; Certificate of Occupancy $ .! S'••�°•tt�' Building/Frame Permit Fee $ s�cwus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /n 4- 19862 Building Inspector AORTIy Town of No. o� dover, Mass., J; Q M. LAKE I� COCKICKEWICK 0,4"4 RATED PPG �5 1 ` BOARD OF HEALTH PERMIT D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT... / ���. ........ ...... . .. �.10... ............................................................. Foundation 1 has permission to erect................................... ... buildings on....10...... �tr��if�r�.�.� A.Kh........ Rough to be occupied as....�4 .�.�..�........ � .......44..r........ I. .....h .I.. .. ...... himney cprovided that the person accepting this permit shall in every respect conform to the tef the application on file in Final this office, and to the provisions of the Codes and By-Daws 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 qr PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR AR Rough ....... Service BUIL SPECTOR Final Occupancy Permit Required to Ocacpy 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. y b { M 1 , i v a , r 1 f � �• � �` ' � III TOWN OF NORTH ANDOVER OFFICE OF it BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suire 2-64 North,kridover, Massachusetts 01345 Gerald A. Brown Inspector of Buildings Telephone(978)688-9545 HO%v1EO%VwP 1 [C"'Q Fax (978)6,S8_9542 SE EXEMPTION !'!case print DATE: S15a,,,d_ me JOB LOCATION: Number Street Address Map;Lot 11 01M E OWN ER AC,_ Name Home Phone 7 6; Work Phone PRESENT MAILING ADDRESS 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 no acts as supervisor). State Building (Code Section 108.3.5.1) t possess a license,provided 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 intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not he 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 undersigned­homeo�jper"certifies that lit'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. 1J0_NlEOW_\ERSS1GNA FLRE APPROVM.OF RUILDUNG OFFICIAL r;ed If) It,5