HomeMy WebLinkAboutBuilding Permit #922-14 - 90 SPRING HILL ROAD 6/17/2014TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued: jqji��
IMPORTANT: Applicant must complete all items on this page
LOCATI
Print
PROPERTY OWNER-�JQhfl Uarl JQa!;J
Print 1 bo Year Old Structure yes no
MAP NO: PARCEL��)! - ZONING DISTRICT: Historic District yes no)
Madbine Shop Village yes (� no
TYPE OF IMPROVEMENT
PR.OP-OSED USE
Residential
Non- Residential
0 New Building
0 One family
D Addition
[I Two or more family
11 Industrial
0 Alteration
No. of units:
El Assessory Bldg
El Commercial
El Repair, replacement
El Others:
0 Demolition
0 Other
El Septic 0 Well
D Floodplain 0 Wetlands
El Watershed District
El Water/Sewer
Ytor,2 lee/ DESCRIPTION OF WORK TO BE PERFORMED:
Y. 14
Identification Please Type or Print Clearly)
OWNER: Name: PhonV.
I
Aririreq-,:
CONTRACTOR Name: r\ Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCH ITECT/ENGI NEER Phone:
Address: Reg. No
FEE SCHEDULE: BULDING PERMIT., $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F.
Total Project Cost: $-) $
FEE:
Check No.: Receipt No.:_
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
nt/
gnature offi�ge Own Siginature of contractor
Plans Submitted Plans W (Certified Plot Plan Stamped Plans
I
-Plans Submitted[] Tlans Waived -0 .".Certified Plot Plan[] F1
Stamped Plans
TYPE OF _�SEWERAGE_D1SP_0_SAL*
Public Sewer
TanninglMassage/13ody Art F]
Swimming Pools 0
well
Tobacco.Sales
,Tood Packning/Sales 11
Private �(septic tank, -etc-
Permanent Dumpster on Site F1
THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
.-:..,DATE REJECTED DATEIAPPRZOVED
.PLANNING & DEVELOPMENT
COMMENTS—
,CONSERVATION Reviewed on 41-D-11 11 q - - Si(,jn2fijrP1__�_
COMMENTS
HEALTH
COMMEN
I (\,\ (C -Y-)\
Reviewed
42N j -1 t-1
V
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes-..
Planning Board Decision:
Com
Conservation Decision: :Comments
Water & Sewer Con nection/signature & Qate Driveway Permit
'DPW Tow�, Engweer: Signature:
Located 384
FIRE Dt -NT.:_',Tenip Durnpster on site yes
PARTM.L no
Located7bt 124 Mair. Strbet
--Fire Dep�tiMer&signa'ture/date"
COMMENTS
ood Street
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
DANGERZONE LITERATURE: -Yes 'No
MGL -Chapter. 166. Section 21A --F and G min.$10041000fine
NOTES and DATA — (For denartment usel
Doe.Building Pennit Revised 2010
NV_L �W.-tA�
El Notified for pickup - Date
Doe.Building Pennit Revised 2010
NV_L �W.-tA�
Building Department
:----The fol',lowing i a-1 list of, the req:- uired-forms to belilled out for: the approptiate:permit tobe obtained.
Roofir,g, Siding, Interior Rehabilitation Permits
u Ruilding Permit Application
u Workers Comp Affidavit
o Photo Copy Of K.I.C. And/O�*C.S. L.Licenses
Li Copy of Contract
• Floor Plan Or Proposed Interior Work
• Engineering Affidavits for Engineered products
NOTE: All dumpsterpermits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
L3 Building Permit Application
Li Certified Surveyed Plot Plan
L3 Workers Comp Affidavit
• Photo Copy of H.I.C. And C.S.L. Licenses
• Copy Of Contract
Li 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)
u Building Permit Application
Ei Certified Proposed Plot Plan
• Photo of H.I.C. And C.S.L. Licenses
• Workers Comp Affidavit
Lj Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (if Applicable)
Ei Copy of Contract
L3 Mass check Energy Compliance Report
Li Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
in all cas,�% if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the api),�al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submJted with the building application
Doc: Doc.Building Permit Revised 2012
Location9D!5ps-4�0� VJ-
No. _q22 -M- Date
Check #
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee
Other Permit Fee $-
TOTAL $
Building Inspector
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"OFN HANDOVEp
0MCEOF
BUMDING
I)EMMENT
—1600 OskOC)dStrcct]3uffding2Os.S-uite2--36
'1'�O-rth And0vor, Massadhnsettq ol g45
Gerald A. Drown
Inspector of Bi�ldirigs Tr-lePhOne(979)6S8-q54s
F�7- (978) 689-9542
HOMMENBR-LICENSP
�11MD�IN E—PERMT APPLICA-HON
DATE. -V / 7'Lly
�OB LOCATiON.- T)
Number
ManfLnt
-F -.M.X.UV.UU
-PRESENT MAMiNG ADDREss—
A
I T
t3�41-�
Zip Code
T'le current cxeropfin for'l-omeowers- was c�xtendod to inOILOC OWner-oorf1pied
to aBOW SW,311 hDMC-D-VMe,-S to enggge an in e�!ivj dual -f�,- hire -who do as dlvelli'ags to two units -or less and
acts as supervisor). StafCDO' ding (Code Soobon 108.3.5. 1) Mtpossess a license, provided that th a* OVM1_r
DEFMITION OF 110MEDVMER
P'.ISDIL(s) Who _�wus a parcel of land 0. Which he/sharesiaes orintends to re
be, a one or two fhaily structure "side, or, which there is, Or is ktaudod to
considered a homeowner. A person who constructs more thatnne home 111 a two -Year period shall n ot b a
The undersigned "homeftner"assumes respo-usibifItYfOTr-OD2pliaures with the State Buildi gCodeandoth.,
Applicable codes., bY-laws, Tales andregulations. n k
The undersigned 'homeownej?, ccrt�Ues that he/she imderstands the To'
MinimuTn -0 00dares and raq . W -u Of goTth AndOvOrBuilding Departraeut
"s'POctiOn PI uzeme ts and tMh
requirements, it -he/she will cOmPJY With,said procedures and
-UMMOWNERS SIGNATURE
A-PPROVAL 01? J3UjLI
Re,ylsed 7.2009
FOXM liomeowners Exemption
'80ARD OF APPEAM 698-9541
IkIFICIAL
CONSERVATION 698-9530 BEALTH 698-9540
PLANNING689-9535
�3`D 1 -3 (D ) :�z
North Andover MIMAP
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Horizontal Datum: MA Statelplane Coordinate System, Datum NAD83,
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Meters Data Sources: The data for this map vas produced by Merrimack
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definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER
MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING
THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY
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OF THESE DATA . THE TOWN OF NORTH ANDOVER DOES NOT
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40
ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
THIS INFOR MATION
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