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Home My WebLink AboutBuilding Permit #570-12 - 94 MAIN STREET 1/27/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: 2� Date Received Date Issued: 2 7 YMN) Applicant must complete all items on this page LOCATION 1 PROPERTY OWNER I�L Print Unit# Print MAP NO: a PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0 One family 0 Addition XTwo or more family ❑ Industrial 0 Alteration No. of units: ❑ Commercial }�1 Repair, replacement ❑Assessory Bldg 0 Others: ❑ Demolition ❑Other (® epfic Well ®F1_o ai''nr� �'®1We Ian"s} 4 - 0 iik f d isfrict - �O�Watei/S __ - - DESCRIPTION OF WORK TBE PERFORMED: OF M f (Identification Pleaw Type or Print Clearly) OWNER: Name' �JJ��/ Phone: Address: Abb-4942 ,47A 503; U' J ,8x57 CONTRACTOR Name: 137611 his Phone: Address: �,� J480� S-T Vim\ oly 6 / Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: z Address: Reg. No. i FEE SCHEDULE.BULDING PERMIT.•$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $_ ?j�,[�t'S R (�� FEE: $__ 4/y Oy Check No.: Receipt No.: NOTE: Persons contracting with acnregister dcontractors do not have access to the guaranty fund Signafure,ofAgent/O.wner� _ . . - _ -- -- ;�; 'riatur _ ►._ontacto �t' ,r ., I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools ❑ Tanning/Massage/Body Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Signature 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 servicedroprequires approval of Electrical Inspector Yes DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 20117une/mi 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks ❑ Building Permit Application ❑ Certified 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) ❑ 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) ❑ 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit 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 Doe: Doc.Building Permit Revised 2008mi Location lr'�/ /✓/ G/ii'/ �� No. _ s— Date Q z- NORTp TOWN OF NORTH ANDOVER 3? •. • O N R P Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ � sACHUSa 9 Foundation Permit Fee $ r Other Permit Fee $ I TOTAL $ �y Check # 2490 Building Inspector µORTH oEst`ep ,b.�tio TOWN OF NORTH ANDOVER o� OFFICE OF BUILDING DEPARTMENT Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 A�HUS Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION BUIDING PERMIT APPLICATION Please print DATE: Z 2�7 JOB LOCATION: r NNuum�b,.er Street Address Map/Lot HOMEOWNERc�Vo �JQ �l�' Name Home Phone Work Phone PRESENT MAILING ADDRESS City ToMm Sty*e. Zip ode The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such b0Me0VTiers 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 Awns 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 requirements d that he/she 11 com ly wi said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 7.2009 Form Homeowners Exemption BOARD OF APPEALS 688-9541 CONSER\DATION 685-9530 HEALTH 688-9540 PLANNING 688-9535 AORTH Town of. Andover .. . 0 o , dover, Mass.. �-- • O� COC LAKE ICEWICK V RATED PP�`�,�`� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT............................................................................................................................................................... Foundation has permission to erect...:.................................... buildings on �f,�...! l..Q� ..... ......................................... Rough � to be occupied as................. ........................................................................... Chimney A�?.Q..r.... ... .0..2.F.�4.r..... :........................ 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 b MONTHS � 7T 1� T ELECTRICAL INSPECTOR UNLESS LESS CONST1�� CTIO TARTS Rough Service BUILDING INSPECTOR 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 i Street No. SEE REVERSE SIDE Smoke Det. 0"' Town of. Andover ., No. X= WIR& �, o , lover, Mass., X? � �- Q - LAKE COCHICHEWICK AQRATED PPP�� S V BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D BUILDING INSPECTOR THISCERTIFIES THAT............................................................................................................................................................... Foundation has permission to erect........................................ buildings on ... ....f..:.L..Q� ....: ......................................... Rough ..A0.Q.. , ....�.exo.c1...� ...:................................................................................................... Chimney t0 be occupied as............... 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 b MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO §TARTS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocatpy 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.