HomeMy WebLinkAboutBuilding Permit #727 - 98 MARIAN DRIVE 6/18/2006L
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Permit N0:
Date Issued. —o
TOWN OF NORTH .kNDOVER
APPLICATION FOR PLAN EXANUNATION
AF IL
IMPORTANT: applicant must co
Date Received: "o (/1
all items on this
LOCATION
,I' int
PROPERTY OWNER CIIA" -
Print
im,w NO.: /04,C- PARCEL: 5� ZONING DISTRICT:
TV'vc & Nn I T.%F. OF BUILDING
TYPE OF IMPROVEMENT
= New Building
Addition
Alteration
epair, replacement
Demolition
Moving relocation
Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
HISTORIC DISTRICT
PROPOSED USE
Residential
One family
Two or more family
No. of units:
Assessory Bldg
Other
s�l�s
Olh'NER: 'dame:
Identification Please Type or Print Clearly)
� -e_
,kddress: a I oaf ; wr b r- )k) o-,- �( 4
YES 0
Non- Residential
Industrial
Commercial
Others:
S e-a-jU�
CONTR.,XCTOR Marne: - 0 w- - _ . - - -- - - - one.._.___
,Address:
Supers isor's Construction License:
9;-Jz22.
Exp. Date: t
-r,
HomeEr Improvement License: P• Date:
ARCHITECT'ENGINEER Name: Phcne:
\ddress:
Reg. No.
FEE SCHEDULE: BULDIAG PERS11T: SIO.r9O FER $i JOO.00 OF TILE TOT. I L EST111ATED COST BASED Usti •5115.00 PER S.F'
Total Project Cost :$.__...-._WD00 x10.00- FEE:$
Check No.:f S � S� Receipt No. ! . _
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
a 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 Hydraul
Calculations (If Applicable)
Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
zi Building Permit Application
j Certified Proposed Plot Plan
a 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
%ppeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. one cop) and
proof of recording must be submitted with the building application
?nr: I�tiPl.C'f101,\L. til?R\A,pi DRI' \R'!'11EN TA11EOR`10
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Building Setback (f.)
Front Yard
Side Yard
Rear Yard
Required
Provided
Required
Provides
Required
Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
c .,..;", 1 .ic
TYPE OF SEWARGE DISPOSAL — SH imming Pools
Tanning"Massage Body .art
Public Sewer — To
Sales -- Food Packaging Sales
Well — --
Permanent Dumpster on Site
PriNate (septic tank. etc. Electric Meter location to
NOTE:
project
Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent Owner
Plans Submitted
Plans Waived
Signature of Contractor
Certified Plot Plan
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
Stamped Plans
DATE REJECTED DATE APPROVED
❑ ❑
❑Water Shed Special Permit
❑ Site Plan Special Permit
Other
DATE REJECTED
u10
DATE APPROVED
DATE REJEC'T'ED DATE APPROVED
i
HEALTH
CUMMENTS
Ioninp-Board of Appeals: Variance. Petition No:
pa `
Zoninv Decision; receipt submitted -,es
i.'Ianning Beard Decision: —.__-- Commcnts ---
Cli,lscr\aftll Ducition:
'k*:itl'r & S,:m-r .onnection -ILnaturc �i'& ulatc J/
i'cmp Dempster cn site )cs_l✓ c�l=ire Department si;natur_,, date _ Ai�e�'N
Building Permit Appro%cd and ISSLIud by: �t"� �
Location v rn ear -,r 4 A 91-44/-
No.
'"4/No. Date o G»
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
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Check # s S
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Building Inspector
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Noark TOWN OF NORTH ANDOVER
OFFICE OF
4 BUILDING DEPARTMENT
400 Osgood Street
?.q "Ar. North Andover, Massachusetts 01845
Gerald A. Brown Telephone (978) 688-9545
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
DATE: 5 -
JOB
JOB LOCATION:
Number Street Address
HOMEOWNER J L-\)� A e..
Name
PRESENT MAILING ADDRESS
AA_
City Town
C 83 - 3 Z-22 ��� 30'� 6 G �Io
Home Phone
State
Work Phone
? -Y
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 requirements and that he/she will comply with said procedures and
requirements. 'N -
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Fonn Honwowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-
9535
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