HomeMy WebLinkAboutBuilding Permit #822 - Exception 6/20/2006L_
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Permit NO:
Date Issued: 0
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
�U U R LL®
Date Received:
—
I IMPORTANT: Applicant must complete all items on this page I
LOCATION 10 " k2 FG S-� Lk) 41k -p- (_ 6 t
PROPERTY OWNER \_ )_�'U--`()'M_ �
MAP NO.: to / PARCEL:
TYPE AND USE OF BUILDING
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Print
ZONING DISTRICT:
HISTORIC DISTRICT YES 4/ )r) ice_ i•..., z� -
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
❑ One family
❑ Two or more family
No. of units:
❑ Industrial
❑ Repair, replacement
❑ Demolition
❑ Assessory Bldg
❑ Commercial
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
Identification jleaslr fiype or I3rint Clearly
OWNER: Name: *x , T,}
P'horie:
Signature p� ` � ^ °
Address: \ 0 v—:: -,O
. t� �' 'SC– 1 y �
CONTRACTOR Name:
Phone:
Supervisor's Construction License: Exp. Date:
Home Improvement License:
Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
a
FEE SCHEDULE. BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST B SED ON $125.00 PER S.F.
Total Project Cost :$ 'I 2.9(9 1 no x10.00=FEE:$
Check No.:_% CS� Receipt No.:
Page I of 4
Location /D` /Z ��' w�7� r --
No. Date rn • Ty 'D �o
,NaRTM
OTOWN OF NORTH ANDOVER
;t��•o ,•,hG
• . • OL 4
9 �
Certificate of Occupancy $
Building/Frame Permit Fee $
s�C."
Foundation Permit Fee $
Other Permit Fee $ r
TOTAL $
Check # 3�
w
Building Inspector
TYPE OF SEWARGE DISPOSAL
Tanning/Massage/Body Art ❑
Swimming Pools
Public Sewer ly
J ❑
❑
Tobacco Sales
Food Packaging/Sales ❑
Well
❑
Permanent'Dumpster`on-Site— ❑
Private (septic tank, etc.
Electric Meter location to
project
NOTE: Persons contracting w' h unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owne t,\ XL" !' Signature of Contractor
Plans Submitted ❑ Plans Waived ❑ ertified Plot Plan W Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED
❑ ❑
❑ Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
DATE APPROVED
DATE REJECTED DATE APPROVED
CONSERVAkbr1)KA-1,UP5
N ❑ x I q ;:r&
COMMENTS WL&WF- ISIS
tri l00' cockId m41K_Dxaok__ lIN0
HEALTH
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Water & Sewer connection signature & date
DATE REJECTED
Comments
Comments
Temp Dumpster on site yes_nox Fire Department signature/date
Building Permit Approved and Issued by: 6 YL VV11'—
Page 2 of 4
❑0
DATE APPROVED
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required
Provided Required Provides Required
Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
NU"I ES and DA I A —
of 4
SERVICES DEPARTM
Created JMC. Jan.2006
Total square feet of floor area, based on Exterior dimensions.
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:BPFORM05
Page 4 of 4
Gerald A. Brown
Inspector of Buildings
Please mint
><OWiv Or INOXYH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
400 Osgood Street
North Andover, Massachusetts 01845
HOMEOWNER LICENSE EXEMPTION
DATE: 6,9
JOB LOCATION: I Z O
WqACC6-�
Number Street Address
HOMEOWNER. IP b Q - On k
Name Home Phone
Telephone (978) 688-9545
Fax (978)688-9542
69 �?_
Map/Lot
PRESENT MAILING ADDRESS It) 1&5+ U-3 -+c f' 5t
City Town
C V t4I^ PA -
State
Work Phone
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. /--% ,
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING Of ...., —
Revised itL:ou5
Form Hoincimicis Exemption
BOARD OF APPEALS 683-9541 CONSERVATION 088-0530 HEALTH 08-9W PLANNING o88-
0535
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CERTIFIED PLOT PLAN
LOCATED IN NORTH ANDOVER, MASS.
SCALE. -I"=40' DATE. 6/5/2006
Scott L. Giles R. P. L. S.
Frank. S. Giles R. P. L. S.
50 Deer Meadow Road
North Andover, Mass.
11
LOT 2
14,2 75 s. f.
73'
EAST WATER STREET
I CERTIFY THAT
DI
MMING O
THE OFFSETS
N
v
APROP.
v
O
co
)24APMEOTLER'
26'
+
O
AND SUCH USE IS FOR THE
WITH THE ZONING
DETERMINATION OF ZONING
S
Ii38
BYLAWS OF
NORTH ANDOVER
CONFORMITY OR NON -CONFORMITY
W
WHEN BUILT
WHEN CONSTRUCTED.
U
W
Y
LOT 1
28'+1- FE1 25'+/
a LOT 3
PARCEL 26
T.
EXISTo
DECK
O PARCEL 28
6.5'
X
�ISTL
T-1
Q
BIC. CONC I y
0
DRMWAY I �2
(10
20' 17,75' 18'
`O
73'
EAST WATER STREET
I CERTIFY THAT
OFFSETS SHOWN ARE FOR THE USE
THE OFFSETS
F
OF THE BUILDING INSPECTOR ONLY
SHOWN COMPLY
4���LtH
AND SUCH USE IS FOR THE
WITH THE ZONING
DETERMINATION OF ZONING
S
Ii38
BYLAWS OF
NORTH ANDOVER
CONFORMITY OR NON -CONFORMITY
o,
cr A o
s� WE
WHEN BUILT
WHEN CONSTRUCTED.
LAtN S
G