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Home My WebLink AboutMiscellaneous - 163 HIGH STREET 4/30/2018 163 HIGH STREET - 210/067.0-0036-0000.0 Location No. 3 Date NORTH TOWN OF NORTH ANDOVER 3? � 0 � n Certificate of Occupancy $ s i � �'�s',•°•Eta Building/Frame Permit Fee $ 3 +c"us Foundation Permit Fee $ Other Permit Fee $ I � TOTAL $ 3 Check # C?,+-S � I /PA/( �- 1 6 9 2 3 / Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING a �uw xFor BUILDING PERMIT NUMBER. 3 DATE ISSUED: �_ 6 SIGNATURE: � --Building'Commissioner/Inspector of Buildings Date SECTION 1-SITE INFORMATION o 1.1 Property Address: 1.2 Assessors Map and Parcel Number: -to q 3� Gam' Map Number Parcel Number Y/ J 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R redProvided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Bz Al 4 Al t✓ S ame(Print) Address for Service t � Sign re a ephone 7 2.2 Owner of Record: V ` Name Print Address for Service: z �Sature Telephone m i n SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Wn j Address Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number M Ad4,ress — Expiration Date ^z Signature Telephone M/ i SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all a licable New Construction 0 Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition ❑ Accessory Bldg. '❑' Demolition 0 Other 0 Specify Brief Description of Proposed Work: A Lk SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beFCIAtiU �(31vLY Completed b permit applicant 1. Building (a) Building Permit Fee 3066 Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbina Building Permit fee(8)X (b) 4 Mechanical HVAC 'J 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act o a f in all matters rel ive to authoriz by t� .b ilding permit application. o S&agre of Owner Date CTION 7b OWNERJAUTHORIZEDAGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si ature of Owner/A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlvIBERS OT 2 ND3 RD SPAN DIMENSIONS OF SILLS DRvIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS � SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE r �10RT1•t Oo<t�e� 6g1.0 O A Town of North Andover * i Building Department ` 'q-� M-�- 27 Charles Street SSACHUSEt�� North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE / JOB LOCATION f 3 �7` S I Number Street Address Section of Tc "HOMEOWNER �J /�� Cs— ( r S Number Hofne Phone Work Pho PRESENT MAILING ADDRESS —3 if�o fT /r/f�G1li�f� /�� City Town State Zip Code The current exemption for"homeowners"was extended to include w - p e o ner occupied dwellings of 1 or 2 units and to allow o 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 HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which of two there is, or is intended to be, a one family dwelling, attached or detached structures accessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official, a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 108.3.5.1) The undersigned"homeowner"assumes responsibility for compliance 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 No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and re ire ents. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note:Three family dwelling 35,000 cubic feet, or larger,will be required to comply with State Building Code Section 127.0 Construction Control. Revised 4.30.03 Home owner Exemptions Form LAK 4 dover, Mass., COCHICHEWICK V ADRATED p`?�� `s U BOARD OF HEALTH Food/Kitchen PER. MIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .A10R.M.A.A)........... .l1rl.. ..q.�1..1r..�........... .... .... ... ..........................•�••'............. Foundation has permission to erect.....�(�. #a.�...��. ........... buildings on ......�... .3.... �1..5.."!�..........s...r................ Rough to be occupied as Q o so r 0 f.0 al-W,t"..... Chimney ..............................)...........�/4..'! ...........................�.............M.... ................... 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-La relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 607 .3 3 p r PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMU EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS T ' 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 Street No. ti SEE REVERSE SIDE ji Smoke Det. s Location No. (002 Date v NORTH TOWN OF NORTH ANDOVER O'tt�ae Certificate of Occupancy $ " Building/Frame Permit Fee IfFoundationWeel ?Fee $ mit $ Sewer Connection Fee $ Water Connection Fee $ 3' TOTAL $ Building Inspector 010/19514:05 25.00 PAID 1 = 9289 iv. Public Works M I 120 Main Sbee C. 015 °' __�=Tvwn Of 508) 62-&M NORTH AiN VER BCILDI�G �•��' ptvsto�af • CCXSErZ�ATION HEAL"ri \.NNIN : PLANNING 3 CONDIUN.- = DEVELORNMN . CHT.le; f APPLSGATT_ON AND PER-KIT D�T� D PEiLMIT s/. CW S NAM S BLT ER' S NAMIE N;-MI r� :L'.SCa ' S ADDR?SS L S: OF F._ _ `o tr ^e:r cr SLGi:nTLR OF MA SC:`+ CoN R. LI.C. ^_NSTRliC;ICa CSS=•`C.::`-- :RICE �� -U N�CETT' , SL ILD=_:G =_ Cc=_.:,R .:.S?ECT:.7 RE MARKS _R_Cr R_CU17ZE-0 THT_S P�c`�I_ _IC _= DISPLAYED ON THE PRr T-SZS NORTH F TOVM Of 3 over 0 No. Ar 4 r o l rt dover, Mass., 19 96 COCHICHEWICK ADRATED ,�5 `-' BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... ....... ... ... ..... . . . ..... . ... .... ..................................... Foundation has permission to Bret ............. buildings on �6. ............................... ltough to be occupied as... ................................................... c:l,in,ttev provided that the perso accepting this per it shall.1 ry respect conform to th rms 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUC ON STARTS ELECTRICAL INSPECTOR Rough ....... .......a... .. .. ........... ... ..... ............ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. f i 00 ON3 ' • Town of North Andover t HORTOI , OFFICE OF O•t COMMUNITY DEVELOPMENT AND SERVICES ° • o9Q .� 4 146 Main Street KENNETH R.MAHONY North Andover, Massachusetts 01845 "SSACNuStit Director (508) 688-9533 HC`fEOW1EER LICENSE ESENiPTION Please print. DATE a A lo //S� • /� JOB LOCATION Number Street address p Section of town "HOMEOWNTER" ko&el6k 2 ZL (9. , G� 6 Q 05o S r-- Name Home phone Work phone PRESENT MAILING ADDRESS /y/ 3 City/Town tate Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six 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 Sec- tion 109.1.1) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which heishe resides or intends to reside, on which there is, or is intended to be, a one to sLY family dwelling, attached or detached structures ac- cessory to such use and/or farm sit Scures. A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building perm,it. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, bv-la:vs. rules and regulations. The undersigned "homeowner" certifies that�he,-she understands the Town of No. Andover Buildin; Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. � HOMEOWNER'S SIGNATURE e, APPROVAL OF BUILDING OFFICLU Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Buildin; Code Section 127.0, Construction Control. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9j35 Julie Parrino D.Robert Niow- Michael Howard Sandra Stan KaUem Bradley Colwell