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HomeMy WebLinkAboutMiscellaneous - 32 BLUE RIDGE ROAD 4/30/2018 32 BLUE RIDGE ROAD � 210/065.0-0111-0000.0 a Location No. 5 So Date ( NaRTM TOWN OF NORTH ANDOVER Certificate of Occupancy $ �'�s'••°� MU5t, Building/Frame Permit Fee $ � 4C Foundation Permit Fee $ Other Permit Fee $ TOTAL $ — Check # v © 0 C. { / k.+ I Building Inspector y TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING rz.t BUILDING PERMIT NUMBER. 3 57R DATE ISSUED: 11 1�� X SIGNATURE: Building r----i--ri0MLnspc1or of Buildings Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 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 Regifired Provide RegWred Provided ReqWred Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 _J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M 2.1 Owner of Record KHQA D� M - _ . 0 �' e(Print) Address for Service: Signature Telephone Vv 2.2,Owner of Record: Nkme Print Address for Service: o Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction Supervisor: O License Number mn Address Expiration Date Signature Telephone r -t 3.2 Registered Home Improvement Contractor Not Applicable ❑ r Company Name M Registration Number Address r Z Expiration Date Q Signature Telephone V I f y SECTION 4-WORKERS COMPENSATION(M.G.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.......0 SECTION 5 Description of Proposed Work(check all a livable New Construction ❑. Existing Building ❑ Repair(s) ❑--] Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: r SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beUSE;{)I!73.Y Completed by permit applicant 1. Building 0 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC �- 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 on beha , ' all matters relativ work authorized by this building permit applicatio . SinaVe o OwnerDate SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION ,c 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 TIMBERS 1ST 2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS t HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE t►ORT1j O - p Town of North Andover Building Department n� •��'''' 27 Charles StreetCH�" �., .•"��y SSgc►+usE North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE &iyLm AEI 1�T2 D"D3 //�� JOB LOCATION 2J� SLu,C— b.6 G F &A—b PJ, &�b D Uk-2 Number 7Streef Address Section of Ti "HOMEOWNER /��,�5=���1 r(j0� 2LY ®P_j5- Number A Home Phone Work Phc PRESENT MAILING ADDRESS AS G3� " City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of 1 or 2 units 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 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 requir ,ments. 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 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: mcyb r r hz 4L, le Lq;-U_ 12w, (Location of Facility) AA- Signature of Per0i Ap;&ant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NORTFI Town of No. LAKE O dover, Mass., COC HICHE"'C CO 7�SDRArE D P'? Gj 1 u BOARD OF HEALTH Food/Kitchen -PERMIT T D Septic System lek /� BUILDING INSPECTOR THIS CERTIFIES THAT..... �`� �....�.. '� IV .......r. ......................... .............I................... ................................... """" Foundation has permission to 9mt9W.P ........ buildings on ., �..a I V! ��... Rough Go ato be occupied as...... AA v '� "� r ..... Chimney 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. #aS h o t `$ -•o mom PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS AR S Rough JA.�..... .......... 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.