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Home My WebLink AboutMiscellaneous - 323 DALE STREET 4/30/2018 (3) V v J _ V �' .,�.: Location A I`e S No. Date Mo"T TOWN OF NORTH ANDOVER ` F e a Certificate of Occupancy $ Building/Frame Permit Fee $ 3 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ O Check # 15792 - -- uilding Inspector J I TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING Ef MR BUILDING PERMIT NUMBER. g DATE ISSUED: 0 -13 _® 9- X SIGNATURE: Building Commissioner/IEskxctor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: �=Z 3 17 A 11= 5ri. Wap Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: i Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 1.7 Water Supply M.G.L.C.Q. 54) 1.5. Flood Zone Intion: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Prinb Address for Service: Sign re TeL.; hone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3 -CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed ConAruction Supervisor: O License Number 1 Wn Address j Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name rn Registration Number r Address r nn. Z Expiration Date /) Signature Telephone V� SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(b) 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 au applicable) New Construction ❑ Existing Building ❑ Repair(s) ;K Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: aec,_ <4w'6 4 lacy- zg'c'C,/-s /J. CA -Tb SI SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be (3]fICIA)(, TSE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of ~� Construction 3 Plumbing w .L BuildingPermit fee c8 X b ) O 4 Mechanical HVAC 5 Fire Protection N„� 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 I, s e as Owner/Authorized Agent of subject property Hereby authorize to act on My b ha - in all matters relative to work authorized by this building permit application. � SigiikiA of Owner Date ' SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION ,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 Pri Si ature Uf Owner/A ent Date i NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIvlBERS 1 gr 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS 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 FORM U LOT RELEASE FORM -o �' ✓ INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION *****************—**-*-*-*-*--I APPLICANT 3 /A AJ PHONE yp9K- 3y/� LOCATION: Assessor's Map Number PARCEL_ad Q 5' SUBDIVISION LOT(S) STREET DA-1(_r5r ST. NUMBER 3.L.7-1� *****************************************OFFICIAL USE . ONLY*********************************** RE OMMENDATIONS OF TOWN AGENTS: CONSERVATION ADApffISTRATOR DATE APPROVED DATE REJECTED COMMENTS (A41"J.a �d� al) e 6A '::� J/do/ "a.0 A cls, .�L t�,uce.�,cs,T'bnlV � �"wV `��C�O�i�WltulcZ �ccwt.S' 3�.r�.s;v� con�rot5 .s`u.�l U2 plc�@.� in a. 16u��-,flh a/�p�?7V� TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE_ Revised 9\97 jm Town of North Andover 4 ' - Building Department 27 Charles Street North Andover, MA. 01.845 "+�9 •.�� D. Robert Nicetta .Building Commissioner (978) 688-9545 978 688-9542 Fax HOMEOWNER UCENSE EXEMPTION Please print ,( DATE O ?1 JOB LOCATION 3l� o ,-3 1.J�YL C �%. ' C)O's Number Street Address Map "HOMEOWNER J/C 6'f C�/� �i�JU j I0 7,W— Name , '`— Name Home Phone Work Phone I 'RESENTMAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of two units or less and to allow such homeowners to engage an indWuallbr hire who does not possess a license,.provided that the owner acts as syperAsor. (State Building Code Section -108.3.5.1) DEFINITION OF HOMEWOWNER: Persons)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 dwelling,attached or detached structures : cessory to such use.and/or farm strictures_ A person who corstructs more than one home in a two-year period shalt not be'corisidered a homeovrner. 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 compty with said procedures and requirements_ HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL - 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: 377 — s41 _ y �� (Coca ion of acifity) Signature 60ermit Applicant 31 z- '-bate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I e I J U '\ CO I 39 9'. /Anl K o r p� o/s> GDT 1p . 44 to&5 5.F �3 00 1 t i ,a r INVERT ELEVATIONS AT HOUSE` TANK INLET . /93. fp- TANK zTANK OUTLET . 192.88 PUMP INLET 192.83 PUMP OUTLET 192�'7l0 DIST. BOX INLET . . . _ . _ _20 4. !04 DIST. BOX OUTLET . __-- END OF LINES . 202.0(0 END OF LINES END OF !INES AS - BUiL T DRAWING SUBSJUR = ACE SE WAGE DISPOSAL SYSTEM SCALE ! J" = 40' DATE Arl(,c1S77' 9, 1984 OWNER' 2AC14AIZY eEAL-fV C0ePD2A—rl01 i i F _OCATION: LOT !A GALE 15fCEE1' j! N0)e-7-N AtJP0VEe , MASS. I uo n/dover1 { ¢ c y� l ' Inc. 213 Broadway,Methuen , plass. Tel, Et7 - 3823 L i THIS DR��W;NG raUT TO S .'GNSTRUED THAT THE 3Y;? r-._MWI!_?-- FUNTION FRi;P`vfl: _`i 011T, T E D own of Andover No. 0 0 t�- L A COCHIC over, Mass. 16 163 MAO OCHIC TED H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT...... �:��.�...0A00...... BUILDING INSPECTOR........ aftTa.AP*._, .......................................................... Foundation ............... ... .. T ...................... has permission to erect .. buildings on ... ....................... Rough to be occupied as... IP ...... ................................. Chimney provided that the person acceptinglis....pe-r-m--k-s-hal-1--in every respect conform to the terms of the application..o.n..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. & 94 1 %v =map PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voi s this Permit. Rough PERMIT EXPIRES IN 6 MONTti§ Fin;?] UNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR 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. SEESmoke Det. REVERSE-SIDE �`w✓s i,3 �LGlO�1 Fi 6G c s 6E-k-M \l � S 1 ` \,\ Ca ' LOT \ O ` \ Fl20 N ♦� Q 192 y • 00 194 rn ,r 43,6(r0 S.P � 1 11JG WA 1 I Zoo .00 Zoo _ 9 3 y 1 9 Z04 * \ \ • I � 1 lop IV z 08 o \ I r \ \ (Soo(SaL..Ta Ic 1� t \ • , PUMP CFko BE 194 Le.&cwiwGTrZENGN --208 G \ 1 z\�� e>:s>=V-VE a�EA N/ zoo a 3.-79 F Z,&G1-4d0-Y 12 GA,LTY 198 I--