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HomeMy WebLinkAboutBuilding Permit #192 - Exception 9/10/2007 MUILUIIVV rGr%1n1 Fr4�.� :..,,�•e op TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Receivedkwrty SA HU Date Issued: ` I IMPORTAN pp complete T:Applicant must all items on this page MINI a k n o �,�. Ufa � � � � z r �, • K TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family �Okddition Two or more family ❑ Industrial ❑ Alteration No. of units: Q Commercial ❑ Repair, replacement ❑ Assessory Bldg o Others: ❑ Demolition ❑ Other s 'Ag Moe DESCRIPTION OF WORK TO,BE PREFORMED:. OJCkP-� dentifr ation P�Ie a Type or Print Clearly)OWNER: Name: W-'i� Phone: V Address SIN a :„ `� a. .s• k zxr � :. a "xx :{"rhro"bzs ro� '" „ .<; $.��` - ,` ., darn» w 'f7 t , mW x" � `�"��. ��� ��x� � •� � e �M 1*01 P A . WIN as ��`3�r �' vim` � �'•".�P '� a x"} -�,"� ,�:� ,.a ,a ��'� � %+r� a. -f ��,�� -�`���� ��' �• s w "max a z° a 5 z 1 n .�T'.lhFa+. r.+'eW.PSN MiSFlRig„•.'ki F'ua'+4'e..e^•?�: � �5,.� • ARCHITECT/ENGINEER r I'4M lr� S' _ Phone: Address: -73 E7ern �)-° �<L,�m Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ W Check No.: / Receipt No.: ON '(.4- NOTE: Persons contracting wi unr ered contractors-do not have access to the guarantyfund � � j nat rI'd fi oa��rarr� � 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 Li Photo Copy Of H.I.C. And/Or C.S.L. Licenses Q Copy of Contract o Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Li Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Li Building Permit Application o Certified Proposed Plot Plan a Photo of H.I.C. And C.S.L. Licenses a Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report D Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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:BPFORM07 Revised 2.2007 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING &-DEVELOPMENT ❑ ❑ COMMENTS REJECTED DATE APPROVED CONSERVATIONL IN C MMENTS Cr� � DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water $ Sewer Connection/Signature $ Date Driveway Permit Located at 384 Osgood Street Dab, y g © rste sit �e� n. I.- a3iUl "w�ap..�� i�u:l„ £'3.^s,u, °, a5' *s', 'Y�rr '. 3 s 10, },:. . .•Y �..'': §47}�a3i rx iF �+"" =e t x,"kvYr Y x e`k $rf� '� k'�, �* .a,,,35"k . 1= '00 c11 t't� #1 51 r@/ aft£ ? ,,� "'.` ...,a.'aaa: j� . sa r ,.¢,-t s.,'.' 's ...�a5 jos' `� '� 'n�P � "' .cx ,ten �&^rr {�<��. �" "➢. �r.�y�. a � �w.a..'�.. +.z.�'��;',»�,''�"--zre�..• �"..'��' $�v �+�'�w� 2."fes 3 k �e �`"� - .. �, y z. Dimension Number of Stories: Totalsquare feet of flo or area based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical .Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date .................. Doc.Building Permit Revised 2007 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified 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) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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:BPFORM07 Revised 2.2007 BUILDING PERMIT TOWN OF NORTH ANDOVER °3 APPLICATION FOR PLAN EXAMINATION Date Received °AA*•°►°" ay Permit NO: v �SSACHUSE� Date Issued: T `-0 IMPORTANT Applicant must complete all items on this page NON �w � :;, �� ^x*s"�x ���. 's .� ��`�',�ax �' �Sf�' '�•�`��.'�. 2 �5 e r � frr �x� fir: < �� �'�.���.�" �� ,�y=«a, r`°•"'° s Sk,�� esw �.�^4m�a.�•� 'e s "�fij:;t .��k•�d^ .tea kx � s 2 IN M �r ;r�1�.€ +s4 a 5 atvl, ..: q �� '_. '•ca 'r... ., �Y„ - *-rte "yn-'�, . vi � 1" a a.� -. .3�.:°�,. 5 ..��u �,�. <,.F"iwc'a.r�..-:.�. .�.�,..xz,.:�.,• s.=r�..�1�, �i�"'€��"S".'•,�,�, �2:.r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential - ❑ New Building ❑ One family �C4dditionTwo or more family ElIndustrial ❑ Alteration No. of units: D Commercial ❑ Repair, replacement 0 Assessory Bldg El Others: ❑ Demolition ❑ Other j XRAW- ` DESCRIPTION OF WORK TO BE PREFORMED: fi ation Pile a Type or Print Clearly) Identi �(_S 3 OWNER: Name: A Q� r �, Phone: LO Address a.e ".v ,�... a•�r� �'� � � '� �•,i z � a*m. �;��� �.,����,`.' s�s��+e ,y r�y'�^'k, � ."� � �'� ,'a�� •`s�f''3' "�8'� ti's ""� S-� °n 'r s�� z '��`✓� ���' r � � � �° 'has � k f �• V� :Y.:. R ���v'dw` : £ ��hr ��P� "S�n 2 �� f��ia.'z ?y13 ' l b � '. .. .��~'.'.,:' a _.. r. ^4c:F '� T`i'p �^," z+ s��n,:''• r"�`' :,Pa,wi`-. a`'',�3�",^ -' � -,, .� $� +a�'�f " `�•'��as���,,'���'"'�y,` ��°,'y�"y. ��+.��` 3 ti� ���i Ji `i'�` ' .�� r? �y�,'.c���' r� �y; ,.r� n'.�a� ,spa �c xaa"��.�.,a�r s'� ��� ''<� -;�Y'� ��1;itsU.r���S �i,s ���a��sr s�;';" a w� ;` w � �a�: �„� ,., rr .u;:y re'r=" .� �# s! � e, ''�';*,� ���#� �" '�`-uo- •�{'�g��fl"�$° ............ - '�.�.� � n ARCHITECT/ENGINEER h Mn� CT;\ _ Phone: Address: -? 3 L<L.mr c� �-.{� Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �,oeL' FEE: $ Check No.: / � Receipt No.: '?d � NOTE: Persons contracting wi unr Bred contractor^s do not have access to the guaranty fund Location fvGl�'�'/ No. _ ✓ Date _001 NORTp TOWN OF NORTH ANDOVER 0 s • ; ; Certificate of Occupancy $ cNuE�� Building/Frame Permit Fee $ � s� s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # / — 20581 Building Inspector • :r VAORTH Flom" AL No. CN o dower, Mass. o LA f COCHICMEWICK 7 �AORAT E BOARD OF HEALTH L , Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT..... .. .. .. .............................................................................................. Foundation ej es has permission to erect........................................ buildings on ......6.I ......... .d............ ..... .... ®...... Rough to be Occupied as....... ...� ...... �.... .� ..�................ .. �. Chimney . . . .............................................. provided that the per on 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final ® PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION 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 Mall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE S0®� Smoke Det. NORTh TOWN OF NORTH ANDOVER ° t"'" '•'" OFFICE OF F BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-36 �.''•;,;.e �+ North Andover,Massachusetts 01845 1ss�ca►�5�� Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please pig/ DATE: JOB LOCATION: O O W Number SUM A&Wss Map ut HOMEOWNER naO,k '^'EJ q)y` 'aU`r S- 3 Name Home Phone work Phone PRESENT MAILING ADDRESS r 4-- � �L •W\V V!/' ! V `� ( Jam•. City Town State Zip Code The mmut exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less am 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 sbuctureS. 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,Hiles and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures andmqu' its and that he/she will comply with said procedures and requirements. (544 HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL xevind 10.2005 Fmm Homeow un Exemption BOARD OF WEALS 688-95+1 CONSERVArI0\683-9530 ITEALTH 688-95.30 PL.L\KING 688-9535