HomeMy WebLinkAboutBuilding Permit # 5/31/2016 %AORTII
BUILDING PERMIT �'��"r 0 "1+�
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
Permit Flo#: f �' Date Received rEp
Date Issued:
1 311
f
I P RT Alva': Applicant must complete all items on this page
LOCATION
LOCA
Print ,
PROPERTY OWNER
Print Year Structure yes na
MAP PARCEL: 12-1ZONING DISTRICT: Machine Shopistrictyes no
Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential — Non- Residential
❑ New Building ❑ One family
11 Addition El Two or more family 11 Industrial
Li Alteration No. of units: 11 Commercial
❑ Repair, replacement O�Assessory Bldg f, ❑ Others
❑
❑ Demolition Other
/f, r /;,,, s /';" % ;❑'Watershed,Distract /
/, /<, od Iain / ,❑Wetland
F O
/r ,.Well , p r o ,,
/,❑.,Se �..,/ ,,,,; /n,.. /: it ,,,r
r /�[+ r ,n, ... / /. / /" i ////1' / /. it ,.,; G /.. /r .:r ///�l✓i/, ri�r / r -",,,,,;,,,
!!RF G!Watt',„„/.:J,P.,wer%,r, ! % ///,/„r./,,,
DESCRIPTION OF WORK TO BE PERFORIVIED:
R � .
Identification- Please'Type or Print Cleanly
OWNER: Name: Phone:
Address: ---_ — _
a
�.
11[Em
ractor Name
.: �, : :�� Phone: ��,:::�
.:. a d: ”" �” d k” ^
il:ess:ervisor's Construction License: Exp. Date:
e Improvement License: Exp. Date:
. ., .w
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.-$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ _ FEE: $
Check No.: )r ceipt No.:
NOTE: Persons contract. g with Unr .s re c tra of have access to the gnaranty funcd
- - -
- 1
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
[Public
YPE OF SEWERAGE DISPOSAL
Sewer ❑ Swunmin PoolsTamaing/Massage/Sody Art ❑ g ell ❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private(septic tank, etc. YX Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m U FORM
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed onJ
��- Signature
f
1
COMMENTS
Mu
)kEEALTH Reviewed onJ05' f 6 Signature
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
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp.,Dumpster on site yes no.
Located at 124,Mainstreet' _ _
Fire Department sfn tur''Mate
COMMENTS
®R'A'H
Town ofiAndover
h ver, Mass,
O LAKE 1
COCKICKE WIC.(
A°RArEo P �5
S U
BOARD OF HEALTH
Food/Kitchen
P E R� I T IF %Aoq LD Septic System
THIS CERTIFIES THAT ...... ..... �'� '�%'�... �.��.f. BUILDING INSPECTOR
........ a ............................................................................
... buildings on ....... G
Foundation
has permission to erect
....................... .�...�f.....�1..��................................. Rough
tobe occupied as .................. .. .., .... .......... `.. .................................................... chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in 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
MONTHSPERMIT EXPIRES IN 6 ELECTRICAL INSPECTOR
UNLESS Rough
Service
........... ...... .. . .. ...........:: ................... Final
BUILDING INSPECTOR
GAS INSPECTOR
ccupancr Permit Required t® Occupy Building Rough
Display in s Conspicuous Place on the Premises — Do Not Remove
Final
No Lathing or Dry Wall o Be Done FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
North Andover MIMAP December 14, 2015
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Interslates �+✓ Horizontal Datum:MA Slateplane Coordinate System,Datum NAD83,
I ���WWW�•�J��'""' Me{ers Data Sources:The data for(his map was produced by Merrimack
--SR Valley Planning Commission(MVPC)using data provided by the Town of
Roads �'�4t,So. � Noah Andover Additional data provided by the Executive Office of
Easements +Z�� *q. Q Environmental Affairs/MassGIS,The Information depicted on this map is
ParcelsG for planning purposes only. It may not be adequate for legal boundary
-- _ definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER
MAKESNO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING
THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY
{c 2 +# OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT
ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
THIS INFORMATION
� ACHIIs
1"=45ft
?age 10 of 11
OFFICIAL INSPECTION FO —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE ISPOS SYSTEM INSPECTION
PART C
SYSTEM' ® ON(continued)
Property Address: /Z
Owner: /"'J d r/
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEMreference
Provide a sketch of the sewage dis no100 feet Locate where public orate upply enterstthe building.landmarks or
benchmarks.Locate all wells with
k
0.
It
10