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Home My WebLink AboutApplication - 135 RALEIGH TAVERN LANE 10/18/2010 BUILDING PERMIT pORrh TOWN OF NORTH ANDOVER ° ,1 6 APPLICATION FOR PLAN EXAMINATION �� y�.. ° Permit NO: Date Received " � ; e Date Issued: a` �'� Argo nPp�y.(�7 SSAClius�t IMPORTANT Applicant must complete all items on this page LOCATION f + `-1 Ue n PROPERTY OUj/NER °` I -} Print MAP NO PARCEL' ` Print: . ZONING DISTRICT._,: HISTORIC DiSTRIGT yes na TYPE OF IMPROVEMENT PROPOSED USE ❑ New Building Residential ne family Non- Residential 'Addition ❑Alteration ❑ Two or more family 11 No. of units: Industrial El Repair, replacement ❑ Commercial El Demolition ❑Assessory Bldg ❑ Other ❑ Others• G P 1, 9 f Weti iFlaodp�alrt CllNetlands �Cl Wat�riSe�nrer ,. .. C� 1Nafersh �d District DE RIPTION OF WORK T BE PREFORMED. S1 � d C Identification Please T ' �t`` `:(,i) OWNER: Name: - Y e or Print Clearly) c° y _ �.t J �` � (n 0 Address: Nd�mPPhon Gz� � e: � CC3NTRAtTUr'�, Phone. Atldress upe►visor's Constructtort License '` --" 9 �xZ Tome I M rQU p ement LiceiseF Exp1r, Date: I / ARCHITECT/ENGINEER 0 Address: Phone: FEE SCHEDULE:BOLDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL $ESTIMATED deg' No. �(1a " Total Project Cost: �� c, ��FEE: COST BASED ON$125.00 PER S.F. -heck No.: 'OTE: Persons contiacti with unregistered contractors do not have access to the guaranty ignature of Agent/Owner Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF -U FORM Th ob DATE REJECTED DATE APPROVED R PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION El F1 I / COMMENTS_ j I DATE REJECTED DATE APPROVED HEALTH ❑ X COMMENTS �� L ILI TYPE OF SEWERAGE DISPOSAL I Swinvning Pools Public Sewer L] Tanning/Massage/Body Art iJ Well ❑ Tobacco Sales ❑ Food Packaging/Sales J Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ 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 FIRE DEPARTMENT I Temp Dumpster on site yes _no Located at 124 Main Street Fire Department signature/date COMMENTS—_ Dimension Number of Stories: Total square feet of floor 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 �-, r 1 /y ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 'b e f Date Issued: IMPORTANT:Applicant must complete all items on this page ff LOCATION i 3S Pk OIL 6)4 OVEN iq PROPERTY OWNER @�� , �� i�I Print Print MAP NO: C�'' . � PARCEL:6/o --?,e ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ` Mew Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well 0 Floodplain El Wetlands ❑ Watershed.District 0 Water/Sewer t DESCRIPTION OF WORK TO BE PERFORMED: Z 201 entition lease Type or Print Clearly) OWNER: Name: Phone: Address: I S 14L E1C,d *azfo I r CONTRACTOR Name: S Q---) Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $-- `� cc� FEE: $ �- Check No.: Receipt No.: NOTE: Persons contracting i, unregistered contractors do not have access to the guaranty fund Signature of Agent/OwneC . Signature of contractor 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 ❑ �' d �0 COMMENTS CONSERVATION Reviewed on I D f Signature s COMMENTS HEALTH Reviewed on 1tq&))-' Si nature/ n. 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 Main Street Fire Department signature/date COMMENTS x TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received /v Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION .� - _ =p- 1?ROPER Y OINNEti � Pnnt dUJAF NOPAROEL _ 01111G DISTRICT t Hstor�d:Distr�ct yes no 777 77 - IlachIne Shop Village. . �es :no : . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne farm Addition wo or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other, e ti Weil floodpja�n_ etlands 1Natershed District ater/Sewer DESCRIPTION OF WORK TO PERFORMED: Ins a "p'p !r ��fdl 7I�fI _ Ip� Identification Please Type or Print Clearly) OWNER: Name: ElZtV- -� f)EDFA Svu-1 Phonel"18 sc mW Address: 15-S iRAL H I! Jv6-'R,4 L&A phone; Acr Tess tf - St�perv�sorsConstrucfioh License' Exp Day _ Forne lmproVeraent License: , = xp ;Date ARCHITECT/ENGINEER Phone: Address: 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: $ 0A J FEE: $ Check No. Receipt No.: NOTE: Persons contracts ith unregistered contractors do not have access to the guaranty fund SignaturefAgent/Owr►er - Signature of contractorT Plans Submitted Pla s'Wbived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(sep ' ,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM, DATE REJECTED DATE APPROVED I PLANNING & DEVELOPMENT 1 COMMENTS I I '- CONSERVATION Reviewed on Signature . COMMENTS _ HEALTH Reviewed on �. Si q nature 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 Durnpster,on sits. yes'- no Located at 1241 Nlair'Street' Fire.Departrnent signature/date COMMENTS