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HomeMy WebLinkAboutApplication - 266 BARKER STREET 6/1/2016 p g y{� "ORTh BUILDING PERMIT O� �S�c° 16 6 TOWN OF NORTH ANDOVER_ o ; ' x APPLICATION FOR PLAN EXAMINATION`" :: z y ^0R Permit No#: Date Received- C Date Issued: IIydP®1ZTA N7C: Applicant Vuscomplete all itemsan€# s'page LOCATION °' Print L1 PROPERTY OWNER Il�� '��' jJJ,Cinz,", r 7 Print 100 Year Structure yes . no MAP PARCEL: ZONING DISTRICT-/�- " Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family [Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ ❑.Septic; ❑Well . ❑ Floo'dplain ❑Wetlands ❑ Watershed District , O WaterSevver DESCRIPTION OF WORK TO BE PERFORMED: Ze -1�1A jl),-?4 - CC),- r ratification- Please Type or Print.Clearly OWNER: Name: ; �e�� . t ,'1 �,d - Phone: 1 �� !� Address: CC � ' f W Contractor Name: l�U �°' i'�`td�t L s Phone: Email: in,c _v.�, �' S Address: Supervisor's Construction License: C)�� j Exp.. Date: Home Improvement License: Ex p._ ARCHITECT/ENGINEER Phone: ' Address: Reg.Flo_ 1 FEE SCHEDULE.BULDWG PERMIT;$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSE rSSVON...$125.00 PER S.F. Total Project Cost: $ C FEE: $ Check Na.: Receipt Na-, , NOTE: Persons contracting with unregistered contractors do not have:access=io the guaranty fund Siq Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL -: Public Sewer ❑� Tanniug/Massage/Sody Art ❑ 'Auming 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 o U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSER\IATIOM Reviewed on ( /(� Signature , COMMENTS__- �\_C) c o- HEALTH Reviewed on Signature COMMENTS C, Zoning Board or Appeals:Variance, Petition No: Zoning Decision/receiptsubmiited yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/S_"rc�nature &©ate Driveway Permit 10 PW Town Engineer: Signature: Located 384 Osgood Street F(RE ®�PARTM.._alT Temp. Dumpster on site yes - Located at 124 Nain Street Fire,Department signeiture/date COMMENTS { Dlmensuon Number of Stories: Total square feet of floor area, based` terior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, crust or service drop-*-A� giires approval of Electrical Inspector Yes No DANGER.Z®k1'E LITERATURE: lies No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) ® Notified for pickup Call Email - Date Time Contact Name Doc.BOdinb Permit Revised 2014 -` I 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 v Workers Comp Affidavit Y 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 OTE: 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 :z Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) r Engineering Affidavits for Engineered products OTE: 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) T Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit gxa all cases if a variance or special permit was rust thentet Town i recorded office t the Registry of Deeds. one copy and proof of recording that the appeal period is over. The applicant must must be submitted with the building application Doc:Building Permit Revised 2014