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Home My WebLink AboutBuilding Permit # 2/16/2017 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �~ � � _ Date Received___2 Date Issued: i �— IMPORfANT:Applicant must complete all items on this page Pant " PROPERTY OWNER Pnnf " 1 oD Year Ctld Stf acture yes w no MAP NO: PARCEL: Z'UNINO DISTRICT ^ : ,, Historic District yes nc ' Machine S-h©p Village yes no TYPE OF IMPROVEMENT PROPOSED USE _- Residential Non- Residential ❑ New Building ❑ One family Addition ❑Two or more family ❑ Industrial X Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other U Septic H Well ❑ Floodplain ii Wetlands E) Watershed District C7 Water/Sewer DESCRIPTION OF WORK TCDD E PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: L d�61 ` ,1"7",1 Phone: t7ec ' C ,Addre � F CT R Nam Phone: d ;ess. a . Supervisor's Construction License: Exp. Date:. Home Improvement License Exp Gate: 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-, $ � � r.: ��,�� FEE: $ Check No. _ Receipt No. NOT ': Persons contracting with unlegistereccartrrctar ca not have tcces�s�to t/c °u crtntauzc i nature of A �, tlOnrae g g signature of counfiractor Plans Submitted Plan Waived E-] Certified Plot Plan ❑ Stamped Plans .. k tk®RT� 'g own of Andover ver, Klass, O L / zo CO[,feG 1'![wt[K 1' �A re D S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ..... ... ..�.�' lf. ., . ... BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on ....� .... /.1�'1, �, ....;F ..�................. Rough to be occupied as . .. ...4W.", Chimne provided that the person accept' t is permit shall in every respect conform to the terms of the application Fin 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 Forth Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS C ST U ION S RT Rough ervice ., . .. BUILDING INSPECTA Final ` GAS INSPECTOR ®ccupancy_Permit required to Occupy By 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. Smoke Det 0 g Q I NEW ENGLAND FLOOR PIAN ' X7OOC-16 SEALING BOSTON GHOWDA °�1ON#' _02/0512017 138 HAVEN ST. NORTH ANDOVER,MA ��f{•tet•-0• NEW RAVEN, CT (203) 776-1116 n yhe commonwealth of Massachusetts Deparment of g�ust zal Jcc r e ats r et est ,�' IM 100 1 congr a Boston, lVlA 02114-2017 .•Y � 'www rna�s.gavlcli� �`" s"'0. esxsatiox� nsurazic A da tzB dexs/Co actoxsl�+,7eeixXczax3.s1pjWb exs. YVnexs' CompT]'1 ' �7GaT3t1uTormatlon Name,(Buri 7.essIC)'9 IIZa'74I3J�Y1i�1V1E1LI��• C� CA t �Qe91 h a/17 Addr=ess: O Phone city/,,state/Zzp= O �7 hype o rn eet(xe ea) )xayo-a an empTayer?Cheel[tlia appxolaxiateTaax: F 6 o11On • 7. Q N'e�consf� x.�l am aemplcyex p�0yees Gill and!°z part tune}•x �oxrue in 8. 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Y aPphcaattbat che°ksi' i HorneovvneTs lvhe MA,mAtbis-MOOt indicat€ngth°y arc doing all work andfhen bile outside contactors and st s,rrhnc�t CantrscforstbatehecicihisYioxmustattacliedauaddtia�stP� etheirwarkers'aamp.flhapnlicyn�e andsi ewhefherorn°fes°se.erzilt<es OMP.eyees. Ifthe sub-cantractars have nrLtpl�yc , eY eraz to er triads�r ovidi tg7vorkers'compensation�surancefor°my ernpToyees BeZaw ias ttiepolicy arzd a site x arae are p �' irzfa�rnatiox�. tsorace CoxnpanyNae:. pixatiozE7�ate• policy#or SeWhls. CiLyISEa.#elzip: . dab Site Address: e shavvi a g the Volfey)Ilrex an d epi t'at?co� date). �,�tar7z a Gary of e voxkexs3 co i=cy dec�axa oxo fag e re etl updexMGL c_152,§25Ais a oricn Ralvialatian paoislxable by afiv to 00.00 Fail3xre to secC7e covexag ` enalixas lle toxin of a STOP Off'VORT ORDS and a$ne anuli to $7,50.0 a ata dlor one yam xmprzsonme, t,as-well as 0179 P Tie�oxvvarded to the Office n£�vest€gat3.oxq ol:tlte ill&Ibrh s�mnoe day against the violator'.A Copp of t statement may covexage vexifxcatzon. zarade�aXie airs arzdp Zties of•�etjur`y tlzctt the inf arx�xratiorz provided abo-�e s due ar?d car�rect; I do Tier eiiy certify p Si at€3re: official use a�zzy. Do not-wr�it`e in this azea,to b8 co�,zpld d by city op ta�vra official • �erp1j�JLiGe�e# City or Town: su gA�thacity(drele one)- ` actor �.� gne�azt zexrt 3.C:ityl'x'ov3.Clerk 4. Uect�XGalXns� 1.$oaxd OfRe !' 6.Other Phone#: �' Contact pexsaaz.