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Home My WebLink AboutBuilding Permit #503-14 - 1 FERNVIEW AVENUE 12/16/2013 TOWN OF NORTH ANDOVER 4APPLICATION FOR PLAN EXAMINATION Permit NO:�b l Date Received Date Issued: k&14�3 IMPORTANT:Applicant must complete all items on this page LOCATION- - L— P.nnt. PROPERTY OWNER - -m � -,ryg �. - - -s �. .�� Print 100 Year-Old Sti`u.cture yes ro MAP NO: _ _ PARCEL:__ . ZONING b$TRLCI" 'Historie District yes no - .r_ 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 �,Qther 114 e ❑ Septic ❑Well Q. FW loodplain! ❑ etlands ❑ Watershed District 0 Water/Sewer - DESCRIPTION OF WORK TO BE RFORMED: i Identification Please T pe or Print Clearly) OWNER: Name: / �' Phone: Address: do CONTRACTOR $' Address: r. Supervisor's Construction License: t'` ,�? _ - Z_r Exp Date:_G Home Improvement License: _ __ _ jEzp Dater _.__ - _ 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: $ � V_FEE: $ Check No.: � Receipt No.: NOTE: Persons Persons contracting with unregistered contractors do not have access to the guaranty fund Srg:natuce?of Agent/Owner: _ Siatureaof cont o Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE--OF°:SEWERAGEDISP:OSAL 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:APPR-OVED PLANNING & DEVELOPMENT - ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS b 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 Tow;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTM�_NT -Temp Dumpster on site _yes no Located at 124-Man Street Fire"Departmeit signatureldate ;. ,;h ,� COMMENTS j . ..., Plans Submitted ❑ PlansWaived-El Certified Plot Plan ❑ Stamped Plans ❑ TYEE-OF°:SEWERAGEDiSPDSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc.. -❑ - . _ .Permanent Diimpster on Site ❑ THE FOLLOWING SECTIONS FOR-OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM -DATE REJECTED: DATE:APPROVED PLANNING & DEVELOPMENT' ❑ _ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS r 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 DEPARTMl , NT' -Temp Dumpster onsite .yes no Located at - + .124 Mair Street - ``` . , Fire*Departme►tt sigriatu"re/date' COMMENTS j . ` 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 M DANGER ZONE LITERATURE: Yes No MGL-Chapter-166 Section 21A-F and G min.$100-$1000 fine NOTES and DATA— For department use El Notified for pickup - Date 3 F Doc.Building Permit Revised 2010 DinienSion.. Number of Stories: Total square feet of floor area, based on Exterior dimensions. I _ .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 L1 Notified for pickup - Date Doc.Building Permit Revised 2010 I Building Department The folrowing is--'a-list of the.required forms to be filled out for the appropriate-permit to.be obtained. Roofirg, Siding, Interior Rehabilitation Permits oBuilding 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 o 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 cans if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apn,,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Bui!ding Permit Revised 2012 Building Department The folrowing is'=a]ist of the required-forms to be filled out for the appropriate-permit to'be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses Li Copy of Contract a Floor Plan Or Proposed Interior Work Li 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 o Certified Surveyed Plot Plan o Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses a 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) o 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 o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report o 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 apw al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doa.Building Permit Revised 2012