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Home My WebLink AboutBuilding Permit #602 - 10 ICEHOUSE ROAD 3/28/2006 i 0 VIA ANDOVINATION �oRTM �No 'TOWN OF N PLAN NM ISN 4�•• .°je OL j *�+ATION FOR P Lll AP Date Received: o , 7SSACNVS permit ND ust complete all items°n this page • t C.O�'^MM� PORT ANT; Applicant m r pate Issued- l print S LOCATION Print G DISTRICT OVERTY OWNER L• ZONIN IC DISTRICT YES ❑ PR I U C PACE NISTORResidential AP NO.:- D SE M SE OF BUILD G PROVO Industrial ,VYpE AND U E MENT Residential ily u TYPE OF lN1PROVxOne famfamily more 0, V40 or 0 Commercial Building rlo of units: 'WNewBldg, Others: 0 Addition AsseSsory 0 Alteration lace►nent 0 Repair'rep 0 Other 0 pemolition ❑Moving(relocation) BE Po- Og1v1ED draulic ON OF W ORK T O , F oundation°nl DESCR1PTl Ort clearly)ar in plea$e Type phone 9 Identification SC St ,tu ( � ra Name: Oho OBER' t•'1 ZI Address: �- � J�l,l1 1� t And (,ON rR�'C,r OR dame� 't Address: 7-) 6SS Date: License'Const�°tion D.P.p• A Supervisor' Ji phone: rom the Bray and me Improved of n1ent License: N� Name: P one P H° 00 ER S.F• is. (ENGINEER Reg N° TED COST BASED ON$lt l O a ARCHITECT TOTAL ESTIMA $ 3(01 b • ,�- 5�' 0.00 OF THE p0 PER 100 1 cI L/) I 3'7 X05 address: ER6 M 'X� to gULD1NG PReeelpt No.. FEE SCHEDULE: Z a* a , T-= Project Cost 1 6 o - Cheev No � page 101 A r i i TYpE OF SEWARGE D1SpOS4L _ Public Sewer Well Tanning/Mass agejBOdY Art private(Septic to Tobacco Sales ❑ - NOTE: soias cSwir' nk, etc. 0 Permanent Dumpster on.e:- — ,I / oirtr � acting witk ro�- Signature of�gent/pw Plans Submitted'' ner arttnent `ttOae°btained' Delp erm Bu��dng {Or the aPpr°pr,ate P °rmsfilled°ut ,St°f the regt*ired{ n P ery its W�n9 Is a, Rehabilitat�O fhe InteCjOr Siding, tion R°° in?" Peet Appda� C.S.L.Licenses o gulidjeg vs Comp Afj C And10r o �N oto Copy 0f tenor�N ork o ph Conti Os ed In o COO . an pr PrOp Vloor pl � o CG diti°n OC Uec tion pd p emit Applica er plan And ding 11 rk kl o B ul eyed plOtplAffidavit d C•S L.Licenses o tth Sprin o Dikes Co of�1,C. Ai' 0f proposed W IIEgLTI, o pCtO COQ Contract �1e�ationplan f Applicable) o C°pY ossectionl 'Cable) epos(I COMMENT, o VloorlCr on if AppComp1ianceR Calculate k Energy 410 I�ILaSs cies �e and T`N°Fa Zoning trnctjOn�S0ng � B°aril of A, pia Zoning Decision/recei, w' Cons erYnit Appllcatipll kler Ne 5edplotplan to 1nclUde Sprin Planning Licenses nin� Building d C S L. RetUr'1ed� o Boars/Decision, 1 o Cel-tefledpr°p0 Na��onsery V1 O Be ation Decision: o of�I C mffida fans (p11e Water of `� Sewer o Pl1 orkers Com wilding P f P�pplicable) connect o B 1 e deciskon n s;� ets of tiioils � Temp purnpster on site � two S alis Calcula ce Rep°i�' a most stampehstry °f Ue Yes�� l�Y ilia )f Contract Complian n Clerks officcrded at the R g Building per o Copy heckBnergY reQuired the then get this res ur'4 mit IPproVed anQ o a55 C s eciaf per applicant g no'ca"o, it a varta°a per oil/S tired with the hoild io all cOO ls that the appy°st he S03 roof of record`ng s V)"'MKT v1EN�:1�eFORs105 Doc:INSP�'CI ISN`I.SN.R�,IC.E A�t`I NORTH QE 4f.l°i��tiO o� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SSgCMUStt Permit NO: 602 Date Received: Date Issued: 3 21 -&* IMPORTANT: Applicant must complete all items on this page LOCATION 2 oUSe Print PROPERTY OWNER % Print MAP NO.: lG y PARCEL: 31 ZONING DISTRICT:--A l TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential VNew Building 'One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: I C�C Phone: '?m6r-1-z4 3S, Address: -A 9,W J CON"TRAC"TOR Name: !� Phone:` /�"` Address: Z i'�A C Supervisor's Construction License: Exp. Date: �6 Home Improvement License:_ a,� Exp. Date: ,-ARCHITECT/ENGINEER �,4W` Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$10.00 PER 1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ Z TF55L.h DZY�I xI0.00=FEE:$ 3 614 . ~r 100 r sem. ♦4 I '��. Check No.: �` Receipt No.: c��' 3.7 6S, Page lof4 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 ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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 appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTNIENT:BPEORN105 Pa-e 4 of Building Setback Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided NI- DIMENSION Number of Stories: 1h Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 2 flC NO'T'ES and DATA—(For department use) I �I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:DPFORM05 Crealed JA-IC.JaR'_U06 TYPE OF SEWARGE DISPOSAL i wmmn SiPools Tanning/Massage/Body Art ❑ � El Public Sewer _ Tobacco Sales L1 Food P g/�ales ❑ Well ❑ Permanent Dumpster on Site ❑ -. Private(septic tank,etc. ❑ E l ec rie er� cation to %j t NOTE: Persons contracting with unre listered c ntr ctors do not have access to the guaranty Intl Signature of Agent/Owner Signature of Contractor Plans Submitted tN' ans Waived ❑ Certified Plot Plan ❑ 64tamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Temp Durnpster on site yes-110— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 NORTH A Town of tI _ - '• 4 Andover .:��. .,. G o z .......�. . No. - _= dover, Mass., COCHICHEWICK ADRATED S BOARD OF HEALTH I PERMIT T D Food/Kitchen Septic System I BUILDING INSPECTOR THIS CERTIFIES THAT....Mt4+` V% 4 -COMM 0"'S....�......�..... ............................... Foundation has permission to erect......................... 6 ...... buildings on ..��.... t t. .��ls►'....RO�t ... ! .. Rough i to be occupied as S � C.6t - -& Chimney .................. ... ...Je+� .............................................................................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relatin to the Inspectio Atter tion a d Construction of Buildings In the Town of North Andover.u 018 r t)J-0 Q 1�IM1 �O ��r P' PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST/��rTS - _ _ ELECTRICAL INSPECTOR "j"/' Rough .L�Idr ..........................................::.................................:.........:......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous -Place on the Premises Do Not Remove Final No Lathing or Dry Wall To Be Donee FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. `