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HomeMy WebLinkAboutBuilding Permit #772 - 100 ANDOVER BY-PASS 6/1/2010 BUILDING PERMIT 01* "°oT06 H ati TOWN OF NORTH ANDOVER } L W- APPLICATION FOR PLAN EXAMINATION 4L Permit Permit NO: Date ReceivedAraD * �SSACHUSS� Date Issued: (D 10 IMPORTANT:Applicant must complete all items on this page LOCATION I O . 'F3 Print PROPERTY OWNER Print MAP 210 PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family difon Two or more family Industrial Alteration No. of units: Commercial air, replacement Assessory Bldg Others: Demolition Other _ Septic Well Floodplain Wetlands Watershed Districr- Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: o� �1 Iae tiflcation P ease Type or Print Clearly) OWNER: Name: Phone: l_��9 Address: CONTRACTOR Name: LIW) Phone: Address: Supervisor's Construction License: AIZ ::=[Q3%S Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER 20 -1— �', �/�b�� Phone: Address: 1�.�sti-.�-.�. �1,� 030(,4 -al 14- Reg. No. <:71 b$� FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. I I Total Project Cost: $ r�� FEE: Check No.: -7C1 7 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund ;,Signature of Agent/Own _ Signature of contract ~ Location ,,� %1 12�cs No. 2—- Date G v NORTp TOWN OF NORTH ANDOVER 10-?0•,,`w I•,hO09 ` Certificate of Occupancy $ �ss�cMusE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check 2324, Building Inspector 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 COMMENTS r CONSERVATION Reviewed on Signature r+ COMMENTS HEALTH Reviewed on Signature COMMENTS i i 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 I 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 i I i I i ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 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 ❑ Workers Comp Affidavit ❑ 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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks i ❑ 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) i ❑ 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 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:Building Permit Revised 2008 NORTH Town of No. z -o dover, Mass o LAKE ., COCHICHE WICK y1. BORATE D P'P�t�� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System / BUILDING INSPECTOR THIS CERTIFIES THAT......... � !1'G�/' ..../\ G /y1�/ SGl/tI.................................................................................. Foundation D o ������� Gss SSa has permission to erect........................................ buildings on .. .............. . ..../ .............................y��........................ Rough �r"� C 1� („J S���f6 2 v / Chimney �D to be occupied as...................... ,®vl.5mll/*.(?�'..��..............,.......... ... .............. ....... . .. . . . . .. . . . y provided that the person ac pting this permit shall in every respect conform to this terms of the application on file in Final 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 North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TARTS Rough ......... ... Service BUIL SPECTOR 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 Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.