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Home My WebLink AboutBuilding Permit #806 - 100 ANDOVER BY-PASS 5/1/2018 q BUILDING PERMIT OR NORTH TOWN OF NORTH ANDOVER ? APPLICATION FOR PLAN EXAMINATION Permit NO:—e0'6 0'6 Date Received Tt0 �gSSACHU`'�.( Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION L 6 Q Print , PROPERTY OWNER cr,,, I---� _,., ► j, ,�„ Print MAP 21 D PARCEL:ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family 'on Two or more family Industrial Alteration No. of units: Commercial acement Assessory Bldg Others: emolition OtherLonk g, Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: e . Identification Please or Print Clearly) OWNER: Name: \/V r �,��.� �-j�` LA C Phone: ( -19 - (0%-1 5-t Address: i I CONTRACTOR Name: "e _-111 L► C i.� 1, --Phone: 17 �, - ►'�'"� - 5 bt . i l3 C A,,d1 m c 't Address: Supervisor's Construction License: 19 0 `�S Exp. Date: i 6z O 16 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Reel- -S'. �/�� _ Phone:___{c�3 Address: Nom: -.�.� _ p.1 , 630`4 - 2114- Reg. No. 9 o $s FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $�:► cop FEE: $a Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agpnt/Owner Signature of contractor QD �F� 4 J Location S No 06 Date c /, i NORT1y TOWN OF NORTH ANDOVER 3 O F s % Certificate of Occupancy $ �,SACMUSEt� Building/Frame Permit Fee $ 126 4� { Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # M 232 :.}� /Muil ing Inspector i 4 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans ; TYPE OF SEWERAGE DISPOSAL i 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 I COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments I 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 Maim Street Fire Department signatureldate COMMENTS 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 Ik I i i I' ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 f 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 o 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 i Addition Or Decks _Ll 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 1 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 i i � "'i R TI-r T 0 , ; 0 0� Andover No. mo o " �` dover, Mass., � iIII6 COC MIC ME wICK 7�SS ATED BOARD OF HEALTH Food/Kitchen .PERMIT T ILD Septic System �j�, BUILDING INSPECTOR T �!s^ ""' Foundation THIS CERTIFIES THAT.................. .........!` ....� .,.... ................. . ..................................................................�..+........yy , has permission to erect.........:.............................. buildings on...ZOd V1041'r.1��I '0 V-r'S................ ......... Rough r/+t � �r'r3a. „67 f � Chimney to be occupied as.........................................................................�....�....................... ........�/....N..��.ffC?�..�'............. provided that the person accepting this permit shall in evert respect conform to the terms of the application 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 UNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR Rough � � 7 ... Service ....................... .. .. ........ . .................: BUILDING INSPECTOR 11�� Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or D'sVwall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ORTFI Town of Andover No. ��6 �o _ o " '� dower, Mass.,LAKE A- COCNICHEWICN y1. SATED 0'P�',`�5 BOARD OF HEALTH PERMIT T ILD Food/Kitchen Septic System THIS CERTIFIES THAT.......... � .. BUILDING INSPECTOR ...:� �... ........................................................................ Foundation ,4 L� has permission to erect.........:.............................. buildings on...Z �. p� '�' .. 7........ ............. ......... Rough to he occupied as...................../.. /y2c.d=....��. ...... . �� O� Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 CONSTRUCTION TARTS Rough ........................ ..:� �--�........................................... semce BUILDING INSPECTOR Final Occupancy Permit Required to Ocatpy 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. Burnei Street No. SEE REVERSE SIDE Smoke Det. a;...... OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: PJ V 1 , A,--A > > �,•, PROJECT LOCATION: 10 vre 'CA O NAME OF BUILDING: ,'t'— NATURE t'—NATURE OF PROJECT: 1= ��- --�,n f; (3;-A IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, 1, off--1— zs" isln4.,,rl— REGISTRATION NO. 9 O% BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS'CONCERNING: ENTIRE PROJECT 0 ARCHITECTURAL I STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. SUBSCRIBED AND SW O SIGNATURE � � HELEN E.STENHOUSE �6 Notary Public NOTARY PUB C \ r ommonwggyppt �grpy4gtts„ N EXPIRE o�� My Commies