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Home My WebLink AboutBuilding Permit #471-14 - 100 LISA LANE 12/2/2013 r TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received r r Date Issued: /- IMPORTANT: Applicant must complete all items on this page T _. Pain T .see,. s .�e, PROPERTY OWNER o I , - - P. t 100 Year'old structUfe,t es no MAP NO: PARCEL:_ - ZONING DISTRICT; Histone District yes o �� - _ '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: "emolition ❑ Other Septic.- q'Well ❑'Floodplain. Wetlands 1Naters.hed'Distnct D Water/Sewer., . �_ • DESCRIPTION OF WORK TdYl ERfORMED: 2 a e � `J ♦ e %fi!.s£ i�"-,Ps, ► }�L.. { ` 4+C''.. 's•� "• +t z� r �/""S I 'a .+�:"-a'r r_.^'+. 'Y Identification Please T pe or Print learlx) y �' OWNER: Name: 4:; n, —usz' :e2 'hbne 4 3 Address: 0�-1 nd CONTRACTOR Name: _ Phone: q7$ • a 3' 7 Address: C_XA_jA � -ear'. fYl 01.1.ij - Supervisor's Construction License �__ (�(()q Exp: Date:_. T 100)�Home Improvement License ._m- Exp. Date: L9 -� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: AT � FEE: $ Check No.: Receipt No.: �`Z NOTE: Persons contracting with unregistered contractors do not have access to the �Signatureof Agent/Qwner, Slgature of contCacto , :� i Plans Submitted Li Plans Waived ❑ Certified Plot Plan ❑ Sam ed Plans ❑ 1 Building Department I The foEpwing is'a list of the required.forms to be filled out-for the appropriate.permit to be obtained. Roofiv,g, 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 a 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 cases 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 bp subm:tted with the building application Doc: Doc.Buiiding Permit Revised 2012 . Plans Submitted ❑ Plans Waived [] -Certified Plot Plan ❑ Stamped Plans ❑ .•TYPE_OF-SEWERAGEDIS�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.APPROVED PLANNING & DEVELOPMENT - ❑ ] a �j COMMENTS I -CONSERVATION Reviewed o n Si nature COMMENTS W g u,r,." U set V-& HEALTH" ' - Reviewed on Signature COMMENTS a 6 • . r E H ♦ 'T, Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision' Comments ? Conservation Decision: Comments Water & Sewer Connection/Si nature& Date Drivewa Permit �- I DPW Towz Engineer: Signature: Located 384 Osgood Street -'FIRE$EPARTM eiilT -Temp Dumpster on site yes no Located'at.124 Mair Street 'Fire-D6 merjt sigriatureldate C0MMENT8 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 ® Notified for pickup - Date € I Doc.Building Permit Revised 2010 r Locatio3oo C YlTr � )—I— No. '� Date v • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ � _. Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee $_ ` TOTAL $ Check# 27146 Building Inspector NORTH own of p to No. 41 - h ver, Mass, COC MICNlWKrt A04ATEO S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ..................S.C# �/ 11 ......�Zt 4w�.1!... ,,, BUILDING INSPECTOR .......................... buildings O ® dation has permission to erect g ��........ .......................�.. Rough 4.2� s7 to be occupied as ........ ........... Z.�. .... ........ .. .....................�n.. .. ..tow Chimney provided that the person accepting this permit shall in respect conform to the terms of the app id Ion Final 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 North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6. MONT S ELECTRICAL INSPECTOR GOP UNLESS CONSTRU S TS Rough Service ........ .......... .... .................. ......................:......... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. SEE REVERSE SIDE Massachusetts -Department of Pubiic.Safety Board-of Building Regµ(atio.ns ah0.�#=dards Construction Supervisor License: CS-0F9055 SEAN SZEKEL� PO BOX 27 ANDOVER MA 01810 Expiration ' Commissioner 08/26/201.4 Town of North Andover NORTH q Building Department °�•c'�`E° F6F do 1600 Osgood Street �? y.r' _ s o� o -' �► North Andover MA 01845 t Tel: 978-688-9545 Fax: 978-688-9542 ro LAKf DEMOLITION OF BUILDING AFFIDAVIT 5 R�r�o ►.p�`�.e(`�. SgCHUS�' DATE �O �� OWNER'S NAME & ADDRESS C J LOCATION OF PROPERTY TO DEMOLISH DESCRIPTION 1 �� OU es 1 rn�cL e CONTRACTOR'S NAME &ADDRESSC0nt4ruc.7hbn ,L4---)c �c )9l DEPARTMENT SIGN-OFFS 1 DEPT. OF PUBLIC WORKS -WATER:_- ��/ 1 1 ` SEWER: DEPT OF CONSERVATION HEALTH DEPT: Septic Well HISTORIC COMMISSION _ l�l d a�Q fYylil 0 sTog►c co v�rv-k s s 0 0 GAS &0 (j �-- ELECTRIC -rtes v►� 1��G� +� (�o a--P� _ TELEPHONE �- CABLE TAXES POLICE FIRE r41 EXTERMINATOR 1" v DUMPSTER-ON/OFF STREET DIG SAFE NUMBER DATE REC'D BLDG, INSPECTOR Doc.form demolition of building affidavit