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Home My WebLink AboutBuilding Permit #Exception - 100 SUTTON HILL ROAD 5/1/2018 (3) r. BUILDING PEWIT! TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date Issued: IM PORTANT:Applicant must complete all items on this page LOCATION w svcvroh H-0 qd A) r 01 eqs— Pint PROPERTY OWNER CO3,rr1f_ Bid, Twthv Fo5ic,k Print 100 Y Structure yes no MAP PARCEL: 13 ZONING DISTRICT: 3 Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building A One family KAddition 0 Two or more family El Industrial X Alteration No. of units: 0 Commercial 0 Repair, replacement El Assessory Bldg 0 Others: Demolition El Other C7 Septic ❑17Vel�tr. t� Floodplain: G Wetlands _mr bet DESCRIPTION OF WORK TO BE PERFORMED: 6 0( In -ev- iqav-"-C Wdk V&� i r te. -e ckl ld,!V r- eK fre I_�e &YKI lu s u t a Identification- Please e Ty or Print dearly OWNER: Name: Ca- r_-r_ 4f_)vn4L,4, Svs)c' k Phone-. 307-11qy Address: 100 5V_1 F0q 8111 A) ,, Ankyev- IM 4 19yy Contractor Name:"ill, *t s ry a n 5 W Phone: Email: l2•ti 8 6 &-+- A-6t- C n Address: 9 L/ e) 41 Supervisor's Construction License: C,�-071716?8 Exp. Date: -a E- /7 L_Home improvement License: •7 71 a Exp. Date: c2-,9L I,-/- ARCH ITECT/ENGI N EERLIJ leAAt I 'Elarle,4 I* - Phone: 3q7- �69 - q M4 L Address: qo �affl I ?k 1 Reg. No. 3 2-ff 3 2 FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 130 1 0 0 0 FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Si afitirPszf n e Plans Submitted Q 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 Durapster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF R U FORM PLANKING & DEVELOPMENT Reviewed On�j) &)� Signature_ COMMENTS ?eC Wff C 20 WOOL 0U - Pon, Zw-w-. ("Ce4ca sl)- lin P� CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Si-nature . 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 Driveway Permit DPW Town.Engineer: Signature: Located 384 Osgood Street FIRE DEPARTtIfI NT - Temp.Dur�o;sfer on site yes no. .. .: Locefedat 124 Mani Street Fire Depaftmerit signatureldate COMMENTS NORTH BUILDING PERMIT ED 16 TOWN OF NORTH ANDOVER F APPLICATION FOR PLAN EXAMINATION y T 1�� H yyT �' OR n y1e T Permit No#: Date Received �qs R^TEG SACHus Date Issued: IMPORTANT: Applicant must complete all items on this page i LOCATION Print PROPERTY OWNER Print 100 Year Structure yes. no MAP _ PARCEL: ZONING DISTRICT: Historic District yes no 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 ❑ Other � 0 Septic El Well El Floodplain El Wetlands ❑ Watershed District O Water/Sewer - DESCRIPTION OF WORK TO BE PERFORMED: I Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name- _ Phone:Email:,_ - Address: Supervisor's Construction License: _ Exp. Date: Home Improvement License: _Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund signature of Agent/Owner Signature of contractor ~�� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL iPublic Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ + Well ❑ Tobacco Sales ❑ I Food Packaging/Sales ❑ Private(septic tank,etc. ❑ ' Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on ID �( ' Si nature i COMMENTS HEALTH Reviewed on Si nature COMMENTS i Zoning Board of Appeals: Variance, Petition 1\10�0 J (S"0U Zoning Decision/receipt submitted yes C. Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPART�MENT - Temp.Dumpster on site, yes,-. Locate_tl at 124!'Mairr S,freet - s Fire Department signature/date COMMENTS.:, ___ Dimension I 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 Call Email I Date Time Contact Name Doe.Building Permit Revised 2014 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 D Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o 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 o Building Permit Application u Certified Surveyed Plot Plan o Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L. Licenses u Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) u Mass check Energy Compliance Report (If Applicable) Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New ConstructionSin le and Two Family) � 9 u Building Permit Application o Certified Proposed Plot Plan a Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o 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 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 2014 Location IDD �AN L—U - No. 0 U Ur Date l . - TOWN OF NORTH ANDd;/ER w Certificate of Occupancy $ Building/Frame Permit Fee $: " Foundation Permit Fee $ Other Permit Fee $ t TOTAL $ Check# _ 26 801 Building Inspector