HomeMy WebLinkAboutBuilding Permit #208 - 100 UNION STREET 9/13/2007 uv�a.vu.v ._...... .
TOWN OF NORTH ANDOVER -' p
APPLICATION FOR PLAN EXAMINATION
Permit NO:(71 Date Received �gss,T�o 5<�
ACHU
Date Issued: 3 - G
IMPORTANT Applicant must complete all items on this page
�k,"`r3a k tr s a .#..,
e`�� �`����� � �, . � "�'xi� �^ '6sM� �S� �:� ,� ^x� "{�„ K?� .�,.,, ��a
awa
t..d i `��„ti F ��x �i �r�°� � � .��'z�•*a 1 a���' ��7���� ?` as �`" c a �4`� _' .-" � '��'G � r� - �'�
a
�-
���Fg� �a
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building 0 One family
[I Addition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units: 0 Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other ONy
� _ t"s'"�rfi� 1s3 „
IN,?,"y^'�..,�..,
DESCRIPTION OF WORK TO BE PREFORMED:
U 9�
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address
17
' 77'" 60
x 3 nx1�-vF '' 1�i + ' tl- i� '" "'FS 3"°"a'Aj% •-.,.� .
MR
a"�`'�•rg,
Rg�,.
1 ax5 c a344"u x«.,. two2 ..r
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: $ L TJ FEE: $13
Check No.: a� Receipt No.: 0-O
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
nidi15 OuDMmea a Hans Waived LJ 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
DATE REJECTED DATE APPROVED
CONSERVATION ❑ . ❑
COMMENTS
DATE REJECTEDDATE 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/ Driveway Permit
Located at 384 Osgood Street
' 3 "�'�d '" €';3''' �'".�7,� N"s' „y .::xt az�,�,<..s"...r "4"- ,g;, ✓�,z"' ,s ?x'°
Sc*� ...�" `�€A - t»�„ SPr, � r {� •vy<••.�.; xn '' 4 any:.• " x' `
�T �. amga n
l
Me
*M0 k+ '•yx�r„��•�`�4
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
Doc-Building Permit Revised 2007 ! ___
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
❑ 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
o 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
Location' " p on S 'e—
No. Z Date
�ORTM TOWN OF NORTH ANDOVER
O
3? OL
� n
• ; ; Certificate of Occupancy $
1'�s'••° ;<� Building/Frame Permit Fee $
s�cwus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
2062
Building Inspector
NORTH
Town of Andover
0
No. Z Q - __
0
dover, Mass.,
'^K
0
0
COC NIC HE ICK
'$?A T E
U BOARD OF HEALTH
Food/Kitchen
PER IT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES TH .......... ... .. .......... .. .............. 111111110
... ......... ................................................................... Foundation
twISM
has permission to erect........................................ buildings on/OP.#........../40..AW.........L)40.1.0 ........;0 Rough
to be occupied as.. . ...........3.41d.......r..04.4-00%. .............VWra.*......... . Chimney
... . . .0 gro'.
provided that the p;r Pon aMcepting 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 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
PERMIT EXPIRES IN, 6 MONTHS Final
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIS TS Rough
............................. Service
BUILD TOR
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 __jj Smoke Det.