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Home My WebLink AboutBuilding Permit #240-13 - 101 ELMCREST ROAD 9/17/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO for 13 Date Received Date Issued: �f F PORTANT: Applicant must complete all items on this page LOCATION... _ Print PROPERTY OWNER �� Lw< Print 100 Year Old Structure yesn1noMAP NO:67Q PARCEL: ZONING DISTRICT: - Historic District yeMachine Shop Village ye TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family 11 Addition 11 Two or more family 11 Industrial 11;170eration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 11 Other 'Septic ❑Well 0 Floodplain ❑Wetlands 0 Watershed District El Water/Sewer _ �+ DESCRIPTION OF WORKJO BE PERFRMED: a)ti ion Please Type or Print Clearly) OWNER: Name: � Phone: qn-&k3 I `(?c) Address: _ CONTRACTOR- Name: _ Phone: Address: Supervisor's Construction License: ._ C S 77.3'r- Exp: Date: 8 t� 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: $ €EE: $ y Check No.: Z� Receipt No.: 0 . NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own —:::R::::::: Sig afure.,of-contracfo -- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location A3 No. Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ ' Other Permit Fee $ TOTAL $ Check# l� 26859 I Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ g TYPE_OR 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 CONSERVATION Reviewed on Signature COMMENTS 4 HEALTH Reviewed on Signature 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 Tow;: Engineer: Signature: Located 384 Osgood Street FIRE-DEPARTME Temp Dumpster on site yes no Located-at 124 Mair Street Fire Departmei f-signature/date•' C011 MMENTS e -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 ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The foil'swing is-a-list of the requited forms to be filled out for the appropriate.permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application Li 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 u 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 Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract L3 Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) L3 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) u Building Permit Application o Certified Proposed Plot Plan L3 Photo of H.I.C. And C.S.L. Licenses Li Workers Comp Affidavit L3 Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) L3 Copy of Contract L3 Mass check Energy Compliance Report L3 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 apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Bui?ding Permit Revised 2012 NORTH own of ndover O ;A - to No. L�p-1 IANC h , ver, Mass, Q �� COC "I WIC WICK y1. p�RA7ED S u BOARD OF HEALTH Food/Kitchen PERMIT L D Septic System THIS CERTIFIES THAT ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, BUILDING INSPECTOR ............S.44.0 ......... ... ..I. . Foundation has permission to erect .......................... buildings on .. .0. ........ .�. .. .. '�!�� ............... Rough to be occupied as ..... r.0I%!-VT.......�r. .......: ....... .1� ......p!!!�!�!!!!�........... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final 3b PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO ART Rough Service ................... ........................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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