HomeMy WebLinkAboutBuilding Permit #Exception - 1060 OSGOOD STREET 5/1/2018 (5) i
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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Date Received
'Date Issued: ' '
IMPORTANT:Applicant must complete all ' ms on this age
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LOCATION -o �A -A-
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PROPERTY OWNER --` I' Unit#
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MAP NO: PARCEL: ZONING DIST'.ICT: Historic District ye no
Machine Shop Village y s no
100 year-old structure ye no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units:
11 Commercial
❑ Repair, replacement ❑Assessory Bldg 0 Others:
❑ Demolition ❑ Other
� SephcCWell ; p)Filoodplan ��WeflWSJ~ Watershed Distract. __
��Water/Sewed '
DESCRIPTION OF WORK TO BE PERFORMED:
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1--'42c C-4f Per_.w,r
(Identification Please Type or Print Clearly)
OWNER: Name: QJLI Phone: '3 3 9 /V
Address: V2.
CONTRACTOR Name:
Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED/COST BASED ON$925.00 PER S.F.
Total Project Cost:
FEE: $ G v
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access t
o the guaranty fund
�ignatureofAgent/®vyner _-- ,--_,�
��.-`Signature,of�contractor.��
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Plans Submitted ❑ 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 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
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HEALTH Reviewed on Sionature
COMMENTS
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Zoning Bohrd 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 DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
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 4
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
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NOTES and DATA— For department use
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❑ Notified for pickup - Date
Doc:.Building Permit Revised 2011 June/mi
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
o Photo Copy of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
o 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
o Building Permit Application
❑ Certified Surveyed Plot Plan
o Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (if Applicable)
o 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)
o Building pp Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
Li Copy of Contract
a 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: Doc.Building Permit Revised 2008mi
Location /060
No. Orr!o Date
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40*TIq TOWN OF NORTH ANDOVER
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i ; ; Certificate of Occupancy $
2 CHUSE<� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $ •
TOTAL $
Check # 1
2 4 9 L 9 Building Inspector
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CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Date: March 12 ,2012
THIS CERTIFIES THAT
Power Yoga Evolution located in
THE BUILDING LOCATED ON 1060 Osgood Street , North Andover, MA 01845
MAY BE OCCUPIED AS a Fitness Studio._IN ACCORDANCE WITH THE PROVISIONS
OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS
AS MAY APPLY.
Certificate Issued to: Rob Iorio
121 Hanscom Avenue
Reading, MA 01845
Building Inspector
Fee: 100.00
Receipt#24929
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