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Home My WebLink AboutBuilding Permit #504-13 - 11 EMPIRE DRIVE 1/8/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: S-b n Date Received Date Issued: 1 3 IMPORTANT:Applicant must complete all items on this page LOCATION #G I �w I� �I U� 3� ,,00ma�''JJ Prin C PROPERTY OWNER / ��i7 1 [ � Print 100 Year'Old Structure yes MAP NO:/ ,- PARCEL / ZONING DISTRICT Historic District yes _ �-GnoiI Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE - Residential Non- Residential ew Building," - ne family 0 Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 0 Repair, replacement ❑Assessory Bldg 0 Others: ❑ Demolition 0 Other 0 Septic 0 Well ❑ Floodplain ❑Wetlands. ❑ Watershed District Aater/Sewer DESCRIPTION OF WORK TO BE PERFORMED: �4� s u `v«t PAL, Com.AAe A t 166� (DA)Lq Iden�p"fication Please Type or Print Clearly) ) OWNER: Name/�rctF14, P l LL ,.0 &Z-c— Phone:2W—??/-3>/F6 Address: -? >4yJ d S e, v EG4tii? ol CONTRACTOR Name-0 06* ME�!g5/Nt1" Phone:!; 2F—PF/ `-?/ l�6 Address:��-7 W A 4 /f 11�7�p/6 �ec7` C,/�l��ly T� �A ,O 1 �� Supervisor's Construction License: cSr�`&Zjf/ Exp. Date: Home Improvement License: Z Exp. Date: ARCHITECT/ENGINEER ��9r1^ 6� 6A Phone: 2Z9- 352— Fel Address:)9BE M410 � �v�1jXjf 6W AJ1� h DIJ33Reg. No. a z FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ `��d�►� - FEE: $ 00 Check No.: 3 S Receipt No.: C4 NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund , , kyFw�1- Signature of Agent/Owno j YkS�� Signature of contractor Plans.Submitted k' Plans Waived 0 Certified Plot Plan Stamped Plans Lam" Location E� ��L Lai- No. JV I l 1 Date • • TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ 1 Foundation Permit Fee $ IN -- °�'n,�k� Other Permit Fee $ TOTAL $ Check# 26074 Building Inspector Plans Submitted Lfd Plans Waived ❑ Certified Plot Plan d Stamped Plans L�1 TYPE OF SEWERAGE DISPOSAL r ❑ Swimming Public Sewer Tanning/Massage/Body Art g Pools C : D <- 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 Si nature U A COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes e Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT' = Tem Dum ste' n site f p p yes no Located at'1k,Main'Street Fire Department�signature/date COMMENTS L i t Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector lies No DANCER 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 Doe.Building Permit Revised 2010 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract a 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 L3 Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses a Copy Of Contract a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) Q Building Permit Application Li Certified Proposed Plot Plan o 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) 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: Doc.Building Permit Revised 2012 . Ir 1 NORTH . . w: .. . . . . ver' p No. loop y C h ver, Mass, COC HICKEWIc■ S u BOARD OF HEALTH Food/Kitchen .PERMIT T LD Septic System THIS CERTIFIES THAT Q Y_r/' 4 `c �� BUILDING INSPECTOR .I'(. G �. 1:....1 30. Foundation has permission to erect.......................... buildings on ... } ` .-. ...... .. 1^' 1r ...... ...... Rough to be occupied as ................N O .., 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final (00 — PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S T 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