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Home My WebLink AboutBuilding Permit #636 - 111 MARIAN DRIVE 4/10/2006 MOWTF 3? .O TOWN OF NORTH ANDOVER `•�; . ,��• APPLICATION FOR PLAN EXAMINATION 9SSACHUSE4 Pcrmit NO: !�� Date Received: /D-6 Date Issued: IMPORTANT: Applicant nlust complete all ltenls on this page LOCATION__,/_ G ►-,/�Y) 1 ) A " i �� PROPERTY OWNER � n�� Print MAP NO.: /y 7CPARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential =i New Building One family ❑ Addition Two or more family Industrial Alteration No. of units: i� Repair, replacement G Assessory Bldg F! Commercial _! Demolition !7 Moving(relocation) ❑Other G Others: _? Foundation onlv DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: Phone:L?3k 7- 7�'5'jf Signature / Address: //) �Jc�t-la 1� ' ��Y�11�, �/,-- CONTRACTOR Name: )� Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: r' ARCI-IITECT/F,NGINFF'R Name: Phone: Address: Rel;. No. FEE SCHEDULE:BULDUG PERMIT:410.00 PER 51000.00 OF THE TOTAL EST1;11ATED COST BASED ON 5125.00 PER S.F. Total Project Cost :$ .�,�:' :any CJ --"' xI0.00-FEE:S Check No.: lReceipt No.: 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 ❑ Debris Removal Form ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract Li Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Pen-nit Application ❑ Fonn U ❑ Surveyed Plot Plan ❑ Debris Removal Form ❑ 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) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Form U ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report 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 cope and proof of recording must be submitted with the building application Dor:INSPE("I'IONA1,SERVICES DEPARTME\T:BPEORM05 TYPE. ypE OF SE u,,q RC Public,Sewer• E DISPOSAL wellTanning>;, Private(septic tank TobaccoNlassage,RodY Art etc. Sales Permanrmi►r,pools NOTr: nent Du►n pc'r' �>'.� c ori / pster on Site Food odks pac �Slg>tlattU'e I/�•N,/1/� \ �`1)]��Sales O f A iii�rc•,. - grellt/ •Subtllittea �w1 er Plans c , Plans waived Signature i , 1� gnat e o, Ur ►• �� THE Cert'fie Contractor INTFRDEP'NC SECTI a Plot Pl a'1 CI PLANNING A'R SEN ONs FOR OFFICE p Stam &DEVELOP _ _ D AL.SIGN OFF�CEF,sE oN`Y Ped puns ENT 0 ATE RE.ECTED °RM �yva DATE.APpR0 ter 0 - VED CpMMENTs �Site p Shea Special perm. lan S ,t - Pecia/permit ether CpNSERVATION COMMENTS D4T E RETECTE � D DAT E APp ov, D HEALTH COMMENTS DATE REJE�,TED Zoning 13oard DATE APPROVE f ofq D Zoning pE. ppcals: L'ariance, P cision,l.ec etition � pl�rlrnin„ crptsubnritted ,• Nu• 13o s and pccision: Yes conservation Decision. -� eater. ` `�Conllnem, `� Sewer connection si�> Tem drat _�COjrrments p Dunrpster. ure`�date °rr site .Yes`no BUildill , Fr►'e Departrrrent signat g Permit Appl•ove ure,d,'rte a a/la'ss"ea by: �lQy \n all cases if he�appeat 1pmittea eals that t be sub r` APP di g R► `o►a��o5 „� n;r.Sp of recon V)OG Jsrvx�� i DpV ER PTM r,� p�NpRTH E A��IIN,�TIDN �o,a lO ° R•ecti•cd : .. PIC pati - _,mete all itc�»- Buildil1 , Re c uir`�roll Yard Setback (ft.) Pro vided 'Re 9uired�dc Yard i Dj��ENs�O Provides nbcr of Sto) R` Rear y .d tcs. � ai 9uired Total land area- s9� ft.: Total. P1'ot/ided Nr)'t�r;.S'and ' s9uare tact of Moor arca du . based `)rtn)cptF,a tc)-)or use) d in)ct)s. tops, M� Ph°nc' ti Date: :;P- Datc Jne•. o. AL EST111A J• D � COST BASE TED ; 0 /_. �11 99 � , ei tN°•� Ric P i i , I TYPE OF SEWARGE DISPOSAL - S��imming Pools Tanning/Massage,Body Art __ ` Public Sewer -- - f Tobacco Sales Food Packaging`Sales Well Permanent Dumpster on Site Private(septic tank,etc. NOTE: Persons c•ontrading with unregistered contractors tit)not have access to the guaranth fund Signature 0f A ent/Owner Signature of Contractor i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT F1 ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ i COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: f' Zoning Decision:'reccipt submitted yes + Planning Board Decision: Comments Conservation Decision: Comments. _ Water& Sewer connection signature& date _ Temp Dumpster on site yes_no__ Fire Department signature!date Building Permit Approved and Issued by: Building Setback (ft.) Front Yard Side Yard Rear Yard Req uircd Provided Requircd=Provides Required Provided i DIMENSION Number of Stories: Total .square feet of floor area. based on Exterior dimensions. Total land area, sq. ft.: NOTES and DA'T'A—(For department use) 1 I 7111e 1N.111.C'I'Ili\.\I.51.itVll'I S lii l'\Ia I,I i,I 1111FPUIZ1115 ----- --- Crariai J\I( Jan._4un Location No. Date HORT1y TOWN OF NORTH ANDOVER 0 9 Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s�cMusE 9 Foundation Permit Fee $ . Other Permit Fee $ .s TOTAL $ �' Check # /� Building Inspects/ ` NORTH '9 Town of 63 (0 = IN .== o �` dover, Mass., COCHIC EWICK �d C ADRATED pP�\ � 1`S BOARD OF HEALTH PER IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............................ ... ................................................................................ �......................... ...... ... Foundation has permission to erect........................................ buildings on ON ................. ....///..... . ...... ............................ ........... .... Rough to be occupied Chimney ........... ........ ............................................................................................................... provided that the person acce ing this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisi ns 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 CONSTRUCTIO ST T Rough ............................................................................ ... . ........ ......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR DRoughisplay in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det.