HomeMy WebLinkAboutBuilding Permit #Exception - 114 BOXFORD STREET 8/4/2008 OORTFf
BUILDING PERMIT o`
TOWN OF NORTH ANDOVER F
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received .S RATED
71CHU4
Date Issued:
_, IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Resid Non- Residential
New B ilding One family
Additio wo or more family Industrial
A eration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
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WORK TO BE PREFORMED:
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Identification Please Type or Print Clearly)
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OWNER: Name: /to6� � Phone:
Address:
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Address. ° ,. .5 u , �*.��.� - � d
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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: $ Ago 6"ev0! afl FEE: $
t No.:
Receipt_ Check No.: P
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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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
PLANNING & DEVELOPMENT DATE REJECTED DATE APPROVED
COMMENTS
' CONSERVATION Reviewed on
Si nature
COMMENTS
HEALTH Reviewed on D
P
Si nature
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
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Planning Board Decision: Comments
Conservation Decision: Commen
Water & Sewer Connection/Si nature& Da
Drivewa Permit
DP
i W Town Engineer: Signature:
:fFIRE;DEP. RI'�1V1E1T Located 384 Os "oo'
od Street
Located t 124 lath Street Temp:Dumps �n tfi' a`n
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Mareepripht ��natr+e'/ ate
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CO.Y.ME
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Yo-
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 ofEIectncal Inspector Yes
No �
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$1oo-$1000 fine
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NOTES and DATA— For department use
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❑ Notified for pickup - Date
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Doc.Building Permit Revised 2008
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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 s
❑ Copy Of Contract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
Compliance Re Applicable)
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❑ Mass check Energy Comp ort If p ( pp ) ,
❑ 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 f
❑ 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
❑ 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
r The applicant must then et this recorded at the Registry of Deeds. One copy and proof of recording
that the appeal period is over. pp g
must be submitted with the building application
Doe:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
1
CERTIFIED PLOT PLAN
LOCATED IN NORTH ANDOVER, MASS.
SCALE:1"=40' DA7E.-8/21/2007
Scott L. Giles R.P.L.S.
Frank. S. Giles R.P.L.S.
50 Deer Meadow Road
North Andover, Mass.
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1.34+/-ACRES
PLAN#5996 N.E�.R.D.
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259.26'
BOXFORD STREET
I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE �p`t�1 OF
THE OFFSETS OF THE BUILDING INSPECTOR ONLY a� c�
SHOWN COMPLY z SC
AND SUCH USE IS FOR THE
W/TH THE ZONING DETERMINATION OF ZONING 972
BYLAWS OF CONFORMITY OR NON-CONFORMITY
NORTH ANDOVER
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WHEN BUILT WHEN CONSTRUCTED.
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