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Home My WebLink AboutBuilding Permit #706 - 119 MILLPOND 5/15/2010 BUILDING PERMIT 01f p°RTH q TOWN OF NORTH ANDOVER 02 �, °�, APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 744pR`TED pP ,fig Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION = l Lit lO w Print PROPERTY OWNER X Print MAP 216 &!!/PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residen ' - I Non Residential New Building One fa Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other - Septic Well Floodplain WetlandsWatershed'District Water/Sewer C DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone.: Address: CONTRACTOR Name: ( ,, Phone:a G.L--y ,s^vL3 Address: `Z,t *� r� I Supervisor's Construction License; Exp. Date: Home Improvement License. Exp. 'Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �, Lf,0-0 "4 FEE: $ a '7 dl-V— Check No.: Receipt No.: p r� NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund gnature of TAgent/Owner ! Signature of contractor if 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 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 ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ 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) ❑ 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 . ❑ 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 L] 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:.Building Permit Revised 2008 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 r .1, 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 Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT Temp Dumpster on site yes ono 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 MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use I i f ❑ Notified for pickup - Date ................................................................................................................................................................................_........_._..............._............_.........................................................._.............................................................._.........._..................................__........_.........................................._._.._........................_....... Doc.Building Permit Revised 2010 Location No. —)U4 rip Date �� D NORTq TOWN OF NORTH ANDOVER � A t i # Certificate of Occupancy $ CMUsE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 23152 Building Inspector DEPARTMEN OF PUB Refrigeration LC Contractor License Number: RC FETy ' 004055 Expires; 04/01/2012 RestrtTr:no: 2585.0 cted: `ROYAL AIR SYSTEMS INC ARTHUR A PICKET'..jR; 48 CHESTNUT ST N READING, MA 01'864 CommissP o f �: e10RT#q Town of : 4 over No. A E dover, Mass., COCKICMEWICK �d ADRATE D C'P�\ Cl `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........... ..... ..................... Foundation has permission to erect........................................ buildings on...//.5.........A141.....!4.(. ........................................ Rough to be occupied as.................. ......... .. o!0 ✓ .............. Chimney provided that the person accepting this permit shall in ery respect conform to the terms of the application on file in Final 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU STARTS Rough ..... .............................................................. Service . .... . ............................ BUILDING INSPECTOR Final - Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display 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 FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det.