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HomeMy WebLinkAboutBuilding Permit #399-14 - 12 YOUNG ROAD 10/31/2013 TOWN OF NORTH ANDOVER C} j APPLICATION FOR PLAN EXAMINATION Permit NO: �/ / Date Received Date Issued: /4-f/ 0z.. 3 IMPORTANT: Applicant must complete all items on this page LOCATION. 11 ' P ,nf PROPERTY OWNER 5�/ e q ta ! .� Print 100 Year Old Structure yes no MAP NO:/� "`/ PARCEL: & ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resid tial Non- Residential ❑ New Building 916ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ?'Ftepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑floodplain ❑Wetlands ❑ Watershed District 11 Water/Sewer D SCRIPTION OF ORK TO BE PE FORMED: Iden ification Please T p or Print Clearly) OWNER: Name: trG' �.d„ S;vQ Phone' Address: 7 CONTRACTOR Name:,sk it Ln- lk Phone' Address:-a 2 �`�� Ze Supervisor's Construction License: —6j f 76 Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$ $1000 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. / -� Total Project Cost: $ ` �� FEE: $ �� Check No.: ��'�i'3 Receipt No.: 7 6S-7 NOTE: Persons contracting w;h U..Ireg''ter d contractors do not have access to the guara ty fun r Signature,of Agent/Owner _ Signature.of contracfo Plans Submitted Li Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted-0 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE O'F-SEWERAGEDiSPOS Public Sewer Tannin assa eBod Art ❑ .. Swimming Pools ❑ � g Y 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 HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments A Conservation Decision: :Comments Water & Sewer Connection/Signature& Date Driveway Permit u` DPW Tow;! Engineer: Signature: Located 384 Osgood Street FIRE-DEPARTMENT -Temp Dumpster on yes no Located*at 124,Mair Street " Fire�Departmeif signature/date"y COMMENTS 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 ® Notified for pickup - Date F E Doc.Building Permit Revised 2010 - _ r i Building Department The foE,)wing 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 ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o 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 o 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) 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) o Building pp uildin Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit Li 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 cans if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apoaal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building permit Revised 2012 Location /� YCe-,-v �i No. / Date e - TOWN OF NORTH ANDOVER Certificate of Occupancy $ �t Building/Frame Permit Fee $ 36il-Oa 4 - Foundation Permit Fee $ I k r Other Permit Fee $ TOTAL $ R Check# / U . ` Building Inspector r ttORTH Town of t E : �� ndover M.. - O 0 NN No. 391_ ft _ ILV h •-f h , ver, Mass, COCHICHI WIC.[ y1. g0R'4TEO PPA��S S U BOARD OF HEALTH Food/Kitchen PERM -IT T LD Septic System THIS CERTIFIES THAT � ���..` . ! /.. A.(.. ..!.1................................................................... BUILDING INSPECTOR ��` Foundation has permission to erect .......................... buildings on ........... ......... ...... ............................................. Rough l to be occupied as .: , t `✓ :'.4GfDrJ .f...'1.:..f.G�l ?..yt...� © ... �ciil� F. �:.Y� ���./��t 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI STARTS Rough Service ................ ........ ... ..... ................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 30,000.00 m $ - $ 360.00 Plumbing Fee $ 45.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 45.00 Total fees collected $ 550.00 12 Young Road 399-14 on 11/4/13 Rehab Windows, Kitchen, Roof, Heating System i Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS-053176 ' STEPHEN M SMOtAK ' i 762 DALE ST North Andover NFA 01845 r Expiratior -Commissioner 02/15/201; i I