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HomeMy WebLinkAboutBuilding Permit #307 - 121 HERRICK ROAD 10/18/2009 TOWN OF NORTH ANDOVER NORT1i APPLICATION FOR PLAN EXAMINATION o�,.�•� . �� . o Permit NO:� Date Received �► i,. Date Issued: �d ' �sD Ss�cNus IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER Print MAPNO.: -d-6' PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne family ❑ Addition ❑ Two or more family ❑ Industrial Alteration , No. of units: Repair, replacement ❑ Assessory Bldg ❑ Commercial Demolition— Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WO TO WE PREFORMED Identification Please Type or Print Clearly) ! OWNER: Name: 191-M /�9li a Phone: Address: CONTRACTOR Name: Phone: e. Address: Supervisor's Construction License: C)5�0 ` Exp. Date: P i Home Improvement License: Exp. Date: E ARCHITECT/ENGINEER Name: Phone: .Address: Reg. No. FEE SCHEDULE.BULDING PERMIT. 512,00 PER 51000.00 OF THE TOT.aL ESTIMATED COST BASED ON,5125.00 PER S.F. Total Project Cost :$ l© FEES Check No.: �s�3 Receipt No.: �9�y� TYPE OF SEWERAGE DISPOSAL Swimming Pools G TanningiMassage/Body Art ❑ Public Sewer i! Tobacco Sales Well Food Packaging/Sales 01 Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to Project NOTE: Persons contra ' t u gMered co ctor do not have access to th 44ay nd Signature of Agen -n Signature of c Plans Submitted Plans Waived [E] Certified Plot Plan Stamped P ns ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ i COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS A I 1 FIRE'DEPARTMENT - Temp Dumpster on site yes no ' Fire Department signature/date { COMMENTS I + 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 1 Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Cr,!a ed AIC x.„2006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) New Construction (Single and Two Family) ❑ Building Permit Application j ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o 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. 1 One copy and proof of recording must be submitted with the building application Doc:INSPECTIQ.NAI.SERVICES DEPARTMEN'r:BPFORN105 1 i { 4 1 Paige 4 of 4 Location No. 36 —9— Date NORTq TOWN OF NORTH ANDOVER F w A Certificate of Occupancy $ CMUs<� Building/Frame Permit Fee $ t5� y J� i Foundation Permit Fee $,r Other Permit Fee $ TOTAL $ Check # 19702 Building Inspector ,tAORTpl Town. of itAndover 0 No. .3 A dover, Mass., A L COCHICHE.C. PS` ATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT............410W. .144.1 ........ ..... . ................ ....................................t ' Foundation has permission to erect........ buildings on 41..... ... .... . e, . .. ...... ... Rough .0 to be occupied as. 197..... Chimney .................. conform to the terms of the application on file in provided that the person acce ng permit shall in every react 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 CONSTRUCTIO ARTS Rough 0 .40i Service io.... .. ....... dGCTOR 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 BeDone FIRE DEPARTMENT Until Inspected and Approved_ by the Building -Inspector, Burner Street No. SEE REVERSE SIDE Smoke Det.