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HomeMy WebLinkAboutBuilding Permit #5039 - 124 COTUIT STREET 2/18/2005 ■ O� BUILDING PERMIT r10RTN ttLeo 6aq�0 TOWN OF NORTH ANDOVER 3� APPLICATION FOR PLAN EXAMINATION w . Permit No#: Date Received �qss ATEED Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition El Two or more family El Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic El Well ❑ Floodplain ❑Wetlands ❑ Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: IIS 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Date.. ./..; . ..!=? NpRT1y o� a° TOWN OF NORTH ANDOVER - PERMIT FOR GAS INSTALLATION SSACHUS" 7 This certifies that . .��-,A, �. �. . . . 1. . . 5. . . . . . . . . . . . . . . . . . . . . has permission for gas installation . .�v L.*y! . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . .. North Andover, Mass. Fee./,'?.S. . Lic. No..lt. <<:. ;..<, __-.,.. . . . . ;(SAS INSPECTOR Check# J J �J Date.. . . S NORTH OFi,.io ,° 0 TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION SACHUSE� This certifies that . .� � Q. . . rd I)i4AJ -e., has permission for gas installation . .��—.'= d c A.�, in the buildings of . M -C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . �. . . C u` G?��r. . ., North Andover, Mass. Fee. .P�. Lic. No..i PT$ tT;D to aZ. .� l . . . . . . �►f GAS INSPECTOR Check# "! 'S L J Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans p ❑ TYPE OF SEWERt�GE DISPOSAL, Public Sewer ❑ ❑ Tanning/MassageBSwimming Art ❑ g 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 e U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Si nature COMMENTS 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: - -� DEPALocated 384 Osgood Street FIRE RTMENT - Tem D - - . ,p� . umpster� ,yes Loc_atedjat l-2g aon site: mpStteet Fire Ddpartrient;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) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 ■ 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 OTE: 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 4, Copy Of Contract ;r< Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) .r< Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 2014 I r� i J Gvvt y� MASSACHUSETTS UNIFORM APPLICATION F R PERMIT TO DO GASFITTING ( Pri nt or Type) Mass. Date G) Permit # 'Q 3 Building Location-L22- �-'tJ� '�' � Owner's Name Type of Occupancy / �25/C.l�� rrs New Renovation ❑ Replacement ❑ Plans Submitted; Yes❑ No ❑ N cc h x O J N w (3 V V1 Ir r �.. Z cc 'K c4 N F ` u: Cr Q Q •0 r W F- N Q N Y! Q = u! �. G 1L C tl 4 ix _ W z Q _W N u; < 0: O p W _ < W J + C F- fW W O > ►► F- W 0 W Vn a > o a �" o V SUB—BSMT. BASEMENT .� .� 1ST FLOOR , O 2140 FLOOR QL 3RD FLOOR 4TH FLOOR STH FLOOR GTtt FLOOR 7TH FLOOR 871{ FLOOR �1, Installing,Company Name_ 1, r'�_c �(✓w.���;n� .� r Check one: Certificate # Addressr� . Corporation ❑ Partnership Business TelephoneCl ] fid' Firm/co. Name of Licensed Plumber or Gas Fitter —J�-c�� •Z S ��Gr��c_� ; Q INSURANCE COY RAGE; I have a current billty Insurance Policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked ves, please Indicate the type coverage by checking the appropriate. box. A liability Insurance policy Other type of Indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER* I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General. Laws, and that my signature on,.this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby certity that all of the details and Information I have submitted (or entered i In above.application are true and accurate to the best of my knowledge and that all plumbing work and Installations Performed under the Permit Issued for this application will be In compllance with all Pertinent provisions of the Massachusetts State Gas Coe and Chapter. 142 of tho General Laws, � Type of License: 4U - M3 Title Plumber rgn re cense r or Gas titer slitter City/Town rler Ucen Nynber Ml'flC7vF?tSTC O Journeyman -r - I�ctl VM PFRt'!i G G.PCt Perini; cuii-_-;nc ' ocsiicnnLot: of•Q�upancv 'v2%'� -� Renovation 'J Replacement _1 Plans Submitted: Yes] Ne :] Fee. Vi v, cn w N t W (n - I W O (n F c� J Ln Cr o - = V) 4 J s c } m Lu¢ 0 ¢ �_ Q ¢ ¢ z � O w. Cr a cn F- w w O 0 O w _ a ¢ a f Lu W N 0 U (n w _ W a 0 > w c 2 w ¢ Cr o v Cr w w ~ - ¢ 0 > LL F U W N Co - c: 1 CD T = ¢ Q Q Ct Q Ww a W �- ¢ o r o SUB-BSMT. I > eASEMENT I I III V I I I I I I I I I I i IS T FLOOR 2ND FLOOR 3R0 FLOOR ?TH FLOOR � , H FLCOD oR i H FLOOR 8TH FLOOR Installina Company Name E p ST^,, C I Address 1 1 Tr( __:F{ rjr n I T IAC' ' Qeck one: Certificate U D-ilTTERS 1 I, 0 E'-timate Value of Work: Carporation Partnership BusinessTeieahone �1i:`_�=C_��;' :.1 Firm/Co. Name of Lcensed Plumber or Gas Fitter INSURANCE COVERAGE- I have a current liability insurance policy or its substantial equivalent which meets the requirements of MCL Ct. i42. Yes'K No ] If you have decked vas,please indicate the type coveraoe by checkine the appropriate box. A liability insurance poiicy;( Other type of indemnity ] Band OWNER'S INSURANCE WAIVER: I am aware that the licensee d0e_ot have the insurance coverage required by Chapter 1d2 of the Mass. General Laws, and that my signature on this permit application waives this requirement_ Check one- L21 of Cwner or Owners Aaam dwnerL Agent hereev carniy:hat all of the aetalls ana information I have<_u Omined(or mV�no`"IeaOe -, ntefeC)In aD0'JE?aOGIICzilon are true and c'L�;J(ate tG the tmesi of anC(ha(al1,Ie 'Aa na cors ria zt tallCas C Genormeo unser-.,'Ie oermlt issues 'ar-n's application will re in�mollanc2'Nijn cl1 Gemnent GrCVIS1Gn5 at'he 'taSaaC'USe Z tdIa Gds cud2 ana rilacier ',42 zf vne General - I dV ... I ; :vpe of''canse: -'umo-_r Eicna(ure of L`. nsa-o,=umcer �irer I _ 1 i Master�(";'Ni own i r'" _tensa Number !Apa9C�.'ED F=C= SE -,NL _ curneyman Town of North Andover pORTH Building Department 't I-e o ,e f 400 Osgood Street a OL North Andover Ma 01845 0 ti i A (978) 688-9545 Fax (978) 688-9542 •yA tocmc«rwcw`7• �SSgCHU APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS C li L� LOT NUMBER Af23 SUBDIVISION oil? 4 75 DATE REQUEST FILED / D DATE READY FOR INSPECTION 3 TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. -WATER METER di—"l Ui DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE SPECTION REQUEST DATE. :5 off SIGNATUR DPW AUTHORIZATION Town of North Andover NORTH 1 Building Department O tt_E D ,4" 1rO 400 Osgood Street 32 y! s 0 North Andover Ma 01845 O 2 +� (978) 688-9545 Fax (978) 688-9542 �.'gDR1TeD ro���5 SSwCNus*- APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS_ Co•t ,Wj LOT NUMBER a'� 8�1 SUBDIVISION a77 -4- �7 E DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER DATE D.P:W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/ THORIZATION a Ric)RTy N . CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number /'7a /4- Date _ 8o 6- THIS CERTIFIES THAT Ti 1E BUILDING LOCATED ON 1 .a a DLXY BE OCCUPIED AS �6-- Poo M , . /3,47-,4/ � I S fa 11 O nLcle v— IN ACCORDANCE WrM THE PROVISIONS OF.THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO A/!Hyl! u! w l` C_._ cC-Q-- -- Building Inspector IAORTH A- TOIWM Of Andover No. qo? C' r. Mass... L A;$ COCHICHEWI[C of?A*rED AdAIM OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ...................... ........ ..... Foundation ,,*G� SP— has permission to erect.............. ...................... buildings on.... .........10............................................................... Rough ..i�j IA. %*go'Ift Chimney ...................... .......... ................................ to be occupied as..... . ..!m. provided that the person accepting this permit shall in every 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 andjonstructl n of Buildings in the Town of North Andover. of-owl 0&Wq*;?04jV PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PEPJvffT EXPIRES IN 6 MONTHS EL CAL INSPECTOR UNLESS CONSTRUCTION STAR S Rough ..4Service .. 004 ............. BUILDING INSPECTOR (:F]i Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough J No Lathing or Dry Wall To Be Done FIRE D f ARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE __Jl Smoke Det. ?a U a x ,SSACN175b'. CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number / 'Ja t3 Date THIS CERTIFIES !H T►!E BUILDING LOCATED ON / .;?- C{ MAY BE OCCUPIED AS — Dy P lie IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING C=)DE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO f,c I Lot w Building Inspector NORTH Town of 0 Andover - %"*Oro No. `�o 8 _ 9► z=0 Aover, Mass.,- to W62 11 COC RICH WICK 5�kl OA?ATED P? BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... ........ .. ........4 ......... .. . . .. ..... ..... ....... FoundationL has permission to erect....... .................... buildings on ../ Y e0...,.......................%S ........�� � ... Ap Rough '0 Whimney to be occupied as.....ff...................... ............................... ... ot.. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in - _Final ,"V this office, and to the provisions of the Codes and BW-Laws rel 'ng to thlinspection, Afterati and ConsIrUction gL Buildings in the Town of North Andover. Q)%W0 5 W dp 111Ao PLUMBING INSPECTOR ?7.*4 a)*4Y VIOLATION of the Zoning or Building Regulations Voids this Permit. R& PERMIT EXPIRES IN 6 MONTHS 1 ELECTRICAL INSPECWR UNLESS CONSTRUCTION STAR �ou .... .. ............... .... ..20 ...............................P'Oop� . ......... .... ..... ... .................... ....... ... BUILDING INSPECTOR ff t4' Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove 61 e� No Lathing or Dry Wall To Be Done FIRE DEP NT Until Inspected and Approved by the Building Inspector. Burner r— + ;..... Street No. or SEE REVERSE SIDE Smoke Det.