HomeMy WebLinkAboutBuilding Permit #101 - 123 MAIN STREET 8/7/2008 BUILDING PERMIT of r10ROORTFr H
TOWN OF NORTH ANDOVER o? ooZ_
APPLICATION FOR PLAN EXAMINATION
Permit NO: 4/ Date Received
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Date Issued: " /rU
IMPORTANT:Applicant must complete all items on this page
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LOCATION &J!�S_ ,CO�Jk > �
PROPERTY OWNER_�� L g �& /i C
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.MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Vitlage yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
No. of units: Cftfflffilecia
epair, replacement Assessory Bldg ers.
Demolition Other
Septic Well Floodplain Wetlands Watershed District
Water/Sewer
DESOPIPTION OF WORK TO BE PREFORMED:
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104_A� W6S
Identification =W7;2aS7-
P t Clearly)
OWNER: Name: � ) �.�c� Phone:T78 68ig 666
Address: b AA-11i
CONTRACTOR Name: a40� ZAQ40 Phone: e-?78
Address: ls�;eK i(If 13 A4, <n( <770
Supervisor's Construction -License: ' g Exp. Date: / t `
Home Improvement License: A Exp. Date:
ARCHITECT/ENGINEER � �T CO. Phone: !Z78 7¢¢
Address:`Z� W Llll�(,' ZC� • Reg. No. S •W. LIllzs7 oq�_
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ OQ, FEE: $ r 700
Check No.: 79 - `i� / Receipt No.: �Ls QD
NOTE: Persons contracting t nr- istere contractors do not have access to the guara z zd
signature of Agent/Owner Signature of contractc)&,,L����
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 Aer I P O1/e Me I O
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
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
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPART VIENT -Temp Dumpster on site yes no
Located at 124 Mair&treet
Fire Department signature/date
COMMENTS
I
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 - Date
Doc.Building Permit Revised 2008
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
❑ 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
❑ 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:INSPECTIONAL SERVICES DEPARTMENTMFORM07
i
Revised 2.2008
s
Location,
No. ,/c f Date
MORTIy TOWN OF NORTH ANDOVER
� 2
Certificate of Occupancy ' $
'SJ�cNust`� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ ��
Check #
2 � % V V Building Inspe-66r
NORTH
TO" Of 16 Andover
No. Q'�y o dower, Mass. �-
T O Z LA >
COCHI CMEWICK V
ADRATED
`S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT..... ...... ...... .. . . .... .. ... ............................ Foundation
has permission to erect.............. buildings on./CAA....... ......... . ...........,. ...'.
-. t- ... � Rough
to be occupied as................... ... ... . .. .. ..... ............... . .. ...
..................................................................... Chimney
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, Afteration 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
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
Rough
..................... Service
Bia
UILDING INSPECTOR
Final
Occupancy Permit Required t0 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 FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
d;":'M OFFICE OF BUILDING INSPECTOR
TOWN OF NORTH ANDOVER
'• ."�`` . r% CONSTRUCTION CONTROL
PROJECT NUMBER: ( JLC
PROJECT TITLE:
PROJECT LOCATION: D i ' Y
NAME OF BUILDING: +'
" • G (1v%j
N TUR OF PROJECT: / )
IN OR NCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING ODE,
I, M V UL'- wl#X/ REGISTRATION NO.
BEING A REGISTERED PROFESSIONAL GNGWEEWRCHITECH HEREBY CERTIFY THAT I
HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,
COMPUTATIONS AND SPECIFICATIONS CONCERNING:
ENTIRE PROJECT ARCHITECTURAL 0 STRUCTURAL 0 MECHANICAL O
FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY)
FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS,
COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS
STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES.
AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B
EPRESENT ON THE CONSTRUCTION O SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT
THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING
PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0
1. Review,for conformance to the design concept, shop drawings, samples and other submittals
which are submitted by the contractor in accordance with the requirements of the construction =�
documents.
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2. Review and approval of the quality control procedures for all code-required controlled materials. } z o ,
3. Be present at Intervals appropriate to the stage of construction to become, generally familiar N Z
with6the progress and quality of the work and to detenni
ne, in general, if the work is being S€
performed in a manner consistent with the construction documents.
PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT
TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR.
UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE
SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPA Y.
aSSCRIBED AND SWORN FORE ME THIS sl ru
DAY OF � : 19 '00D e
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H.H. Mo
rant & Co., Inc.
Messina s Sho in Center Architects�
1013 123 Mainpreet
Date P.O. Box 4485
North Andover, MA mg/m�/�g221 Washington Street
`•.'•1=. '•''•: Salem, Massachusetts 01970
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Building 'C' Unts C4 - Gl - AAAA 978 744-5354
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�`•'•�''�`````'' �978� 740-9161 fax