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HomeMy WebLinkAboutBuilding Permit #582 - 124 Pleasant Street 3/20/2006 i Of NORTH 9ti TOWN OF NORTH ANDOVER •' APPLICATION FOR PLAN EXAMINATION � pO°•r.° 9SSACMUSEt Permit NO: \6-3 y Date Received: Date Issued: J IMPORTANT: Applicant must complete all items on this page I LOCATION 191-ER6*0 I S 1 Print PROPERTY OWNER A) ovz IQESCIMRitlt� Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building One family ❑ Addition ❑ Two or more family ❑Industrial R'A"iteration No. of units: ❑Repair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED F/�tlSµ B�kSEsnt�T G�SINE s rJs m�Z-- F ws*/,. Sys�r I 35 7 Sty F 7- 2 cA&3 ` fit° colec-.e— r 7 f Qo�n T11�' Cl-S�D� t� ,�►►�Y /�ay��T zi(� �I Identification Please Type or Print Clearly) s M OWNER: Name: aqm00 V (kE.4C-rnt Phone:9-7o -G P7-GG 3 �� Signatures' p Address: 12� REE Ao-Si /(�� �jViy0'(, /I')*. CONTRACTOR Name: )C-(- Af��4�Nwz - Phone: � Address: Supervisor's Construction License: -7 c1 1-4-3 Exp. Date: A) S 02 Home Improvement License: f 3-7q L(3 Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BOLDING PERMIT.SIO."PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. ' Total Project Cost :$ 221,57, UV x10.00=FEE:$ ` Check No.: /�'�3 Receipt No.: 15a Page 1 of 4 yI I TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ F1Permanent Dumpster on Site F1Private(septic tank,etc. NOTE: Persons contracti with u reg' to c ntractors do not have access to the rant and g g y Signature of Agent/Own Signature of Contracto Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS I y4 DATE REJECTED DATE APPROVED HEALTH ❑ ❑ I 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&d to Temp Dumpster on site yes no Fire Department signature/date rrB.uilding Perm*t :ppred and Issued by: Page 2 of 4 i k Building Setback (ft.) 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) I i Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.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 y ❑ 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 ❑ 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 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 DEPARTMENT:BPFORM05 Page 4 of 4 I Location/,),/ � •- ' No. 15"� Date 3?o.,40oT:,�o TOWN OF NORTH ANDOVER f� F w 1� A Certificate of Occupancy $ s•►cNusEt�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 191,41 v Building Inspector, NORTH Town of t over No. dover, Mass., COC LA HICHEWICK y1. ADRATED PPS` -`C S BOARD OF HEALTH PERMIT - T Food/Kitchen Septic System • BUILDING INSPECTOR THISCERTIFIES THAT....................... ..............................:.............................. ... .......................:.................... ................... Foundation has permission to erect............................ ........... buildings n./ ...... ......... Rough to be OCCUp18d a .. ....�........ ..... Chimney .. ...... ................................................................ provided that the person accepting this permit shall i ery respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and B ws 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 CONSTRUCTION STARTS Rough ... :.. Service BUILDING ECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous -Place on the Premises — Do Not Remove Fina, No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. 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JAN 10,2006 10:03A OWNS COINING BOSTON 7818218552 page 1 Lierty d, ?m4jWT2m j Ott t:Vt t-V '� i *mUftaTdtp6o.7 P"du--x" �ia�(6t1��3t-16,43 Ug2k 2006 RE: et Warioens C`ampra laswarae btstQak OWENS CORM4FOUMD BENT 9601 5T CANTOK KA 4@1 rally l ow W(2-313-3435"15 5 44aW Fag m*w 5 L 4aW (3pamot7tt6 " waft W*xmf LtsQfoefs at77 mQ MA tiara�ierrrs l�ietiit4c BoftbjmyBy $ SKM Em& Bomybmbyvm=c 3 Soots smsf aea<blr�r�►g►tra,a.ac s s�,eieo tb>G4rt3o� At ofdis d*,Qe&&mHvft=mdpdKoaftisitr w abFLdmdyYiftwtFira)t=mwcotmftgo pafcsrs"Awic 7u ismo aattim"byre trod puky is wow b an Ae omm and cooda oaf dkm kywl' um m oam"i=afmYar ea 6mmats as ngmd b Z6 gw msifioole tttaybeimm L dis aeefi5a17 is isseod s:a atatsat diafram6m aalya7d cord nod*npra M Ate a xUgo o yaldt7 owe—""*is not as peliq d&w ad amend,aderi ar atter Ae eavww attaelod` ac okyk"aA Itau/oie�is seaodbd t+ofare lie wtad espbatioo�Iie�lllanad w3R aadravar b7arQly�oa efsae! 7mateB+atiao nsttt�tr� t�rtrrtettar;. oat0ar s 11ACMffaie baser177t8tYri0rIIA1. 1�R�����ru1��f�ii�iw��� oc Lowet 1f+odaoerdlRoeord QWM exuxM rtt=HW wAsse,%W,r AH M--W G 0UXJX)N VC CANM MA 4M1 ,MA 8?otil ti- f _ Board of Building Regula ons and Standards One Ashburton Place- Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 137943 Tyco Supotment Card Expiration W912007 OWENS CORNING BASEMENT FINISHING DANIEL WALSH 960 TURNPIKE ST. - CANTON, MA 02021 Update Address and return card.Mark mason for chang vrsC+a 0 SOM44004[i101216 (�Address ❑ Renewal ❑ Employment E] Lost Card 94 �ii a sroxuba�i o��� uFe,Qb, �I Board of Building Regautions and Standards License or registration valid for individul use only HOME MiPROVEMENT CONTRACTOR before the expiration data If found return to: Rogistra�N 137943 Board Of Building Regulations and Standards One Ashburton Place Rm 1301 �7 Card Boston,Ma.®2108 OWE�NS COt�'�N\tjt�d 1NtE�J `Tl 4j 9W, RN UCC ST.',;: CANTON.MA 02021 Not valid witbout signature