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HomeMy WebLinkAboutBuilding Permit #Exception - 125 FLAGSHIP DRIVE 5/1/2018 NoRTy BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ~ Permit NO: Date Received 712-2-1 (Q 7 A0RAreo �SSACHUS Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION: Pmt ` * PRO-PERTY OWNER 0 aS';r.6'c c 1 PHA_t _ MAP 210 S PARCEL:Du ZONING DISTRICT: Historic District yes Ma C Snop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory BldgOPers Demolition Other Cf!� �6,Z- Septic. Well floodplain Wetlands Watershed District - - UVate�/Sewed _. D CRIPTION OF WORK TO BE PREFORMED: items Gee2 41A, � �" - J fYC Identification Ple se Type or Print Clearly) OWNER: Name: �D12 QSla c,'71"J Phone: Address: S'" / ©SPS 0 Alk O/P CONTRACTQR Name:: hone Address-, Supervisor's Construction-License:. Exp. Date.. 'Home-improvemer t License: Exp; Date: ARCH ITECT/ENGINEERZ)/' , rll i of a ` Phone: 5/S- 6'b•67'?U Address*// "41 /2-110 Reg. No. �S/ FEE SCHEDULE:BULD/NG PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracWilnrwistered contractors do not have access to the guarantyfund of A ent/OwneSi nature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL , I Public Sewer Tanning/MassageBody 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 eelll� 2TIIII al 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 Conservation Decision: Comments Water & Sewer Connection/Signature &Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street =;FIRE WEE WENTDumpsteraon s : �,ilr..r- -'" a. Located-at 124 Main Street ��- t«. �� ��. � �,��'�.•i""i � aster+ �-..�,.�x� � ��,.���� � •.:s-,a .� �' vw.va� -�e.-.t f h � :.• °s ri y } �' s�. �.r z y�i��-, rR��y°� �K"µ'�"�ss7 'P'x'�' ,� f ° "L �5�.�'. ?..x„FS..,c�c.. �.�-e' k 1.x4t�..yiisa+' �.}.e.3'..k'sw.c4."d <'ka .z& F-.�.L sr_:�as.- .�• "ia%' N. 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 li 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) 'I I - l ❑ Notified for pickup - Date II� I 1 Doc.Building Pennit Revised 2010 I 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 o 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 i 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 a 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 thea appeal period is over. The applicant must then et this recorded at the Re ist of Deeds. One co and roof of recording q PP P PP � g g� rY PY P g - must be submitted with the building application Doc:Building Permit Revised 2008