HomeMy WebLinkAboutBuilding Permit #Exception - 128 MAIN STREET 5/1/2018 NORTH
BUILDING PERMIT 320ry tyeo 6'9'�•O
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION z
Permit No#: ^eh
Date Receivedo�RArED
SSACHU`��
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
u Print-
PROPERTY OWNER Qv-'5
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
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District,
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
19 0 4—
Identifim Please Type or Print Clearly
Name: �./�I S k 7 Phone: `� '1992,erf,
Address:
Contractor Name: Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
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: $ J
Check No.: Receipt No.:
NOTE: Persons contractin .with unregistered contractors do not have access to the guaranty fund
S*qnature of contractorI
- - --
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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on Siqnature
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:
Located 384 Osgood Street
IF emp Durnp►RDAster onilsifetiy�es snow_ "� s_�a«
;1Locateci ati1�24tMaintSt�eaet., `` �"y �` ___
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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
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
Photo Copy Of H.I.C. And/Or C.S.L. Licenses
Copy of Contract
Floor Plan Or Proposed Interior Work
;rw 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
Copy Of Contract
Floor/Cross Section/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
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
Doe:Building Permit Revised 2014
Location V '""�
No. Date
. - TOWN OF NORTH ANDOVER
• Certificate of Occupancy $ w� `
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check# d l
Building Inspector
of No YN AH
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M M
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y'S ACIIISE
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number N/A Date: April 28, 2015
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 128 Main Street
MAY BE OCCUPIED AS a barbershop "Mal's Barber Shop"IN ACCORDANCE WITH
THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH
OTHER REGULATIONS AS MAY APPLY.
Certificate Issued to: Chris Doyle
128 Main Street
North Andover, MA 01845
Building Insjector
Fee: $100.00
Receipt: 28705
Check : 101
�gRYy .
�tS y4. • 4,,i0�� _
jF NORTH ANDOVER BUE WING DEPARTMENT
�SSA� �s 1600 Osgood Street
North Andover
Tel: 978-688-9545
Fax: 978-688-9542
.RUSNW`SS FORM FOR TOWN CLERK
DATE:
NAME:
ADDRESS;
ZONMGDISTB—FOT: �
TYPE OF]BUSINESS:
BUILDINGLAYOUT PROVIDED: YES 3->
A7 AlL,A.ELE PARKMG SP.AMS: P S
ZONING BYLAW USAGE; YES NO
EUMD , G INSPECTOR SIGNATUFX
BUSINESS FORM FORTOWN CLERIC
ui Mo oiM H
•i r
40
3S ACIIUSES9
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number N/A Date: April 28, 2015
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 128 Main Street
MAY BE OCCUPIED AS a barbershop "Mal's Barber Shop"IN ACCORDANCE WITH
THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH
OTHER REGULATIONS AS MAY APPLY.
Certificate Issued to: Chris Doyle
128 Main Street
North Andover,MA 01845
Building Inst ector
Fee: $100.00
Receipt: 28705
Check : 101
COMMONWEALTH OF MASSACHUSETTS
V •ILI&*I - • •
BOARD:OI`
BARBERS ;
ISSUES THE FOLLOWING 't I CE14
AS A FtEmSTERED MASTER BARBER
CRI STOPHER N DOYLE
10 PEQUOT ST =1• ��'fjl,rr
lu,
N B,I LE`ER ICA.; MA 01862 2927
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