HomeMy WebLinkAboutBuilding Permit #500-15 - 13 ELMWOOD STREET 11/24/2014 BUILDING PERMIT o`N°oT bgti
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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Permit No w S Date Received
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Date Issued: 14 2-4 1
I ORTANT:Applicant must complete all items on this page
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,LOCATION;
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PROPERTY OWNER �( /� t�L_
Print 1 db Year Siructure yes no
'MAP' _ .___ ;PARCEL:- a s ZONING'DISTRICT:_ ___.Historic<District yes no
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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 ❑ 1Natershed District
❑Water/Sewer.
DESCRIPTION OF WORK TO BE PERFORMED:
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Identification- Please Type or Print Clearly _
OWNER: Name: I CSS M4,3 PL.2., C- Phone: q'7" (
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Address: �3Q JL'.
Contractor Name: _ _ _ �_ 'Phone::
Address:
Supervisor's Construction License'—. -Exp: Date:_
Home Improvement License __ ;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: $ 2-5! 14�_D FEE: $ 2-557
Check
52Check No.: 2O S a— Receipt No.: oris Zc� 1
NOTE: Persons contracting with unregistered contractors do not have access the guaranty fund
Signature of Agent/Owner - Signature of contractor
Location 1
Lhp W,0401
�P Dale
• . TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee
Foundation Permit Fee $
o ' Other Permit Fee $
TOTAL $
Check
28299
Building Inspector
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Plans Submitted ❑ Plans Waived 0 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 Signature
COMMENTS
HEALTH Reviewed on Signature
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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
FIREDEPARTMENT - Temp iDumpster o-n site ,yes _ no
Located.at 124 Main Street
Fire Department signature/date
`COMMENTS _
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
i
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)
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❑ 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
o 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
a 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
o 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
o 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
Doe:Building Permit Revised 2014
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
23,500.00 m
$ - $ 282.00
Plumbing Fee $ 35.25
Gas Fee 100 comm. $ 100.:00
Electrical Fee $ 35.25
Total fees collected $ 452.50
13 Elmwood Street
500-15 on 11/24/2014
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PERMIT T
THIS CERTIFIES THAT 10,.. .,,,, CTOR
.. . . .. :/ ... .. ..... ............................................
has permission to erect .......................... buildings on .11..1 �,owww"o
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to be occupied as ...... ,�,r�!„ ., �,,,,,,
....... P%A�..1... �.....�. ���. Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Final
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 MONtH ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIT Rough
Service
...............fS
BUILDING.INSPECTOR. Final
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildinz
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.
Smoke Det.