HomeMy WebLinkAboutBuilding Permit #628 - 133 Summer Street 4/7/2006Of NORTH 1
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Permit NO:�[)J`�7
Date Issued: 6
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received: d
IMPORTANT: Applicant must complete all items on this pane
LOCATION 153 Sum mf. r' S -i e �
PROPERTY OWNER �� �kGs bit LL
Print �I
MAP NO.: PARCEL: `t 0 G ZONING DISTRICT:
TVPF. AND IJSF, OF BUILDING
HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
®-One family
❑ Two or more family
No. of units:
❑ Industrial
❑ Repair, replacement
Vf)emolition
❑ Assessory Bldg
❑ Commercial
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
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Identification Please Type or Print Clearly) V I
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OWNER: Name: <-?- �'- �Cy LLC-- Phone:
Signature
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Address:
CONTRACTOR Name - —J I `e:�
Address: -Pb • S4
Supervisor's Construction License:
Home Improvement License:
ARCHITECT/ENGINEER
Address:
(4
o
°o"f Phone: qry
fo )
C65 iiJi' . % l � 0174
Exp. Date:
Exp. Date:
Name: Phone:
Reg. No.
FEE SCHEDULE: BULDIN PERMIT. $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $12.5.00 PER S.F.
Total Project Cost :$q
`� x10.00=FEE:$
Check No.: 33 `T o Receipt No.: 120
Page 1 of 4
A
TYPE OF SEWARGE DISPOSAL
Art F1g
Swimming Pools El
Public Sewer
Well F1Tobacco
Sales ❑
Food Packaging/Sales 11❑
❑
Permanent Dumpster on Site
Private (septic tank, etc.
NOTE: Persons contra 'ng with unre ist red contrV
d not have access to the guaranty n
a
Signature of Agent/Owner Signature of Contractor %
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT ❑
COMMENTS
CONSERVATION
'OMMENTS
HEALTH
COMMENTS
a
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
DATE REJECTED
0
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
DATE APPROVED
DATE REJECTED DATE APPROVED
0
DATE REJECTED
Comments
Comments
Water & Sewer connection signature& ate
Temp Dumpster on site yes no— Fire Department signature/date
Building Permit Approved and Issued by:
Page 2 of 4
0
FE
DATE APPROVED
Building Setback (ft.)
Front Yard
Side Yard Rear Yard
Required
Provided
Required
Provides Required
Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
IVV11JJano UAIA—Icor
Page 3 of 4
Doc: INSPECTIONAL SERVICES
Crcated JMC. Jan.2000
Total square feet of floor area, based on Exterior dimensions.
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
❑ 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
Location 11�-g
No. 67-0 Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ Ii—
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit,,Fee .... .........
TOTAL $
Check# 33�0-
191193 Building Inspector
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Town of North Andover
Building Department
400 Osgood Street
North Andover MA 01845
Tel: 978-688-9545 Fax: 978-688-9542
DEMOLITION OF BUILDING AFFIDAVIT
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LOCATION OF PROPERTY TO DEMOLISH U c(\!nL`(-
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CONTRACTOR'S NAME & ADDRESS
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EXTERMINATOR
DUMPSTER - ONfOF8 STREET Eric Z T)t ,
DIG SAFE NUMBER Abo (Q j (r)CQ (.`Acj G
DATE REC'D
Building of Building Affidavit revised 11.5.04
BLDG. INSPECTOR
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DEMOUTION OF E..,UILDIN AF t Y- ,.
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DATE: _ 2-7--06
TO: BO/.l,F:G OF HEALTH
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AT THE REC UEST OF:
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A RODENT EONTROL DEMIOLI T ION SER VICE i, ;S R�R t:C'R�AEG A.T
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THE i rROPERTY SERVICED WAS:
IF YOU HAVE ANY QUEST ION!<', PLEASE DO NOT HESITftTE TO CALL.
SINCERELY,
Ai I EXTiERAl'/ vA TORS
tp3 Shepara Streel
Lynn, MA 01902-4597
781-592.2731
800.525.4825
781-592-7641 Fax
ADDITIONAL SIGN OFF".-----.-
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Planning Departrnent44/11�--
Town of North Andover
Building Department
1600 Osgood Street
North Andover MA 01845
Tel: 978-688-9545 Fax: 978-688-9542
DEMOLITION OF BUILDING AFFIDAVIT
DATE�b
OWNER'S NAME & AD RES Q
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DEPARTMENT SIGN -!'AFF 00
DEPT OF PUBLIC WORKS -WATER. S
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DEPT OF CONSERVATION HEALTH DEPT: Seatc �ell'
C�oi.�� m.- Sr�.>+t✓ , L a.rK to fir- a/+b �"'�
.gave. �Forw�Y-'or
GAS
ELECTRIC
TELEPHONE
DATE REC'D BLDG. INSPECTOR
Doo.form demolition of building affidavit
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DEPARTMENT OF PUBLIC SAFETY
License: HOISTING ENGINEER LICENSE
-.� Number:. HE 0
Birthdate. 01 1171 1962
Expires: 01/17/2007
Restricted: 2A
MARK K FINN
PO BOX 84"
PRIDES CROSSING; MA 01965.
58075
Tr. no: 14290
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Commissioner /
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