HomeMy WebLinkAboutBuilding Permit #Exception - 135 RALEIGH TAVERN LANE 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received 1 b - I r
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION 15
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MAP NO: ha` PARCEL:O//.2- ZONING DISTRICT: Historic District yes
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
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DESCRIPTION OF WORK TO BE PERFORMED:
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} OWNER: Name: Phone: @
Address: G-5 R14L OG{4 eiw L-r,(
CONTRACTOR Name: Phone:
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1 Address:
Supervisor's Construction License: Exp. Date: I
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Home Improvement License: Exp. Date: f
`p ARCHITECT/ENGINEER Phone:
Address:
Reg. No.
FEE SCHEDULE:BULDING PERMIT.•$12,00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
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Total Project Cost: $ '0 FEE: $ y
Check No.: Receipt No.:
NOTE: Persons contractinith unregistered contracto
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g g rs do not have access to the and
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Signature
of Agent/Owner ;..: ,.1r ,Signature of contractor NIJ
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
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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
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EJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑
COMMENTS
CONSERVATION Reviewed on I f 0 Signature �Ll C4-
COMMENTS
-COMMENTS opo �vj I-,
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'HEALTH
Reviewed on / z- )-r;:, Si natur
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COMMENTS
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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 DEPARTMENT - Temp Dumpster on 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.
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.$10041000 fine
NOTES and DATA— For department use
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® Notified for pickup - Date
Doc:.Building Permit Revised 2008
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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
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❑ 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
❑ Engineering Affidavits for Engineered products
DOTE: 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/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
❑ 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
:I that the appeal period is over. The applicant must thenet this recorded at the Registry g g stry of Deeds. One copy and proof of recording
Must be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
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LOCUS
LOT 124 N74.50'00"E LOT 123
168.00'
LOT 112 0
M PROPOSED SHED
AREA 44,184 SF +/—
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50.2' s? 47.2
15'9 3;. qtr
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LOT 113
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RALEIGH TAVERN LANE
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OF Mgssgc
JOHN yes
U McauiLKIN, JR-
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R. N C E RTI FI E D PLOT PLAN
°�Fs � X120 JQ,�` 135 RALEIGH TAVERN LANE
NAL LaN�s
NORTH ANDOVER, MA.
SCALE: 1 in. = 40 ft.
. �,,.. DATE: AUG. 26, 2009
REFERENCES: REV'D DATE: APRIL 14, 2010
PREPARED FOR:
1. TITLE REFERENCE — BOOK 10308 PAGE 272 NERD Erik Julin
135 Raleigh Tavern Lane
North Andover, Ma 01645
2. REFERENCE TOWN OF NORTH ANDOVER
- ASSESSORS MAP 107A PARCEL 112 PREPARED 81(:
JM Associates
325 Main Street
North Reading, MA 01 664
978-664-6668
www.jmossociateseng.com
www.certifiedplotplans.com
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