HomeMy WebLinkAboutBuilding Permit #Exception - 135 RALEIGH TAVERN LANE 5/1/2018 (4) TOWN OF NORTH ANDOVER
.APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT:A plicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building ne farm
Addition o or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
DESCRIPTION OF WORKp TO
BE PERFORMED:
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_ Iden kation Please Type or Print Clearly)
OWNER: Name: �iztK `L Dim Phone:138 Z ,i1?21
Address: I S ?AeE1C%H
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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: $
Check No.: Receipt No..
NOTE: Persons contracti ith unregistered contractors do not have access to the guarantyfund
of g�nt/l /rernaur o contractor —
Plans Submitted Plans ived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales
Private(sep ' nk,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM,
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS - -
HEALTH Reviewed on l i.� Si nature
.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 Drivewav Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
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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:$1o0-$1000 fine
NOTES and DATA— (For department use
FLIJ Notified for pickup - Date
Doc:-Building Permit Revised 2008
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
❑ 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
LiFloor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (1f 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)
t ❑ 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
and proof of recording
that the appeal period is over. The applicant must then get this recorded at the Registry of Deets. One cony r t
must be submitted with the building application
Doc: Doc.Building Permit Revised 2008
_7
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Scale: 1/8" = 1'0"
Notes:
Proposed Deck extension entirely within
100'of wetlands and is expected to require
approval of Conservation Commission
` Leach
Field
15'x 50'
Septic
T nk
8''z
No
ee�
Proposed o
Deck.Extension
67 x276 w
N Porch
zo No Foundation): 11,1 141
Exiting 0Deck y
9'
--------------
,Y
17'`3
Existing Dwelling:'
`r 135 Raleigh Tavern An
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