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Home My WebLink AboutBuilding Permit #Exception - 136 BRIDLE PATH 5/1/2018 L BUILDING PERMIT o*"0 oT06 TOWN OF NORTH ANDOVER 3� 4� *° �� C ` .,y p APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date Received �,4��'+wr■, * CHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page a , LOGATIf 3( �37126 �1Z Prins �R >=RTY WNER Print 'MAP NO- ; P-ARCEL: ZONING DISTRICT;_ Historic District yes no Machine Shop Village Vires: f . o 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 eil Floodplain Wetlands Watershed Distrix f 1waterlSewer; DESCRIPTION OF WORK TO BE PREFORMED: 2- I Identification Please Type or Print Clearly) OWNER: Name: fl-r ,— (/17Phone: 9?t'q7('— s-;?w Address: 3 efzew ( z--bNTRACTOR dame Phone: Address ...,-Suer�isor' Contruction Licenses xp E ., Date: s Flori3e lrrlpr ve sent License.'' Exp. Date. ARCHITECT/ENGINEER Phone: I 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 contracting with unregistered contractors do not have access to the guaranty fund Si nature of contractor Signature=of i4grtt/Owrier g Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public SewerTanning/MassageBody 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature J COMMENTS HEALTH Reviewed on Z Si nature. s' COMMENTS , e�Lccjrte,, Ti's �w"to Sr-:.e>�r �- z��v"�- �`�' Ta:t�C �� Gez-v✓- i .. t...��e- 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 `L=IRE DEMRTMENT Temp sDumpster on site yes no Locate-dat 124 Nain-Street _. Fire.tepartm,en#�tignature/4at+e 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 21 A—F and G min.$100-$1000 fine NOTES and DATA— (For department use r ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 o 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 o Building Permit Application i o Certified Surveyed Plot Plan o Workers Comp Affidavit o 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) o 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 o 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 o 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 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:BPFORM07 Revised 2.2008 t? it BOARD OF HEALTH 400 O.SGOOD STREET NORTH ANDOVER,MA 01845 TELEPHONE#(978)688-9540 APPLICATION FOR ABANDONMENT OF SUBSURFACE DISPOSAL SYSTEM (SEPTIC SYSTEM Pursuant to Section 310 CMR 15.354 of the State Environmental Code, Title V Name Phone `l -2 `T 7 S-SZ Gf; Address 'J , <R Contractor hired for work: Name Phone Address Date for scheduled abandonment The septic system at the above address has been abandoned according to Title V specifications. Signature of Contractor Method of septic tank abandonment(check one). ( )removal ( ) sandfill ( ) crush other Name of Offal Hauler This form must be returned to the North Andover Board of Health. PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH REP SENTATIVE'S USE ONLY. Insti Agent Date RECEIVED AUG 2 6 2009 TOWN OF NORTH ANDOVER s HEALTH DEPARTMENT a d wY r r2 1 �� , 9•net �.to t "'err �'•yy�f 1