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Home My WebLink AboutBuilding Permit #730 - 136 OLD VILLAGE LANE 6/10/2008 BUILDING PERMIT Ot NORTIy kOR H TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: 0- Qd IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY DINNER Print MAP NO: PARCEL: ZONING DISTRICT` Historic District yes no 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 Watershed District Water/Sewer i^ c / ISE V ce 711.,[/ 11.,ON [/WQC e0 BE PREFORMED: Oa b Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: ,1. 0 G?- Phone: Address: Supervisor's Construction License: f Exp. Date; Home Improvement License: Exp. Date: l ' 0 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: $ /or-U,cfv Check No.: 7 / �� Receipt No.: � a(C)L NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of AgentlOwner Signature of contrac o Plans Submitted Plans Waived 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature w 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 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.$100-$1000 fine NOTES and DATA— For department use ❑ 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 ❑ 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 ❑ 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 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 Location No. a Date N�RTM TOWN OF NORTH ANDOVER F w a �t 41 y Certificate of Occupancy $ / Building/Frame Permit Fee $ swCHust Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 ' 2 2 7 Building Inspector NORTH '9 Town of And &W No. 7�p o dover, Mass., d O COCHIGEWICK 7 AERATED PPS\ �� BOARD OF HEALTH Food/Kitchen Septic System PERMIT T D ___ BUILDING INSPECTOR THIS CERTIFIES THAT........ i. ..............10 XA_ .C..*.�. 0w+►.......................................................................... Foundation has permission to erect........................................ buildings on ..............t..fe.3.......40.L.�.r!� ?..).4w......1 ............. Rough to be occupied as...U.l. N. .. . .. St . . .. .. ... . . *41.1...... v..... .. ....... Chimney pM ............................................ provided that the person acabpting this permit sh II in every respect conform tot terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONS U S SRT Rough Service ......... ................................................................. BUILDING INS Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. i3ropont Page# of pages Qi �v6 Proposal Submitted Tb:-5(,f` 1_ / Job Name Job# Address // 3DI Job Location � Datern Ane /�f, c�}� Date of Plans/" Phone# ��[J Fax,11 Architect We=hereby specifications and estimates for: .. _C. GHQ �� .......... 144. '✓ Q,{........_ 111 S v f n t rj t ( G G J e"U U IC-a— too J y �2,rn t,✓ � 19 v..vr.•, _. ZO, coo .. ..... CUSrr,__ ,�f7PCrC.I ffWe 7prop;os�ehereby to furrnni`shh material and labor—complete in accordance with the above specifications for the sum of: $ tom^^ ✓ /t�lS'+ e �-,'� ' / Dollars with payments to be made as follows vl�'U/U 5 +� � 011e � S car 5 � �UWen 3 SLAPS GaA S,c! ,,J 9 (d1SUJ WAe, e J/^spI('�C� Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order, and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our control. Note—this proposal may b withdrawn b us if not accepted within days. 2cceptance of Propont The aboverices,sbecifications and conditions are satisfactory end are, SI natUfe hliaccepted.You are authorized to do the work as specified. , g PaythenZs w'I�I die made as outlined above. 1 Date of Acceptance n ! Signature >: NC3819