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Home My WebLink AboutBuilding Permit #284-2017 - 141 AUTRAN AVENUE 9/15/2016 O� pORTI� q BUILDING PERMIT r 4�.;�. .•_^.'6 t0'� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION rm�NO: Date Received 10 1l 040 yq, Date Issued: 1 �9SSACHus 1MhPdRTXr4:Applicant must complete all items on this page LOCATION f"UtT_Gll\ PAJ_4 . PROPERTY OWNER Print+1 I'L b Print MAP NO: PARCEL:-Cb ZONING DISTRICT: Historic District yes o Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building #bne family ❑ ition �o or more family ❑ Industrial ['Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer 1 a+�` ;1 i�r`"/� rte' �i ✓�7 "d' r ei /s2,2 Identification Please Type or Print Clearly) \\ OWNER: Name: Phone: �'J ZUG-35H Address: ( Q . N , SOX K(,- CONTRACTOR Name: ro_r\Aul vn'+ CCx1S�Ytp(' 1(fPhone: q Z(t5`69,5(, (r Address: - Supervisor's Construction License: Exp. Date: a Home Improvement License: :7 9LI G Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 38', q�S 'c) FEE: $ Check No.: ®r1 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to he guaranty fund Signature of Agent/Owner QZI`ljnature of contractor t10RTH BUILDING PERMIT of �,�o 06 2 g6,, , ._'h,•6 TOWN OF NORTH ANDOVER " ' ' i F APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received �gSSAcHus�`��y Date Issued: IMPORTANT:Applicant must complete all items on this page y LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no iMAP 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 11 Two or more family ❑ Industrial [I Alteration No. of units: ❑ Commercial 11 Repair, replacement [IAssessory Bldg El Others: ❑ Demolition ❑ Other ❑ S.eptie ❑W.ell ❑ Floodplain El Wetlands El Watershed District ❑_WaterlSewer _ w DESCRIPTION OF WORK TO BE PERFORMED: 6 Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor. Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: . HomeImprovement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:MOO 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 ge_nM vver y _ Location No. Date • TOWN OF NORTH ANDOVER �x Certificate of Occupancy $ •_ Building/Frame Permit Fee $y�n� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check# �� •. -11. t_.' Building Inspector Plans Subrnittc-d_Q, Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISP S { Public Sewer Tanning/MassageBody Art ❑ SwiRUning Pools ❑ Well ❑ Tobacco Sales 11 Food Packaging/Sales El Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On `0I1 ' Signature_ COMMENTS /V(/I- CONSERVATION Reviewed on / fa Signature 1 ! � COMMENTS /� ^ C ��S a Co HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I ` Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: FIRE'DEPART - �_ Located 384 Osgood Street 4. N T.Lemp ®u p ter on sib esu n Lo a"ted atrk1r24!(1inm--��—�-®�-- a Fire Depa�inent gntu %d to ems_ Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I I ELECTRICAL: Movement of Meter location roast or service droprequires a I Electrical Inspector yes q approval of No DANGER ZONE LITERATURE: yes No ' MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine I { I I NOTES and DATA— (For department use) i W e '20 4 � U`n z I f L 117 FUNotified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 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 4 Building Permit Application 4. 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application :a< Certified Surveyed Plot Plan �. Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses 4 Copy Of Contract .� Floor/Cross Section/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 OTE: 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 4 Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ` Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 "7 r � �. r .. L �,,,� I `I` � i � � � �� ' � �.f i �_ i ...r ,r'.,.a I