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Home My WebLink AboutBuilding Permit #622 - 141 MAIN STREET 1/14/2010 BUILDING PERMIT Of NORT#q ,9 tte° 06 TOWN OF NORTH ANDOVERF 4 - APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ��SSACHU`'��y Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Pn'�., ` PROPERTY OWNER p S • (01w m Print MAP 210 PARCEL: ZONING DISTRICT: Historic District yes no Machine Shap 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�-- t.Repair, repJaeeKent Assessory Bldg Others: Demelifion Other Septic Well Floodplain Wetlands Watershed District Water/Sewer Irf' I DESCRIPTION OF WORK TO BE PREFORMED: SEco/v o/v f4*4V ffJ41v�/rVG ce—omix, tepees DSV-rW-0 4Q0XGS 1 e tU;J1 JAInL- P=LQQKZr/DYf}[�L�1 ST/4PbjL)6 GGD?'f�/SVG �2/4L/GS IgtJD �lOp>Z I /spL/9t/S /�D »6-�tc�G-�lcrv� . Iden tificati n Please Type or Print Clearly) HornC-0- OWNER: Name: I'S 0C,,q ll= �e�i4t2T Phonee9']� CpBg-`�'8l0 homE Address: z a A �i2ENrwoab �1 1-, boucle_ CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: 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: $ /000.-- FEE: $ �O Check No.: - aFe Receipt No.: -�22 S'3 5r NOTE: Persons contracting with unre ontractors do not have access to the guaranty fund $ignature of Agent/O Signature of contractor 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 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: t 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 Nov' DANGER ZONE LITERATURE: Yes No z,.-' 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 2010 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 u,'Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract v 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:Building Permit Revised 2008 Location / Cl1 G'/y S� No. 2 Date TOWN OF NORTH ANDOVER 3�Oi�t�•e '�,h�0 F R ' Certificate of Occupancy $ /OC) CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22965 Building Inspector NORTH Town of 10 No. to Z- - .zo = A dover, Mass., COC HICMEMCK ADRATED P? C5 S BOARD OF HEALTH PERMIT T D leood/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........................ ......................L .` .�/0 c'. �.5......... ................................................................... Foundation r �,y has permission to erect' buildings on .... C//.. ..f .:..'..�'... ,f................................... Rough to be occupied as................... `A4f�.r .. :... .�►�� '.,-Y.. �!.%Y.. Chimney provided that the person accepting this permit shall in' r spect conform to the terms of the application on fiI 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 CONSTRUCTION STARTS Rough ....... �.:r:�?::tr 1� �,P.............................................. Service ........... .. BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy 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. I �r 4 I fle5l rno IA � 1 1, .:f . tixo�p ci4�,�t�s - _ * 70 V4