HomeMy WebLinkAboutBuilding Permit #595 - 1420 GREAT POND ROAD 3/24/2006 NORTff
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° : I % TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
9SSACHUSEt
/ C
Permit NO: Date Received:
,11
Date Issued: —o
IMPORTANT: Applicant must complete all items on this page
LOCATION ,'� &�
Pri e
PROPERTY OWNER ��
Print
MAP NO.: � PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑New Building ne family
❑ Addition ❑Two or more family 11 Industrial
0 Alteration No. of units:
`i&epair, r&Tacement >4ssessory Bldg 0 Commercial
❑ Demolitio
❑ Moving(relocation) ❑Other ❑ Others:
{ ❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
a
fid 17
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Signature
Address: 1 26b, �!tD 0
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg.No.
I' FEE SCHEDULE:BULDING PERMIT:$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost :$ /��'y xI0.00=FEE:$ ,36
Check No.: 7�. ReceiptNo.: I�SJ
Page 1 of 4
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
Addition Or Decks
❑ Building Permit Application
❑ 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)
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
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:BPFORM05
Page 4 of 4
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required Provided Required Provides Required Provided
DIMENSION
Number of Stories: _ Total square feet of floor area,based on Exterior dimensions.
Total land area, sq. ft.:
NOTES and DATA—(For department use)
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Page 3 of 4
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created IMC.Jan.2006
I
TYPE OF SEWARGE DISPOSAL
Tanning/Massage/Body Art ❑ Swimming Pools ❑
Public Sewer
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Permanent Dumpster on Site ❑
Private(septic tank,etc. ❑ Electric Meter location to
project
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of Contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
[]Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ y G( �" '
COMMENTS 12e p Qfo
DATE REJECTED DATE APPROVED
HEALTH ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Aning Decision/receipt submitted yes
Fanning Board Decision: Comments
Conservation Decision: Comments
Water&Sewer connection signature&date
Temp Dumpster on site yes—no— Fire Department signature/date
Building Permit Approved and Issued by:
Page 2 of 4
Location � � � '�r �o�r� /1
No. 5-% Date
�oRTM TOWN OF NORTH ANDOVER
ate. , o
f� w
9
i y
Certificate of Occupancy $
MusE<�' Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee ,j JyF-P $ y,
TOTAL $
Check # 7
e � .55
Building Inspector
Location
No. Date , 23
i
• - TOWN OF NORTH ANDOVER
TLEIX •
� Certificate of Occupancy $
Building/Frame Permit Fee $ "—
« Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check# '\�"�����
r
uilding Inspector
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aerly
RNOORI \
D ROAD
01845
LOT 25 // ��,�'�
PG. 201 ,- ;< ;�
41 Ile—
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I L T
-j' EXISTING CONDITIONS PLAN
of land known as
TAX MAP 62 LOT 26 y a
� owned by 10 ;
MEL & CARI MARCHESE 31
& land known as i
TAX MAP 62 LOT 25
owned b
BARBARA J. SADRNOORI Utc 2 2
/f situated along 2000
SCHOOL GREAT POND ROAD -'r'IYTr=, , .
)ND ROAD
CONSE19VATION COP ��^ tr7N
MA. 01845 In
30C LOT 25
887 PG. 489 NORTH ANDOVER, MASSACHUSETTS
COUNTY OF ESSEX (NORTH DISTRICT)
MARCH 19, 1998 SCALE: 1" = 30' PROJECT # 97--1130
b
PREPARED FOR: MEL & CARI MARCHESE PREPARED BY: KNIGHT HILL LAND SURVEYING SERVICES, INC. I
1430 GREAT POND ROAD c/o DAVID HISLOP 1
NORTH ANDOVER, MASSACHUSETTS 34 OLD POST ROAD
01845 NEWINGTON, N.H. 03801
(603) 436-1330
REVISION - 11/15/2000 - ADD POST DEVELOPMENT GRADES AND WORK AREAS
1130ABLT
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EALTY TRUST
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ELLA, TRUSTEE
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62 LOT 40 L, (ASSUMED DATUM)
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or formerly �: \
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DOVER, MA. 01845 i� �� ! /'� J 96
AP # 62 LOT 26 9° .
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\+ \ L'• GARAGE '\ _ I WALK
884 / Q k R9.2
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RAINING
•+•?d•�.� WA7 9 ,3 0 ELEV 19. I \
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SPIKE IN BASE OF 10' MAPLE •Q�/ OJ + 84 1 L.=83'61
ELEV. - 86.02 1 A�°j
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(ASSUMED DATUM) WORK / py
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AREA — 3
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PHILIP F. & LYNNE RICH SULUVAN \ \ GRAPHIC SCA.
1408 GREAT POND ROAD
N. ANDOVER, MA. 01845 \ 30
\
0 1s ao so
TAX MAP # 62 LOT 24 \
E.C.R.D. BK. 2857 PG. 35
( IN FEET )
1 inch = 30 ft.