HomeMy WebLinkAboutBuilding Permit #Exception - 1440 SALEM STREET 5/1/2018 RT
BUILDING PERMIT G� quab 6- �
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Receivedrev 0,
�9SSAGNUS
Date Issued:
IMPORTANT:Applicant must complete all items on this page
IQa' a
Y.
f �4
.�. �:W ,. ,. . ... ',... .'..,..:- ,, A�3$��.. �-�° ,:�:�. ° w: ,��x.,�.��.' .,m1 r. �` �- -z:.::,s..n.•eb��.^,akv �.�- .-o�»�.�:a:.M:� " ,.�.,-�:
TYPE OF IMPROVEMENT PROPOSED USE
Residenti Non- Residential
New Building 6ne family
A�era;o
Two or more family Industrial
n No. of units: Commercial
Repair,"replacement Assessory Bldg Others:
Demolition Other
r I
' cel �
�n arils
� �'�
a�w,,.'r'.",�._..,„ur .., ... -.'?� .�:; .. .... i. n.3c ":+.-• .. �'^:a�E:z.?i.,�...... . ..-��'s,.'� ..%f�;.���,... ..wr�i:,5^°,'. .�.'r.:3
DESCRIPTION OF WORK TO BE PREFORMED:
51211c
Identification Please Type or PrintClearly)
F
OWNER: Name: a Phone: &Z-,7,76
Address:
�� r/
�»
� �y .,
OM
i�
g311&Mq '
@ p
"x5^ '
\ �Y t:i.�....*r�_4�AY.. ,'�."rd.�r:nr,`.�,r R^a•nr�"s sA�x{"va.:. _. r,..oi�,,. .�+�� � �a 5d. ... -..� �1.R+ "��x.
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: $ OeP FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
firer , "" jlgt�aI�eofotr
ator ,,�. a x
� I
Plans'Submitted Plans Waived Certified Plot Plan Stamped Plans !
f
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
i
Well Tobacco Sales Food Packaging/Sales
Private �Ptil
etc. Permanent Dumpster on Site
I
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
1107, �
DATE REJECTED DATE APPRO ED
PLANNING & DEVELOPMENT o
COMMENTS
l ONSERVATION Reviewed on Si Lht
COMMENTS
'a
HE LTH Reviewed on Si nature
lIr
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 Os ood Street
�i� tC'.i°i '.-` r �,�=its*'' `"
�:� '• .� °yrs' +,.+r n� �� ��� ��Sx ` �t� "�x ,�:��,
Men
id
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 2.1A—F and G min.$100-$1000 fine
NOTES and DATA— For department use
i
i
i
❑ Notified for pickup - Date
Doc.Building Permit Revised 2008
j
alp
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 PP 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