HomeMy WebLinkAboutBuilding Permit #Exception - 145 COLONIAL AVENUE 5/1/2018 BUILDING PERMIT pORTN
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TOWN OF NORTH ANDOVER F?�4`.1
APPLICATION FOR PLAN EXAMINATION
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Date Received
Permit NO:
SAC HU`s
Date Issued:
IMPORTANT Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
El Addition EJ Two or more family [I Industrial
❑ Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ °`ssessory Bldg ❑ Others:
❑ Demolition Y Other /D
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�- ..� .. ., .. ' 'DESCRIPTION OF WORK TO BE
PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name:���s .s ��� C� Phone: 1
Address: A6 YA
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ARCH ITECT/ENGINEER-J!��vPhone:
Address: ko X;L" V\ No.
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ '�/J�. FEE: $
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Check No.: Receipt No.:
NOTE: Persons contracting with nregistered contractors do not have a , to the guaranty fund
Signature of Agent/Owner ' Signature of contractor
Plans Submitted I`I Plans Waived ❑ Certified Plot Plan I Stamped Plans d
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF- U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
DATE REJECTED DATE APPRO D
CONSERVATION ❑ , �
COMMENTSL�jl-op, Z`2 axl
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DATE REJEC ED DATE )VED
HEALTHJ
COMMENTS "
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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 ❑
ZoningBoard of A eal :
pp s Variance, Petition No: Zoning Decision/receipt submitted yes �
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/Signature& Date Driveway Permit
Located at 384 Osgood Street
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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
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DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
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NOTES and DATA— For department use
❑ Notified for pickup - Date
..... ._..__..................................._.........................._......................... ......................._........................
Doc.Building Permit Revised 2007
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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 2.2007
PROPOSED SWIMMING POOL o,
PROPOSED
CONCRETE DECK
PROPOSED FENCE J VIM-
1'
1' OFF PROPERTY LINE �
PROPOSED
ARBOR
238.36'
LEACH TRENCH
(TYP. FOR 3) ��\ 10.22' 10.00' + ����0
RESERVE TRENCH �\ \\ \\ �\ �\ ppp 0'
(TYP. FOR 3)
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LOT 15
AREA=22,254 S.F.
=0,51 AC.
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SEPTIC TANK ti� ��� /n7 MO
00,
AVE
1511
PROPOSED
POOL EQUIPMENT ; A�
-��
NORTI-I AND(
r SHOWING PROPOSED POOL
PREPARED FOR