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Home My WebLink AboutBuilding Permit #92-12 - 1476 SALEM STREET 8/2/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received Permit NO. s _ Date Issued: IMPORTANT:Applicant must complete all items on this page _LOCATION 4-7 �� I &0- e4it/`7�0�/ PROPERTY OWNERG- PROP Print MAP NO: oq/ PARCEL: IL,1)6 ._ZONING DISTRICT: Historic District yes o U--/04,19 G 0fc�—&09—05 Machine Shop Village yes no t TYPE OF IMPROVEMENT PROPOSED USE Res' ential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family 0 Industrial ❑ Iteration No. of units: ❑Commercial Repair, replacement ❑Assessory Bldg ❑ Others: [IDemolition ❑ Other _ � ®�Floocllain` ®Wetlands3 ",Wa ersheclDistrict ' �" �a irk ] i g =�?+" �J.w !: 'rw s'�.�. k Vii.�.a[ � � � }e �'}i� � �i.�Ser i.'€,��tl' ,+�'+• •'`G,.t{P� -�,. �Ji°�-� DESCRIPTION OF W ORK TO BE ERFORMED: Identification P e Type or Print Clearly) OWNER: Name: c� eKCS f rl Phone: — A ,0 Address: q �o �''9 Qom""' .� )k) f 7� c�5'S CONTRACTOR Name: Y`CJI•Q, Phone: Address: 6� 3:7 A) X.' Supervisor's Construction License: 4/e'/ —Exp. Date: / //,o Home Improvement License: x_33 Exp. Date: ARCHITECTIENGINEER Phone: ' Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. (a Total Project Cost: $ �saC) FEE: $ 11I 1W Check No.: // I S� Receipt No.: 9�110- 1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund S nature`of°contracor '= - �9�+..._�.._—._._— -- - 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 Permll AdditionI 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 F ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 10TE: All dumpster permits require sign off from Fire Department prior to issuance ofBldg Permit i all cases if a variance or special permit was required the Town clerks office must stamp the decision from the Board of Appeals to t the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording It St be submitted with the building application Doc: Doc.Building permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming P0013 ❑ 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 HEALT k 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 Engiiaeer 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: ___Total square feet of floor area, based on Exterior dimensions.; I Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of I Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA For-de artment use I ! I - I - i I I I I - I I I ® Notified for pickup- Date I I I DomBuilding Permit Revised 2008 1 I Location No. Date — f ,.QRT1y TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ Building/Frame Permit Fee $ s4CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # � 2442.9 I Building Inspector NORTH 0'"" o � over ou 14L o , * dover, Mass.,- 1049 COCHIC HE WICK AERATED p` ��J S U BOARD OF HEALTH PERM IT . T D Food/Kitchen Septic System oilBUILDING INSPECTOR THISCERTIFIES THAT.............. .................... ............... ............................� ......................... ............................ ` qt ...�.................... Foundation has permission to erect........................................ buil gs on . ..... .. Rough h to be occupied as ' ........... ............. ... ... ....... Chimney provided that the person acceptin this permit shall in every respect c form to the terms of the application on file 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 I "_kS ELECTRICAL INSPECTOR UNLESS CONSTRU Rough ..... .......................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy 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.