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Home My WebLink AboutBuilding Permit #181-14 - 15 DOUGLAS ROAD 8/27/2013 NO DT a�N BUILDING PERMIT Y TOWN OF NORTH ANDOVER p APPLICATION FOR PLAN EXAMINATION 00 Permit NO: Date Received Date Issued: ^ SACH�S� `� IMPORTANT:Applicant must complete all items on thisa e --- C LOCATION -*--- Print — PROPERTY OWNER Ir Print MAP NO: PARCEL ZONING DISTRICT: "Histoeic:District yes •.no.) Machine Shop 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 ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic 0 Well ❑ Floodplain',";'' Q Wetlands ❑ Watershed District D /Se L Q. Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: 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: $ FEE: $ q � Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have a sTo tile gua anty fund ignature of Agent/O a attire of"contractor °°''' W TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION. Print. PROPERTY OWNER Print 100 Year Old Structure yes no MAP NO: . PARCEL:-_ ZONING:DISTRICT: Historic District yes no Machine Shop 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 ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic. 0 Well ❑ Floodplain ❑Wetlands ❑ Watershed'District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name:,._ _ _ Phone: Address: _,_ _ - Supervisor's Construction License: r 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: $ FEE: $ Check No.: Receipt No.: NOTE: Perons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner M � Signature of contractor �~ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location No. Date 1 . - TOWN OF NORTH ANDOVER �._ Certificate of Occupancy $ m Building/Frame Permit Fee $ ' Foundation Permit Fee $ , Other Permit Fee $ TOTAL $ a Check# 26764 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ � f a 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 PLANNIN DEVELOPMENT F1 ElCO ENTS CONSERVATION Reviewed on C6 �� 13 Si nature '-j)" COMMENTS HEALTH Reviewed on Signature CO M-ENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes F Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Tod,v;., Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Mair Street . -Fire Departmerit signatu're�date`' t COMMENTS 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 21A-F and G min.$100-$1000.fiine NOTES and DATA— (For department use El Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The foli`wwing 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 o 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 casts if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apo,-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Buii,ding Permit Revised 2012 North Andover MIMAP August 27, 2013 ,c ( 1. V01 L r i t d a , n. War .rVP ori v.. �b� �ti. .y� O, a to e� • � sit � �.�,is. � ,�, R m m � a - , " een"a treet � , r� 1 Interstates Interstate —Major Roads Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, Roads Meters Data Sources:The data for this map was produced by Merrimack v10RT11 Valley Planning Commission(MVPC)using data provided by the Town of r Easements Ot"'60 q� North Andover.Additional data provided by the Executive Office of rs Environmental Affairs/MassGIS.The information depicted on This ma is C3 MVPC Boundary �. 9a �s O P p C]Parcels 3' L for planning purposes only.It may not be adequate for legal boundary F -^ la definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING • SlowTHE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY 4 i ^ OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT �o,� • ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF ° THIS INFORMATION �4SSAGMUS< 1"=60ft ^�° NORTH own of EAndover No. jgj_ Iq h , ver, Mass, . /A-4 COC HIC..e w1C.t V1• gD4ATED /.V S U BOARD OF HEALTH Food/Kitchen PERM T LD Septic System THIS CERTIFIES THAT .1I� .....SCI..I�. .l ! .....`...... ..Q'..�!lr...'�.Y.I�.C.S............. BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .....1..T........ Dlawis).141W...do..................... Rough to be occupied as 1..0..w...'.L. ...................................... .......... ...... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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. �/U (f 1-!),6--f, . k,&n p �,•�_, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TA Rough Service .................. ........ .... .. ...................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. Smoke Det. SEE REVERSE SIDE