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HomeMy WebLinkAboutBuilding Permit #888 - 15 EMPIRE DRIVE 6/12/2012 j NORTF/ BUILDING PERMIT °f TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION ��Permit NO: Date Received � pDRATE Dss CH•pP`�4`� Date Issued: pa IMPORTANT Applicant must complete all items on this page LOCAT�(�QN - `r `,/!I -11 r r � _ � �° 8 ; 2�T Vrlllt ,. �€ g 'i "3 N� � hRo�s 4} m# 4 s �PtiROPERTY, ®1NOk ,3p.'A r � 'r�� a,,�r ? z^t, N `` ' °� ". Psiflrlt� b °� a:`• M���� a e u.,r t z. [r P �; �H f, Historic Dis#i=ict �; YeS� n�, % V �ZONINGf�DISTRICT r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building One family 0 Addition 0 Two or more family ❑ Industrial ❑ Alteration No. of units: 0 Commercial 0 Repair, replacement ❑Assessory Bldg 0 Others: j ❑ Demolition 0 Other � 0 Floodplain ' F[�'.Wetlands � . �t�❑ 1Naterstied�Dis'tiict �� �r F DESCRIPTION OF WORK TO BE PREFORMED: F__Ocl 1J oArt o �— Identification Please Type or Print Clearly) �� OWNER: Name:�� ED �)lU , L-C Phone 4- vGLfgND 3 Address zi 1CONTRA`CTOR Marne ' b� /Lk '° Y Phone t' i t-.: i?< 1 ph,,. ,u i 4 �" -f f �: T�7 3 i a ' tt„ "J-„yhr�{ r'i' r Y 'art o -� :i•' v r�, `' °` -C mak, Y�'� �” ?c, z'7"r xSu�ervisot's Construction:Licensefu, l� :�,�,.� 'k.. � 4 .�2'� i <.�r <� �.F.3 p... •4 5 u s 3b 2 -,� Viz' •';l,�b`at -:.n:;. Horne lrnprove�rrtentL�eense � xrt _. _, x c ARCHITECT/ENGINEER - aN Phone�9�7; ze Address ZT fJ 6JF33 Reg. No. Z7 761' FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1OC70 FEE: $ Check No.: ���,`�11/ Receipt No.: NOTE: Persons contractin with unregistered contractors do not have access to the guarantyfund X •- x , ,+ Signature of Agent/Qwner' . wi.1` t,;A:ASlgnature of contractor= . r I Location No. Date ' TOWN OF NORTH ANDOVER �' xb j,4 • �� s Certificate of Occupancy $ x .µ Building/Frame Permit Fee $ Foundation Permit Fee $ D,) Other Permit Fee $ TOTAL $ Check#_ 11-7 25401 Buiidh&nspector ` Plans Submitted Plans Waived ❑ Certified Plot Plan V/Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Seng 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 PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ —11L COMMENTS -] )e DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature Date Driveway Permit Located at 384 Osgood Street FIRE.DEPARTMENT TempDumpsteron Locateda# 124,-Main SsR- freet f o Erre D`epartrnent signature/da#e a t . _ COMMENTS s � x 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.s100-s1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 a 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 FORTH of overo _ No. - _ o dower, Mass., co:.,C...CK 7�SD'4ATED 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... .:.....4:-..,....... Foundation has permission to erect...........:.:.......................... buildings on .. ......, ...... '(.iJ,r................................... Rough to be occupied as -.���"'/' Chimney It .................... .............. .............................. .. ................................................................. provided that the person accepting this permit shall in every re pact conform 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 IN 6 MONTHS ELECTRIC INSPECTOR UNLESS CONSTRUCTI ST UARTS Rough .:..... d ,-..:ll..l.-t . ....�.................................................. 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 FIREE_DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.