HomeMy WebLinkAboutBuilding Permit #134 - 1503 OSGOOD STREET 8/18/2006 v
TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION qt,f'D 0 6
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Permit NO: 13 / Date Received
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Date Issued: 1 ACHU
IMPORTANT: Applicant must complete all items on this page
LOCATION /�� �S Gi O e) d '
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PROPERTY OWNER a 0,i
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MAP NO.: ,-� PARCEL: ZONING DISTRICT: ✓ ) r
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑New Building ❑ One family
❑ Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units:
❑ Repair, replacement ❑ Assessory Bldg ❑Commercial
❑ Demolition
❑ Moving(relocation) ❑ Other ❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
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Identification lease Type or Print Clearly)
OWNER: Name: / � Q o C'� Phone: �/7 G y
Address: 2 ��o'� v 4 cs
CONTRACTOR Name: `'�A -� C"hone: 97�
Address: Z Q
Supervisor's Construction License: d S e/ Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address: Reg.No.
FEE SCHEDULE:BULDING PE IT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost :$ ;—� 0 a ; U D FEES ��lU
Check No.: Receipt No.:
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TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑
11Tanning/Massage/Body Art E] g
Public Sewer
Well 11Tobacco Sales ❑ Food Packaging/Sales L1
Permanent Dumpster on Site ElPrivate(septic tank,etc. F1 Permanent
Meter loca on t
project
NOTE: Persons contracting with unregistered contractors do not have access to thptampedPlans
Signature of Agent/Owner Signature of contracto
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan . ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
[]Water Shed Special Permit
❑ Site Plan Special Permit
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❑ Other �
COMMENTS w
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DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
0" HEALTH ❑ ❑
d COMMENTS
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water&Sewer connection/SiEnature& Date Driveway Permit
Temp Dumpster on site yes_no Fire Department signature/date
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Building Setback(ft.)
Front Yard Side Yard Rear Yard
Required LProvided Required Provides Required Provided
Dimension
Number of Stories: Total square feet of floor area,based on Exterior dimensions.
Total land area, sq. ft.:
NOTES and DATA—(For department use
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Page 3 of 4
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created JMC.Jan.2006
t 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
Addition Or Decks
❑ Building Permit Application
❑ 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)
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
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
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Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Pave 4 44
Town o oaY North Andover O0 H
Building Department
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27 Charles Street
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North Andover,Massachusetts 01845
(978)688-9545 Fax(978) 688-9542
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Building Demolition Affidavit
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OWNERS NAME&ADDRESS
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PROPERTY LOCATION
DESCRIPTION
CONTRACTORS NAME&ADDRESS
DEPARTMENT SIGN-OFFS
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ELECTRIC G`
TELEPHONE
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DUMPSTER-ON/OFF STREET 4 L46'd
DIG SAFE NUMBER 2 66� ��'v� C)!S
BLDG. INSPECTOR DATE RECD
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Robert C.Pendrake
Supervisor of Support Services
July 14,2006
Ranger Development Corp.
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2 Bridge Circle
Tyngsboro, MA 01879
RE: Removal of electrical service and meters for demolition.
Dear Tracy:
This letter is to confirm that the electrical services and meter(s)were removed from 1503 and
1505 Osgood Street, Forth Andover, MA on July 13, 2006. If you have any questions or need
further assistance,please feel free to contact me at 978-725-1320.
Sincerely,
Robert C. Pendrake
Supervisor of Support Services
RCP/cmc
1101 Turnpike Street
North Andover,MA 01845
978-725-1320
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92 Glenn St,Lawrence Mass
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08/02/2006 10: 02 7815927641 Al EXTERMINATORS PAGE 02
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41 Exterminators
pest control professionals
DATE: AUGU,131! 2, 2006
TO: BOARD OF HEALTH
.N. AN!LO EV R, MA 01845
AT THE REQUEST OF: RAN IER DEVELOPMENT 978-649-421
2 BR.IDGEVIEW CIRCLE
TYNGSBORO, MA 01879
A RODENT CONTROL SERVICE WAS PERFORMED PRIOR TO DEMOLITION AT:
1505 OSGOOD STREET
N ANDOVER MA 01845
THE PROPERTY SERVICED WAS: (1) SMALL SHACK
IF YOU HAVE ANY QUESTIONS, PLEASE DO NOT HESITATE TC CALL.,
SINCERELY,
A-1 EXTERMINATORS
183 Shepard Street
Lynn. MA 01902-4597
781-592-2731
800-5254825
781-5927641 Fax
Location ���Dd�• •�'�
No. �I Date y Q�
MORT1y TOWN OF NORTH ANDOVER
F 9 a
Certificate of Occupancy $ _
Building/Frame/Frame Permit Fee $ '
s�cNust 9
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
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Check # I�
1 ., 375 Building Inspector