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Home My WebLink AboutBuilding Permit #061 - 1507 SALEM STREET 8/1/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION q6 0 'u'o iPermit NO: � Date Received Date Issued: � sgcHus�� IMPORTANT: Applicant must complete all items on this page LOCATION r y SP Le 'V' 5- ' Print PROPERTY OWNER %A0,1 r i(qAN Print MAP NO.: PARCEL: ZONING DISTRICT: 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 /V gaw Identification Please'type or Print early) OWNER: Name: .5 N4nTPhone:`1l? 746-4-927 Address: CONTRACTOR Name: S,•9 Phone: I Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ � c) - -200r Ox12.00=FEE:$ �o Check No.: J s Receipt No.: c Page 1 of 4 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 o Mass check Energy Compliance Report j 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:BPFORM05 Pave 4 of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools 0 ❑ Tanning/Massage/Body Art ❑ Public Sewer ❑ Tobacco Sales Food Packaging/Sales F1 Well ❑ ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner /)-�*~ Signature of contractor r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS �} Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Sinnature&Date Driveway Permit Temp Dumpster on site yes no Fire Department signature/date i Building Setback (ft.) I Front Yard Side Yard Rear Yard Required Provided 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) i II I I Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan.2006 Location / 570-4 No. 4961 Date NORTH TOWN OF NORTH ANDOVER of,...o ,•�tio Certificate of Occupancy $ Building/Frame Permit Fee $ sAcHus Foundation Permit Fee $ Other Permit Fee $ r— TOTAL $ Check # r 19298 Building Inspector XA®RTH Town of : t _ 4Andover No. io o dower, Mass., Cz-_ OC MIC ME WICK 7�ADRATED BOARD OF HEALTH PERMIT .T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT....... ......... .. . �.r.. . ��..�....................................................................... Foundation has permission to erect........................................ buildings on./r49-7.......S/.!4 on....777.0 *.......... Rough to be occupied � � ......... ...... ... .t.S/C�1..�. .. .......1.0 . Chimney provided that the person accepting this permit all in every re�ect 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 160 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTR O TS_ ELECTRICAL INSPECTOR Rough ..... ......... lcraftft� .......... Service ILDSPECTOR 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. NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 15'o7S-It' is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits`are required under Fire Prevention laws'Chapter 148 Section 10A. The debris will be disposed of in: %2, , (Location of Facility) Signature of Permit Applicant Fire. Department Sign off: Dumpster Permit Date ✓1e 60MINro0/— BOARD BOARD OF-BUILDING REGULATIONS,1 „ License: CONSTRUCTION SUPERVISOR j .: Number: CS 005535 ` Birthdate: 09/0311947 Expires:09103/2007< Tr.no: 3686.0lot `. s } Restricted: 00 JAMES A HARTIGAN -t 36 SPRING ST UANVERS, MA 01923' ��^°" /✓ Commissioner i