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HomeMy WebLinkAboutBuilding Permit #362 - 16 MEADOW LANE 11/7/2007 0ORT11 BUILDING PERMIT of tt,1D I6 qa TOWN OF NORTH ANDOVER ,�? 4�''`- .•_'_ °0 ° .,1 APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date Received CHU Date Issued: LlU IMPORTANT:Applicant must complete all items on this page OCATON �= Pn t � BERT OW1 ER ',�t,.-. lu i R a 7.�&y _ � i � f`J6 r♦l '.AF ,.+ft.,meq.� � Z -, .�++aazzA3P�l0 v 4 P�+►RCEL � �0`Nt�G D)ST.RI��' �-I�s#or�c��s#rct � fires Bio k �_ �... :r �11ac�ie Staop Village ,,�es rao - _ TYPE OF IMPROVEMENT -PROPOSED USE _Residential Non- Residential New Building - One family6, Addition Two or more family industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other efiat�c Welloddplar td W6" �1latershed t3istrlct r 2 1 DESCRIPTION OF WORK TO BE PREFORMED: 44 e 146 Lt Identification Please Type or Print Clearly) OWNER: Name: M/ = ��'1/ � I" Phone: Address: v CONTRACTOR y >$ C 'Add'ress. " -t< L : f s r S��srv�st�r"s Cons#rug#�on��cen�e � ��p� Da#e i I-lorne�mprove:nent L�cerise � - - ='Exp Date ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$12/500 PER S.F. Total Project Cost: $ �� �� FEE: $_Check No.:No.: v / Receipt No.: �9O 7 7 ,6 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund .Ig,nature=ofi Agent/Owner - = Signature of contractor �C , Plans Submitted Plans Waived Certified Plot Plan Stamped Plans 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 PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS- DATE REJECTED DATE APPROVED HEALTH COMMENTS 4 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 Located at 384 Osgood Street FIRE±DEPARTMENT Temp Dumpster on site des no Located at 124 Main Street " Fjre Depa rtmerit signaturefda#e - ` 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 2 1 A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date i 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 ❑ 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 Location /� `!// �c•�-� ""' `-� No. ��Z--" Date MORTfI TOWN OF NORTH ANDOVER 3: .• OL + ; , Certificate of Occupancy $ ��s',n°•E Building/Frame Permit Fee $ 4C NUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #� 20716X'/ r Building Inspector 71. Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR "Registrationt 118384 Expiration 3/7/2009 Tr# 126998 �, Type lndrvidual MICHAEL J.SULLJVAN- MICHAEL SULLIVAN 919 E.BROADWAY "e ry> t HAVERHILL,MA 01830 � "� Administrator i NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance ith the provision of MGL c 40 S 54, a condition of Building Permit at: Z& NI, • • ©ry G n is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cll, S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 1 OA. The debris will be disposed of in: (Location of Facility) Signature ofPermit Applicant Date NORTIy Town of No. J G 2 o- dover, Mass., Q LAKE COCHICHEWICK V 7�ADRAT'ED qS BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT r `.. .! ......................................................................................................��.��....................................................... Foundation >� ...Ca.C10C4J..XM.�.............................. Rough has permission to erect........................................ buil mgs on .....` .......���: .. g , to be occupied as........................... 5. :....l .tl. ?. Chimney .... .... ............................................................................. provided that the person accepting this permit all in every respect 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 ELECTRICAL INSPECTOR UNLESS CONSTRUC STARTS Rough ................ Service BUILDING INS I' -- Final Occupancy Permit Required t0 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.