HomeMy WebLinkAboutBuilding Permit #495 - 1600 OSGOOD STREET 3/23/2009 BUILDING PERMIT cf NORrk q
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2 46:<,i, ••p,4a TOWN OF NORTH ANDOVER 0 - � 0�
APPLICATION FOR PLAN EXAMINATION p
Permit NO:
Date
Received
Date Issued: 0
�SSACHUsE�
IMPO TANT:Applicant must complete all items on this page
LOCATION ' u.
ins a a * c
PRJPERYOVII'NER ,.� :
�;a k "�' � �'"$ Pint _ x "� �•.
MAP NO � ri:= PARCEL �ZOTaI�NG�ISTR��CT,.l.�Hstonc'A`Dastnct � des � �� t .
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eS 10,
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 , Will Floodplain`` N41 ds
� Vershil b�stIct
V0ter/5ewex` tis. Y
DESCRIP ION OF WORK TO BE-PREFORM
D
42 Ce
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Identification Please Type or Print Clearly)
OWNER: Name: .41 Phone:
Address:
CONTRA TQR °'Nar-e r hone
F
QSapervisors Construct�ora :�cense = = Ex
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Ho.m Irnprouerri.ent L� ensew Exp FOae ~ ..
ARCHITECT/ENGINEER �"� / ems, Phone: 2 7 /)
Address: .49 Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
47
Total Project Cost: $ c;9,901_140 R--- FEE: $
&1_�
Check No.:~ Receipt No.:
NOTE: Persons contracting ith ister d contractors do not have access to the guaranty fund
Signature of Agent/Ownar gnatureof-contractor
r
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
M
4
CONSERVATION Reviewed on Signature
• I
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
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
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE=DEPART�I1T =Te1p�k u�npsterP n site deso _.,
Located nt.�2? Main streetd
Firepar rneri# t taat»�ii ,e
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Y `
�CO,MMENTS, su
i
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 fine
NOTES and DATA— For department use)
❑ Notified for pickup - Date
Doc.Building Permit Revised 2008
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
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses I
❑ Copy of Contract
o 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
E 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
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
o 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 2.2008
NORTH
c
ovm Of � _ Andover .
No. qq� y
dover, Mass., 3 4 3 .0i
COC MIC ME WICK V
SRATE D C7
BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
'
BUILDING INSPECTOR
THIS CERTIFIES THATZ>C.A..... . .... .
... �.Q
........................................................................................... Foundation
has permission to erect........................................ buildings on.16100.....0rodsr....*za..... L..... Rough
to be occupied as....I.QQQ.... .. ..Pt•........ .V.4.. Q.! .................................................................................. chimney
provided that the person acceptirfg this permit shall 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 CONSTRU STAR Rough
........ .......... .................................................................................... 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
Until Inspected and Approved by the Building Inspector. Burn FIRE DEPARTMENT
Street No.
SEE REVERSE SIDE Smoke Det.
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Locatiogl%pll CY.av�t__
No. Date - -�
�aRTM TOWN OF NORTH ANDOVER
3? 0
AL
00
Certificate of Occupancy $
Building/Frame Permit Fee $ 3 (,a .---
s�cwust
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
2 ! 8L, 2 --
'10 Building Inspector