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Home My WebLink AboutBuilding Permit #420 - 1615 OSGOOD STREET 11/21/2009 TOWN OF NORTH ANDOVER �iORTi� APPLICATION FOR PLAN EXAMINATION o�st-.o bq�0 's OL FO- Permit NO: v Date Received M�wO9 Date Issued: ��f I NArso o- (y SSAC14US�� IMPORTANT: Mplicant must complete all items on this page LOCATION Ala� - J` Print PROPERTY OWNER Zf G 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 DESC 2TI NOF WO O BEP ORME ` L eSa� Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: s / CONTRACTOR Name: � � 1-141-r 11 G Phone: � Address: 4C� / r� �� • ��, 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$125.00 PER S.F. Total Project Cost :$ a�G FEES -1 00 v -. Check No.:—;—�aT Receipt No.: ! a S Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Tanning/Massage/Body Art ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE:, Persons contracting witka is red o r do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor 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 ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ i COMMENTS FIRE DEPARTMENT - Temp Dumpster on site o Fire Department signature/date 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 Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Re uired 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 Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan2006 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work i 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 Doc:INSPECTIONAL SERVICES DEPARTMENTMIZORM05 II Page 4 of 4 Location &0�/� No. Date 1 NORTH TOWN OF NORTH ANDOVER � P Certificate of Occupancy $ b'•'.°� Buildin /Frame Permit Fee $ U ,SSACMUSt Building /Frame Permit Fee $ Other Permit Fee $ TOTAL $ Check # 19825 �.�.._..� Building Inspector NORTH TONM Of _ 4Andover No. y Z O ~ - �` C, - L A E dover, Mass.//&— O o COCMICHE WICK V A0RATEO '9% BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System &WA4 �� BUILDING INSPECTOR THIS CERTIFIES THAT..... ......... ................................................................. Foundation has permission to erect........................................ buildings on . .. ......�5 &Ait* Rough to be Occupied a . ., ......Sl*w ..... oinef....... .... .�,j.... , ............ X. Chimney e provided that the arson accepting this permit shall in every aspect conform to the terms of the a plicati on fife 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 CONS TR O ST' TS Rough .. .. .. ...... . ... ... .... ....... .... Service BUILDIN C R Final Occupancy Permit Required to Occupny 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. HAVFRHILL ROtPORD AZY I • � "1 OGUS � O-9 as I.P. \ 4 no, LOCUS PLGN SCALE:I��2000 DETAIL:NOT TO SCALE 3 NSF COMMUNICATIONS WORKERS OF AN Lp(sw IM, Le Ungl 115.001 gp.n L:OHT POLO 31.471 V/fie Q ST ar 00 H CATCH Ir m LOT A fVp_ 18,937.2 S.F. = W N N SERVICE r2l O IY r ISLAND 'P 1— Iba D 0 ' .. c N C I FILL CAPS 4 CO-/ I U rn - 01 — �c� P sop' IGHi POLE i 0 F 5,GN POST 6 0 9UP I ` R.R Spi..Ic.II , i I APPROVAL U110CR SULINVISION REFER TO: ESSEX NORTH REGISTRY OF DEEDS PLA CUNTNOL NOT REQUIRED aMASS. STATE HIGHWAY LAYpU,i'OF NOff;Pi'ANDCVER PLAAWNG BUARD 1 s r i a yyf y ` W dY.lf'�b�'n' (�-`C.•.ijtY i . Y'•. AY'�'((i�,M�,,a{p}��,i It j�(�,y� �j��l/.� �hcT/ ,� ✓� -' -' I , y•��Ar�b.'x�'F� (tA tt1 Y•yyrm/Y,+��fQ(�r� R I.i.'4i.if ti�,a-yai Q-r��t` •� - Xel a f +a4a1 j .. t .izl�P I hi`,fyt!r�r'� ky,�y -j``_yxr^3 �.,p r b f•, f '. Al 14 Ij it f � �xi� •�.Cr✓• �r t1''� f -i D l ('i,}r¢;er.;.1f ♦ ` y'� e';' y< , `� ttt4* t t tet. t•. 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