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Home My WebLink AboutBuilding Permit #446 - 1635 OSGOOD STREET 12/4/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: )) I Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page Alr LOCATION �$ 00 PROPERTY OWNER�I`i vi ;I(.:� GS Print,,,,., 100 Year Structure yes . no _ . . MAP NO: � PARCEL: 2 ZONING DISTRICT: Historic District yes no. Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition X'`T'wo or more family ❑ Industrial ❑Alteration No. of units: ,3 ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: emolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑Wetlands ❑ Watershed District, ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Aemo Pii/1 rc Uyl I f C10Vk7 fiU . NUC/S - /J� Ro or Identification Please Type or Print Clearly) OWNER: Name: grlrd,4 mv&ke-1 Phone: �7SZ— Address: Ig pinac,k 0(v 1� d� CONTRACTOR Name: Phone: n Address: Supervisor's Construction License: Exp. Date: Home Improvement License.: Exp. Date: ARCHITECT/ENGINEER 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: $ G FEE: $ Check No.:&d`- Receipt No.: (ez702 NOTE: Persons contracting with nregistered contractors do not have access to the guaranty fund - - - - _ Signature of Agent/Owner Signature of contractor_ Plans Submitted ❑ an aived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 CONSERVATION Reviewed on Sinnature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comment-- Water ommentsWater & Sewer Connection/signature&Date Driveway Permit DPW Town-Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 MainStreet Fire Departrientsignatpre/date` COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Dieter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE:. Yes N® MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use w,c v Q Notified for pickup - Date E Doc.Building Permit Revised 2010 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 submAted with the building application Doe: Doc.Building Permit Revised 2012 /9 Location! V� r S�`---_ No. Date e - TOWN OF NORTH ANDOVER e y�.r1�Lt•Dr�9a • e " t. . . Certificate of Occupancy $ Building/Frame Permit Fee $ C - Foundation Permit Fee $ f' Other Permit Fee $ a , TOTAL Check# 26009 Building Inspector r , NORTH . w: 6 ic ver 0 No. 3 � . LAK. h ver, Mass, A_ cocMicNewicw y1' T 7�S RATED APp��S U BOARD OF HEALTH Food/Kitchen PERMI T LD Septic System THIS CERTIFIES THATTBUILDING INSPECTOR Foundation has permission to erect .......................... buildings on A..( .�.�.. � � - Rough to be occupied as 4.4 .... .. ....... �. ...... ....��a.! ...o►� ........... chimney provided that the person accepting this permit shall in eve respect conform to the terms of the ap cation Final on file in 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. RoughFinal PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR �3 UNLESS CONSTRUCTIOPPST RTS Rough Service ................. ......................................................... Final BUILDING INSPECTOR � GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE