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HomeMy WebLinkAboutBuilding Permit #Exception - 165 CARLTON LANE 5/1/2012 BUILDING PERMITo NO D OF�.ftEfb'9�.� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 'yy- _ Permit N0: Date Received SACHVS Date Issued: IMPORTANT.Applicant must complete all items on this page i3u ��� ���r.�d���' � �` L. �� %�`•��9' 'g e 3 aA£�dv�t a.� '" .'.�f`&3' 3i f5i LGa5PRQPERTYtOWEc � ��, �� , e i istract it r. r::a"... MAP 0- t��- PARCELaC_ Z©NING�DISTRICTHc D ` Yes is or-- M:acT_`hn�Shop..�Villa.9eY .. n�� TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential 0 New Building ❑ One family 0 Addition Two or more family 0 Industrial 0 Alteration . of units: ❑ Commercial 0 Repair, replacement 0 A essory Blot ❑ Others: ❑ Demolition ❑ `0 � gSWaptte"`i3cr/°S.•'eD"`wW�e-r'e�tl,;l.�,...�.sp�_����s *-,�_� �. �� .;�,.�„ o �0;,e 4'� ` DESCRIPTIO F K"TO BE PREFORMED: CIL 4r A Iden cat Please Type Pint Mlearl P n OWNER: Name: 1p% i Address %Rt�°d it ,3 , r aa^ :1r Pi CONTRAG. �T Name e� :�� � � � . . {.�;� t �P.hone �. Ad'tlress Supervisorsi Construction t �.�, y�� f t i��a.�5 4 '� �,tw'rtw*.....r-y'rw" i•�� . c+��'ri.t�+,5 a, C� ,.� �. �'y�� �"y. }'.'s�- i�S'~r Z1x �•5�'Y4w" 4 � f��+h 3���'� zx1 c x�-'� "n y`� Y1�"S y., � � *s ���� �� ^4 aj�ax{#'�`�`7at +� r 'f s� _jf` `��j * +��• -••.�.u,.. t s ,,,s r - �, €Homemprrovement ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.'M00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $sly FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ TanningfMassage/Body Art ❑ Swing 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 Si nature COMMENTS x All S"F—$% it i.i k: �-�-� •�`�` •-- rig �: r +Y f HEALTH Reviewed '-D / ?s Signature COMMENTSZ a Z / Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/si nature&Date Driveway Permit _ DPW Town Engineer: Signature: Located 384 Osclood Street {—'.:.•r:_�t>•.., .:,.:.-„,.vr-.•-vcr sarN.:ter• `-' .:. S'-r` t [i FIREDEPARTMENT«` - Tem D„umpster(on site r yes . Sil ,�:.; t•P� - ', .�'` ”- -'ar' M....,+- - r..v � g-i,r, + Z=, '` �j• '3'1:h„'�, ,' '�r ,� '�'i `RK's1: �' 4 �'' ''ft {Locatetl`at124 Main,Street�: , �NWT ' t4 v•. t { ; s � + .wk•��,�` ``�€1"`iY F Z: r,�p.n ,.��°gas�.r'h'�, . '"t�.:'4 .'f- { �f�� i'"�'' �,,"�;�+.,�'S'�(� 'i•,�� � ,• ' -a•���ec�h�� 1-5 .:_:�.. .:.:--:,-.-.�g,4L::.r���...xe_:�.:__ta�.._. a. .,•'+.?vrx��4ar l.r4._.,x. ..._l'.si_�_.il.tiJ,i�_'__.' ..d_�` -:` _.�.,.La:._::.*.,...IL:.�...- .'......:...Y.N� 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 a Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o. 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) o Engineering Affidavits for Engineered products VOTE: 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 a Workers Comp Affidavit ❑ 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 a Engineering Affidavits for Engineered products N OTE: 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 offiee 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 DEPARTMENTMFORM07 Revised 2.2008