HomeMy WebLinkAboutBuilding Permit #571-2011 - 1659 OSGOOD STREET 2/22/2011 BUILDING PERMIT o�"�ORT" ti '
TOWN OF NORTH ANDOVER 3� ' =~ 1° -0
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APPLICATION FOR PLAN EXAMINATION x ,�
Permit NO: 5���rabll Date Received �s4"�R,r.o
'9SSACHUS�'�
Date Issued: 2 tie I
IMPORTANT: Applicant must complete all items on this page
LOCATION I s y O S S00d :s--t—
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PROPERTY OWNER ��1 c r" + kr;.5. 1 Vt u h rot
Print
MAP No: 3��- _PARCEL:�_ZONING DISTRICT:(-(-O 3 Historic District yes
Machine Shop Village yes n
I' TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
era i No. of units:- ' 2 Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed Distract
Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED:.,
Identification Please Type or Print Clearly)
OWNER: Name: 7-/Ir i- t Kr, S RA A.ro-c Phon`e: !2
Address: 100 �� ?' fi -f 224 S (D/ tYT
CONTRACTOR Name: KA vtv-J r Phone: . k f4T <33 5/
Address:
I Supervisor's Construction License: 05-.3 01'k Exp. Date: y,
Home Improvement License: D 1 17 `1 Exp. Date: 1-ft ( � Z
ARCH ITECT/ENGOC-ER f e g Fo ST c/"• Phone:
Address: �-(� ,/�� �Q.�,�.� rrL Nu A -. 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: $ 2 v-,Qc-?V, O v FEE: $ 02 e7`O
Check No.: d`�/ Receipt No.:
NOTE: Persons contracting unregistered contractors do not have acce s to the guaranty fun
Signature of Agent/Owner Signature of contractor
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 Signature
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 DEPARTMENT - Temp Dumpster on site yes no
Located at 124.Main Street
Fire Department signature/date
COMMENTS
Dimension
Number of Stories:_Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.: • RS ��.
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
E
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
orkers Comp Affidavit
Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
X 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:Building Permit Application
Revised 2.2008
J
Location
No. ���7/ — // Date 2-2I'
�aRTM TOWN OF NORTH ANDOVER
' O:tNo :•'��.0
3? • p
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9
i y
Certificate of Occupancy $
�ssCMUs c� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
t_
ij
23908
Building Inspector
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ORTH
Tomm 0 _
6 over
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Mass.
0 LAK dover, ,
COCKICMEWICK ��.
ADRATED P`"
��S U BOARD OF HEALTH
Food/Kitchen
Septic System
PERMITBUILDING INSPECTOR
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THIS CERTIFIES THAT �.� ......................�.�/..�.G?..�'................................. ........................................... Foundation
........:................... Rough
has permission to erect................. ...................... buildings on ..l�......1�...... .. .. .. , .....�.
Ai��O dGZ. 6
to be occupied as.... ..x r.S. .... 42..... G., r.�..... . ........ � .. .... . !!-.5
Chimney
rovided that the person accepting this permit shall in every respect conform to the terms 6 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
r�M 1STT Final
PEi� .. EXPMES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTI N STARTS Rough
........ ...... .. .. .
............................
Service
BUILDING INSPECTOR Final
Occupancy Permit Required t0 Ocmpy 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.