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Home My WebLink AboutBuilding Permit #612 - 166 SALEM STREET 3/31/2006f NORTh 1 O �t�ao .e� ti0 3g a ....... a OL ° = p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 9SSACHUSEt Permit NO. Date Received: Date Issued: 6 IMPORTANT: Applicant must complete all items on this page LOCATION VW Jli u / 1 Print PROPERTY OWNER 0-11 e --S' Print MAP NO.: 3 7 PARCEL: a TVDT`i A 1V" TJQU n1 RTTTT .ilTNf_ ZONING DISTRICT:_ 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: ❑ Assessory Bldg ❑ Repair, replacement ❑ Commercial ❑ Demolition ❑ Moving (relocation) Other ❑Others. ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED 4�0. Name: Address: CONTRACTOR Name: Address: Type or Print Clearly) PhnnP• ME Supervisor's Construction License: CS o -S J Exp. Dater 01,07 2 Ll Home Improvement License: / 63`-3 Ij / Exp. Date: 02 ARCHITECT/ENGINEER ame: Phone: I -9 7V —373 " Dt3 ! �° r / Address: 561 / J f/ eg. No. FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ '/GCJ x10.00=FEE:$ 9 11 Check No.: /o 6 S— Receipt No.:A� Q-2- r Page I of 4 TYPE OF SEWARGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ Electric Meter location to proj ect NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner--S' Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan E]Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS e CONSERVATION COMMENTS - DATE REJECTED DATE APPROVED ❑ ❑ 331 Qb ❑ Water Shed Special Permit ❑ Site Plan Special Permit Other VA I L KEJECTED El DATE REJECTED HEALTH ❑ COMMENTS Zoning Board of Appeals: Variance, Petition Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer connection signature & date Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 1 DATE APPROVED DATE APPROVED Building Setback (ft. Front Yard fired Provided DIMENSION Number of Stories: Total land area, sq. ft.: Side Yard quiredPEovides Rear Yard sired 7 Provided Total square feet of floor area, based on Exterior dimensions. r 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 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) o 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 Doe: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 Location S)q/ No. (00— Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check Via_& _Is 19075 Building Inspector -60119 Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING is certifies that ..... z, .......... ............. J. �.)Fs permission to erform.,,—,; wiring in the building of ..... ......... . ..................................... North Andover, Mass. at / �.-. ��" ........................... Fee-4.7%.K.6��.. Lic. No ELECTRICAL INSPECT, Check# D FAXnWEW0FPVB[JCMFW permit No. BQ4IfDOFF1REPRE'VFM.MR GVLA771011t5S17(.11R,aim Occnpanry 3 Fees Checked m APPUCATTONFOR PERW TO PERFORM ELEC N. L WORK STS ALL WORK To BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSELECTRICAL CODE=S 527 CMR 12:00 (PLEASE PRIIVT IN INK OR TYPE ALL INFORMAMON) Town of North Andover To the Inspector of Wires: 'The undersigned applies for a permit to perform the electrical work described below. Location (Street d Owner or Tenant Owner's Address �LlhlP Is this permit in conjunction with a building permit: Yea 1:3 No a . (Check Appropriate Box) Purpose of Building Existing Service Amps /� G OVolts New Service Amps �Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Overhead Overlied Utility Authorization No. i Un&Wound C3 Underground M No. of Meters J No. of Meters No. of Liandna Osdo - -AU Na of Hot Tubs No. of Trsosaxro,rs Total KVA No. of Uandm mom Swimming Pool' AboveBebw UOWWKVA No. of Receptacle Oudett i No. of OU Dumas No. of Emergency Lighting Battery Units Na of Switch Outlets No. of am Bamas FIRE ALARM No. d Torras No. of Ranges No. of Air cad. Told Taal No. of Detection sad No. of Disposal No. of Has ToW Told Ton KWbddW% Devices Na Samdtng Declass No. of Dishwuhm Am space MHewing KW No. of Self Co "bW Lord Dconnecdorls®— Other No. of Dryers Heaiag Devica KW No. of Wow Hasten KW No. Of Na of sispe Bdlal No. Hydro Maasge Tubs No of Moron Told HP �`• h�t�neCb�vaaa Plssurttbless�rtmbCt'Ma®dlses�C�lls� IhnesttrrilbdvaidpoddsanbfleO� Yl� � I M§iA-� bat am °m o WOMOStait ; b ' / Signdutd l�,e�dpt*: l�tMNAitdB l `te do YESISA r)cuhatecfledoedYEKpiai� of Die �t;Al�aVAzd13tt3IWhk S Fbid LkwfieNo »ia ZE TUNa ,�� sI47S—�sa5 cad/ OWMCSMRAIKEWAM'IanauraedntdL,Li mea dleinisanecovewormai6etatrideifivalatasaY}aadbj,Mar®d>taellrGenoelLaws ardtllatmysg�ts:ondlbpmrr't� fiirrequierat (Please check one) Owrtar Aged Telephone No,FBB S- `=-- DIEFAX i1fMT0FPi1B(xSAF= pemd.t No, BQAItDOFFAI!IEPREVFIVI.MRBOLIA17g1 527a,&lam�, ,__, C+anpancy 3 FmChecked � APPUCA77ONFOR PERMIT TO PERFORMELECTRICA.L WORK ALL WORK TO BE PERFORMIN ACCORDANCE WrM THE MASSACMSM ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Da Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street d Owner or Tenant Owner's Address V",, Is this permit in conjunction with a building permit Yes 13 No E3 (Cheek Appropriate Bos) Purpose of Building Existing Service Amps 1 0 / 1-0 UVolts New Service /a) Amps/�Volb Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Overhead Overhead Utility Authorization No. Underground 0 Underground No. of Meters No. of Meters No. of Uandna Oet1ft No. of Hot Tube No. of T mmibnnsrs ToW KVA Na of Lighting Rit" Swinunins Pool Above UaWW Below Oaterstots KVA Na of Receptsels Ouded i No. of On Boeners No. of F,me Puy Lighting Battery Unita Na of Switch Oudeb No. of On Beemn FIRE ALARMS No ms a(Zo No. of RmW6 No, of Air Con L Totd Taos No, of Deteciso and Na of Dispoub No, of Had Told Told Tom KW o Na of Sounding Wkq D Derioss No. o(Dishwahen Space Mee Heethrg Kw No. of Self C6Mdhud L oed uac4 �— odw No of Dry= Hewing Devices Kw o Corurecthnrs o No. of Wow Hem= Kw Na Of No. of Sign Beib* Na Hydro Musep Tubs Na of Mom Toni HP hstmnaeCbMW PlmuirsID&MierabatMaead Itttnesttbrrtiltdveidpttnldstuedle0mtn Y$9 � I " W4D °tet f / WOdcloSMt /i)� iepedior,D�Ra�,�d Wu zkr t rmftdpe*zy HRMNAUE Gcase TA �M-rt `�� :•� tae Y do YM NO 0 aywl,�ea,eaosaY1KPhW LWofwmVby B�tivlioBDge &Wr*dvakzdPleodt Wdt s tm UD=Na -I 1'1 Zl i t BudtL'sihlNa lei 5s')/,�S ".;Slid Alt -X OWAII�R'SWSIJRAl�WA1VFRIamawaefirttkLians>:iheiraarl2ao�e�,gear;k�JLCLIIU yye�gffie4it+dbyMa�d>z�GaiaitlIsut� �L ;>rdthatrttys+gntiLaean fiispemdappicRkawrthesfiraquiems (Please check one) Owner Agm Telephone No. nmtmr 'FES �� e9+� IN APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK r^; w. WORK M BE FEMI o a kccoaDAMM went nR MASSACHussrs RWMCAL coot!, 527 cMu 12:00 j (PLEASE pRINT IN INK OR TYPE ALL W11ORMATION) Din Town of North Andover _ _ , To the Inspector of Wires: The undersigned applies for a permit to perforin the electrical work described bellow. Location (Street 3 Number) 6 Owner or Tenant,, Owner's Address" ' is this permit in conjunction with a building peruit Yes E3 No (Check Approprii0e � � ) Purpose of Building Utility Authorization No. Existing Service c�J Amps4OLVolts Overhead Underground No. of Meters New ria �,� Amp.�"Volts Overhead Urldergroupd No. of Metes Number of Feeders and Ampacity Location and Nature of Proposed Electrical Wont Na a( Liaddq OrtWr No. of He Tubi Na of Tr000bmmrs TOW Na of uowq Phrens Swims boot Above Babe Gmaaba KVA rl KVA No. of Recept" On" -70—of Na Of on Haman Na of Emaraeat7 uandna Better7 Units swim& owes Na etoar sumer FIRE ALARMS No. of Zones Na of Rapp No. of Air Conti, Taal Toga of Dbpa�ie No, d Had TOW Tod Na of DstnWns rad Tear KW Wyk f D,e1ives No. of Samd(nS Devices No. of Dirbweben Spoor Arm Headus KW Na Of SaKC=j@hW Locd Wddpd [j ❑ Commdom 011MNo. Na of Dryer Heating Darks KW of Wase Heaters JEW Na at Na of shm Edt..i. Na Hyden Meme Tabr Na of Mobs Told Hr h LIKIC bOsp era MIL" IhsMeaas�tI►iesoraeR�ig�irdrtbmpkboribstdoW Ihnesvtrriedveidpoddsuabfte0�on YM12 a4hi►ederloedlffl� d fie hR r YM NO ---by B°'D ❑ owe [� a V aVahiedamdo W -AS WodCb9oit � iepanrrrDlireRe4a�d �� Sgrred i'tritisdpri�ugr � f%MNAM �. LizwNh Lknm &*s'tliNa Addes`_ - C ouvl�t'sIIVSLAiAI�WAIVPl�IamawaeliKlieLia� �AL'Ie1Na a�diissrrps�falseanlip�ritsppiraf� fid oD�or�"br�la¢irahlte�bYl�ieMcfis�(��ILaMs (Please check one) Owner Agent Telephone Na pg� , FEE ! Mm N