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Home My WebLink AboutBuilding Permit #163-2012 - 166 SALEM STREET 8/29/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: p Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION S rT ,Pr' PROPERTY OWNER T 6 +1 Unit# Print MAP NO: _PARCEL: 9 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes no FE01PAddition OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building 0 One family ❑Two or more family , ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacem(eh -❑Assesso Bldg 9 - 11 Others: ❑ Demolition ❑ Other _ rept c OWelly �,Floodplain []W�etlands r ® t Fatrshe Wed Dlstnct .O.Water 1')Va DESCRIPTION OF WORK TO BE PERFORMED: i r U (Identific tion Please Type or Print Clearly). OWNER: Name: w r Phone: Address:_--577 1011)!!� )fiJd0U r r V-- CONTRACTOR - -CONTRACTOR Name: Qppr,t/ ' kO Pfij�phone: L1-19-m gr Address: R.0 � i Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PEVIT:$92.00 PER�$ 000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project ro ect Cost: 7 1 $ � - FEE: $- / , D Check No.: 3 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have accesWithy, nty f ndreureofc_ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools El Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on-Site- THE nSiteTHE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ l� COMMENTSkpl-ag��l CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature {1 COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Pla*nning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/si natur at =Drrivewayt S�� j Ck.1n t. DPW Town Engineer: Signature:- ---64ood Street �srY Located 3 O gs FIRE DEPARTMENT -Temp Dump�on yes no Located at 124 Main Street i. Fire Department signature/date h . COMMENTS 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 k i k l i i i i ® Notified for pickup - Date I Doc:.Building Permit Revised 2011 June/mi i I �� i LIM Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. j 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 'j ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan An Hydraulic Calculations (If Applicable) d ❑ 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 BldgPermit rmlt New Construction (Single and Two Family) Li Building Permit Application o 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 MOTE: 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 Doo: Doc.Building Permit Revised 2008mi Location No. &y _ 6/ Z Date Of NORT:,h TOWN: OF NORTH ANDOVER Se 41 }0 i. Certificate of Occupancy $ CMUs,� Building/Frame Permit Fee $ /Z` Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �f. +'1 Check # �01 zz- 2 4 5 t .G 4MOding Inspector AORTH ® of over 10�, lover, Mass., Y O LAKE COCMICMEWICK �s RATED U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System �I / BUILDING INSPECTOR THISCERTIFIES THAT................................................................................................ .............................................................. Foundation s buil n s on ... ' .........! ..................................... Rough has permission o erect....... ....... . g ,l�?.�.......f.... g � _ 167M e ' Chimney to be occupie ................................................................................................h.... ... .................................................... . provided that the person accepting this permit shall in every respect confornf to the terms of the 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. �,-. ,�/cr �. j , Ar�/, r.��l- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS ARTS Rough .............................. .R.`.'.. •••✓••` `^ ,,................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy 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 SI®E Smoke Det.