HomeMy WebLinkAboutBuilding Permit #1190-16 - 1661 GREAT POND ROAD 5/1/2018 BUILDING PERMIT of No D b�tip
TOWN OF NORTH ANDOVER0
APPLICATION FOR PLAN EXAMINATION
Permit No#.
• /�I Date Received
�SSACHLIS�4
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION
'Print
PROPERTY OWNER -7 1<7- LLC.
Print 100 Year Structure yes no
MAP �� PARCEL: ) 2- ZONING-DISTRICT: Historic District yes no
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
,[ New Building bKOne family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
El Demolition ❑ Other
O Septics ❑Me I4 ® Floodplain Wetlgands W_ atershed ® tract:
DESCRIPTION OF WORK TO Bq PERFO MED•
S � r �n� 54 ry - v
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address: % �' 01 Jul A
Contractor Name: Phone:
Email:
Address.: St ZQ o >-k A a-
Supervisor's Construction License' 2-2 7- Exp. Date:_ .
Home Improvement License: - Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No. _
FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ fl-Tlo FEE: $ /D(J.66
Check No.: /76/ Receipt No.: �0.5 7
NOTE: Persons contracting with unregistered co ctors do not have access to the guaranty d
Plans Subrnitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ i
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Swimming pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
' PLANNING & DEVELOPMENT Reviewed On w � Signature
-M
COMMENTSu
o uYs &.�+ +D
CONSERVATION Reviewed on h Si nature d `�
COMMENTS_Qc,vsr,�„
10 \ lc,
WEALTH Reviewed on �' �.`( Signa CCS _
A
COMMENTS wekol\ ur;
Zoning Board of Appeals:Variance, Petition No: 2a(C'00Zoning Decision/receipt submitted yes
Planning Board Decision: �rM3 Comments
JConservation Decision: '7&j/- 3 Comments
Water& Sewer ConnectionlSi nature& Date -4- Driveway Permit
!ti.�,
DPW Town Engineer: Signature• n6Y,` li /46
Located 384 Osgood Street
` FIREDEPARTMAENT -;Temppts e�onts teyes "
Locate at 1024 Mainreet
Fire Department� g atur /e date `/
E NTS---
Dimension
Number of Stories:_ Total square feet of floor area, based on Exterior dimensions.Z2,20
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector -- Yes No
DANGER ZONE LITERATURE: lies No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA,— (For department use)
nolyi
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® Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014
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
OTE: 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
4. Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
4 Mass check Energy Compliance Report (If Applicable)
Engineering Affidavits for Engineered products
OTE: 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
2012 IECC Energy code
4� Engineering Affidavits for Engineered products
from Fire Department prior to issuance of
Bldg. Permit
OTE: All dumpster permits require sign off fr p p g
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 Revised 2014
Location
No. f� Date
• • TOWN OF NORTH ANDOVER
. Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ r
Check#
Building Inspector
� NORTI-�
Town of A
0
No. a6Y er, Mass ' f� e�.
1 � ' I v ,
°gyp coca��ewIc«
S U BOARD OF HEALTH
PERMIT T LD Food/Kitchen
Septic System
BUILDING INSPECTOR
THISCERTIFIES THAT ........................... ......,........................................................................................
Foundation
�. ,i�L' fs/lfC ...........................
has permission to erect .......................... buildings on ................
61,A4 0� f
Rough
to be occupied as T /` �'.......... Chimney
provided that the person accepting this permit shall in e'iiery respect conform to the terms of the application 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
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT-EXRIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION RTSRough
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.
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