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Home My WebLink AboutBuilding Permit #010-2017 - 17 FAULKNER ROAD 7/5/2016 ■ NORTH BUILDING PERMIT °�<z`Eo ;6""0 32 yE.;l 16 AbLr— TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN XAMINATION �401M -� Date Received �qs R^►reo Permit No# ` S "use Date Issued: 52 6 this a IMPORTANT: Applicant must complete all itemson page LOCATION 1'7 1%LL.1'�i R, PROPERTY OWNER M1C 14 rL(-r1- ?? Print A 1 oo Year Structuris�ricte yes no istrict yes 6D MAP - PARCEL: ZONING DISTRICes T: MachinHistorice Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ New Building P-0-he family ❑Two or more family ❑ Industrial edition ❑ Commercial [I Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg El Others: ❑ Demolition ❑ Other - - -- - ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ?*ater/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: PL Phone: Address: 17 � Ut—bCI�L t7 Contractor Name:Q�c�t��-�� R�"N� 6 oiLOC2�'hone: 972, -`{S7 '-051 Email: vi r-1 5 v�(� zoiy . rv�L i Address: 31-1c C-T. Ac —6v rL f Ul Supervisor's Construction License: GS 0.S�Z 8 R' Exp. Date: Home Improvement License: MOM Exp. Date:- ARCH ITECT/ENGI NEER ate:ARCHITECT/ENGINEER SLSA-TCkA- Phone: NN Address: k55- LV(NJ?R4AReg. No. C?b 77 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASEDl ON$125.00 PER S.F. Total Project Cost: $ 1 tQ ai)o FEE: $ Check No.: Receipt No.: !� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty and Location No./-)w f 'r Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 4 Apr r'f of�/ Building Inspector !/ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan IV Stamped Plans 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 m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I�'1 ll�(J� SI �aa)n� CONSERVATION Reviewed on Signature ' COMMENTS \.A � HEA-TH Reviewed on Signature MMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision: Comments Conservation Decision: Comments Wafter& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Lo ted 384 Osgood Street FIRE DEPARaTMENT TempiDumpster msite ,yes Located,of-124tMbin.,Stceet Fire•Department signature/date COMMENTS Dimension Number of Stories: 2 Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: e0y0 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) i f ® 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. i Roofing, Siding, Interior Rehabilitation Permits 4, Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 4, 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 Floor/Cross Section/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 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 Engineering Affidavits for Engineered products 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 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:Building Permit Revised 2014 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 1183000.00 m $ - $ 1,416.00 Plumbing Fee $ 177.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 177.00 Total fees collected $ 1,870.00 17 Faulkner Road 010-2016 on 7/5/2016 second floor addition I