The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #01-13 - 172 CHESTNUT STREET 7/2/2012 tIO R T" BUILDING PERMIT 0F�t�ao 06Ati ►°��y°. .6 0;o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: � "oR„rEp Date Received 1SSACHU`'ES Date Issued: IMPORTANT:Applicant must complete all item�sJ on this page LOCATION Z L-A L'S NUC S /vlJ l:/l 191404d i-l`12 Hx, i�? Print PROPERTY OWNER Jul 6 Print MAP NO: r 0 PARCEL: ZONING DISTRICT: Historic District yes a Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building 4wo e family Addition or more family Industrial Iterati n No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer ?Ali DESCRIPTION OF WORK TO BE PREFORMED: Xe hin o e n '1)c90 p. (? C,,ysT fZ-OC T Lti A t l 'J-o r4 CCo k 36 F�_TIZAA" 4L1oS -e Oe 0 Identification Please Type or Print Clearly) OWNEF:: Name: 5 e/- '��y t�-l`4C_ �, ll Phone: 617-- 7/ Address: CONTRACTOR Name: -�e -} 0 A G 9 Zr —90S— Address: 1 t IU C c- s S A. ULA Supervisor'.s Construction License: Exp. Date: HomeImprovementLicense:--z 3 2- Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ / FEE: $ Check No.: 3 0 Z Receipt No.: NOTE: Persons contracting with unregistered c?retractors do not have access-to the guaranty fund Si nature of A ent/Owner Signature of contractor g. g. - . Location &Ae,06;o�T7 No. Date��/'� •'• TOWN OF NORTH ANDOVER F . ' Certificate of Occupancy 1$� Building/Frame Permit Fee _ Foundation Permit Fee $ rt Other Permit Fee $ t1, Nv TOTAL $ Check# 25470 Building Inspector Plans Submitte 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 W, COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments r4 In all 'Vater & Sewer Connection/Signature&Date Driveway Permit tha' DPW Town Engineer: Signature: r 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.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes o /U/4 DANGER ZONE LITERATURE: Yes n 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 ❑ 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 ❑ 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 n 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 NORTH own of E ., Andover No. - �A�, h ver, Mass, ' toc Micnt WIC« �'►• �ds RATES PP�,��y 1 V BOARD OF HEALTH Food/Kitchen PE R L D Septic System 64.1f THIS CERTIFIES THAT „ ........................ BUILDING INSPECTOR .............. .... ......... .... ............... , � �� Foundation has permission to erect .......................... buildings on ... .... .... ........ `��......0 Rough to be occupied as ....am'-ft. . ............ ..... .C9... .......CA.. ..... a.a.. .. Chimney provided that the person accepting this permit shall in every respect conform to A 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTR N TS Rough 3 ®® 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. SEE REVERSE SIDE smoke Det. _4Offt of Consumer Aft-airs&R siness Regulation. k -t_ iiONIE R APROVEMl NT-ONTRACTOR ' i- Registration: . 1323;5 r:: Type: Expiration: .1'1'8?2013 Dr3A ;-1.10 li wt','MERS CHOICE " JEA .AARON =.. 8•PRINCESS AVE N"CHELMSFbRD MA 0.1863 �, i Undersecretary p t - 2yx G'Ommizwea tl1 OfMaSStIchmsetts . D��Of� .e�CCld�s - Ojfree of irzvesfrga yo" 690 Washing M S&,eet -BOBIOY4 MA 02i11 Workers'Com www. L.govldia eansation3nsRnanee� yj&�Bwildersleontraetors�ecician�s/Plmnben �u�icantlnfozamation �Xease �tLe:dbly Name(JBos ' Address: Cifyr/sw * Phone#; ' Ff, employer?CheektheappMpris#e ba, 4 QT am ggwand ff andT �e Oproject(reT*edD: ew(fa and/arpat imx p havehkedfiwm&co�tQffi 6 QNewcrosiraciiOu olePmPiaw ozpatt=— Iisfed ontheaifachedsheet# 7. Remodeling haveno employees These sub-cauhactorshave formaSmanymmitl; 8. QT)eaublition ow workers coup'hs�nanw. orkers'comP.insMM 5. Q We a-re a caTcra&n andifs 9. ❑ addUnn 3.Q II affrcershatre egercisedfl 10.11 Illechicaizepai:s oradd an a homeownerdamgaIIwarTt fetofmauptionparmL 1L[]Plmftgxepansoradditiom ruysel£(No worlcros'comp. e.152,§1(4),andwehaveno hsMUMM )t cavay=-[No wo&M, 12-LI Roarepalm comp amsiuince3 13.[]Other--g�' 'apPlic�tffiatabo� lmnsEatsofiIIoutBiesedi� , rswhosubmi#fib"sa�davitmdi'�Gag$ieY� attworTcffieffwadcers compe�onpoiic3'ia�nnatiom - o��cJieckffiisbox�tad�rdaaalsd�et • sTtc►�ntgfhenameafiheand -smart empiojw#fiatFsprovidnigmnrker$' � 'oamp Po>� aIL aim esrsatiort hZnWariceforrrry ranplrrye4gk Belowis#hepolfcymtdjobante InmincecompanyNam , . :)Iicy#orSelf-ins.Lic.#: - T : h SfteAddress- Each a co3'/ elTp: py of f he workcr3s'compensation pokey declarafion page(oho ePingEhe policy mmiber and expiration date)- Lbre to secure coverage asacgdedunder SeW=25A ofM(3L,c.152 ogm leadto tieimposition ofcaimmal a t $$1,500 00 y agar one-yeardgtor. mneztt;as well al civfl penalties'a&e form ofa STOP WORK ORD S aft xp $250.08 a day againsE flee vidcatoz: De advisedfad a M*afionsofflzeDTE.furimsmrancecoveragevin,spyo£fl3isarmybe dedto$ce0r=of #. R&M ' $ofpajury #&e mform¢tionprOWedabove isimeand COM:4 - ce#: ��luse o�z7,y. Ito noftvrrteitz#ltis areg#o be eo�P7�'edby cf j'�towfz ofj`rcral ly or TOWJ: Pertnit/,L,fcease# ; AmgAufhority(circle one): Board of Health 2-R adingAepartment 3.City/ToVm Clerk 4.Xkci�ieal ?cher`_ Inspector 5 Pnumbinglasnector 22-141 50 SHEETS 22-141 ICO SnEEfS ;'W 7' 22-144 2CO SHEETS x 42,At Co o r_ -SO r, I I I i I I � 1 I I I I � +- +-1-- -+ + -- +--fi + + + + +--+- -+- -i-- --+--r + -... - i I . }--+ + I I , -r t -+-- -� -• r - +-+--�-t- I-r- -r- }-r ;--r r -F - + r + I ' I I 1 I ' I I I I � A + -4- + r M I I I h i I Al