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Building Permit #519 - 172 CORTLAND DRIVE 4/2/2009
BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION s 0J Permit NO: i I Date Received Date Issued: ' IMPORTANT: Applicant must complete all items on this pasze LOCATION t c-tlA J -Dr`k (UP T 3s), Nd r`% / Vk e, t", M PROPERTY OWNER C l E -nt o j,, L C lePrint MAP NO:) PARCEL: I ZONING DISTRICT: ff _Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Reside 1 Non- Residential -w Buil ' g Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Se ticell Floodplain Wetlands Watershed District aterlSew DESCRIPTION OF OWNER: Name: M PREFORMED: Type or Print Clearly) v -ms L C.C. Address:_ u. �i , 1J, .Ay�w-�T, CONTRACTOR 'Name:1r m Yt auQ-(rva Phone: 4 Address f/ (.-F)c iy ; N —A ,LN, � r, M Supervisor's Construction License:_ ©S"S� ) -7 Exp. Date: Home' Improvement License: Exr). Date: ARCHITECT/ENGINEER Phone: WW..T.0 Address: - kReg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ /06). Check No.: NOTE: Persons contracting with aturewof _Receipt No.: tors do not have access to the aranty d iature of contractor 6 Location No. Date 4112 0 r TOWN OF NORTH ANDOVER to Certificate of Occupancy $ A—�„s t� Building/Frame Permit Fee $ Foundation Permit Fee $ 0 Other Permit Fee $ TOTAL $ Check # 117 i3 21 963 A Building Inspector E Sbumitte� Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL TanningimassageBody 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 PLANNING & DEVELOPMENT COMMENTS — C� CONSERVATION COMMENTS ,%� HEALTH COMMENTS (9, Reviewed on /0 Reviewed on DATE REJECTED DATE APPROVED i 0 /�V�) - Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: JV %} Comments Conservation Decision: 2 YZ _ I 1 I 1 Comm Water & Sewer Connecti DPW Town Engineer: Signature: —2-0y / /— Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes ) no Located at 924 Main Street Fire Department signature/date,�,cn"`- COMMENTS Dimension I Number of Stories: I 2 Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: _ 3 , 2 � � ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A 7 and G min.$100-$1000 fine NO Doc -Building Permit Revised 2008 i 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 ❑ 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 ❑ 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 "ALE SMET ii ... ... . ... COU �015tb� , j,e MAX HUX �x Mfii III Hill ROO PIN h.- 9 MAT 9,8 Val PT.; 2T ;X,16 E �, <v It g U Wa 0 0 W cd O c o a 77 o C c w a z o � C m a s V: za L • a z w c V m c 0 as � M" , v ►.a as q co c o o v C U w � a o ci; c � U a w o u � bo o o4 G w w x w v o z U) Q o cn ui E L. if M Z ti O N C CD m CD C m 0 co c �C N O t O Z 0 J CD zip ECO 72 IN r�J v z 0 U E O O s Z °o CL O y � C I cCM CO2 QCO2 CD C .ff /MW W CD 0 CD CD � 3 O C O O O O' a �a c COD ev d O .tOCOD .r CD O Z 0. C.3 C O c y D c o E¢ o C c w o � C m c oCL s V: L • a V1 c V m c V E L. if M Z ti O N C CD m CD C m 0 co c �C N O t O Z 0 J CD zip ECO 72 IN r�J v z 0 U E O O s Z °o CL O y � C I cCM CO2 QCO2 CD C .ff /MW W CD 0 CD CD � 3 O C O O O O' a �a c COD ev d O .tOCOD .r CD O Z 0. 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