HomeMy WebLinkAboutBuilding Permit #Exception - 172 SUMMER STREET 5/1/2018 !
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BUILDING.PERMIT. .
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TOWN OF NORTH ANDOVER bt`,t, +•,�a O0
APPLICATION FOR PLAN EXAMINATION' '°
Permit NO: Date Received prec,�P�`,�9
�SSACHUS��
Date.Issued:
IMPORTANT: Applicant must complete all items on this page.
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TYPE.OF IMPROVEMENT PROPOSED USE
Residential -Non-'Residential
New Building One family.
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
D tion Other _
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification (lease Type or Print Clearly)
OWNER: Name: `,&' L 0e A21 0L Phone: f, 1�q gZ14�
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Address: 17d- .S(�✓AVMe4 #J. ��(o� (t7 - ?0.(.=4159 Ce��
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ARCHITECT/ENGINEER Phone:
Address: Reg. 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: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty.fund
%—Eyre f� a ,Ouun - `'�T =� _ <: -,x Slnatu�e ofcontractor
Plans Submitted 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
I 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 Si nature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: 'Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Drivewav Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
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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
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NOTES and DATA- For department use
❑ Notified for pickup Date
Doc.Building Permit Revised 2010
F-
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
o Building Permit Application
❑ Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
❑ Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application ,
❑ Certified Surveyed Plot Plan
a Workers Comp Affidavit
o Photo Copy of-H.I.C. And C.S.L. Licenses
o 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
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)
o 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
ii
Doc:Building Permit Revised 2008
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0
OV
0
LIMIT OF 100' BUFFER ZONE
I
38' - o
i
121.90'
0 111.40'
0
20.93'
AREA = 130,680 S.F. 42'
40 -
o
0
20' PROPOSED POOL
1500 GALLON o
13' SEPTIC TANK o
21.3'
EXISTING r4 9•
FOUNDA TION - - -
21' - - - - - - -- - - o
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"M71-17
�% f -/sa,O
s�- - __ - _-_ - - ms
34
D-BOX - -' '----RESERVE AREA (TYP.)
43.75' LONG LEACHING
> %4 TRENCH
{ �l �" �= ' (7 HIGH CAPACITY o
/� 10 Ipp; INFILTRATOR CHAMBERS
35' loo' 1 EACH TRENCH)
Op
29'
EoEil
0
?3.95' / 92.43'
00
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� 11\-
,�00 L/MlT OF 100, BUFFER ZONE