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Home My WebLink AboutBuilding Permit #345 - 172-174 WATER STREET 10/30/2006 1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 0ORT01 1 f Permit NO: Date Received Date Issued: d �'vsSgcNUSEc�y IMPORTANT: Applicant must complete all items on this page LOCATION 1`741 S' rc�6 AKJ,"?, PROPERTY OWNER �how (� Pn � ,;�j1 (, Print MAP NO.:_1 `PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building ❑One family ❑ Addition ❑Two or more family ❑ Industrial ration No. of units: Repair, replacement ❑ Assessory Bldg ❑Commercial Demolition Moving(relocation) 1 ❑Other ❑ Others: Foundation only DESC ��TIO�1N OF WORK TO BE PREFORMED l �Cnili �itFe.�itji '� '�l'1S �js� Y L��t}�rc a4ry1. Identification Please Type or Print Clearly) OWNER: Name:—- Phone: r - 770-3�y3 Address: / n 114-1C, 0;i) Rol CONTRACTOR Name: Phone: is Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•512.00 PER S'1000.00 OF THE TOTAL ESTIMATED COT SED ON 5125.00 PER S.F. Total Project Cost :$ C? FEE:$ D Check No.:_ °.5/0 L/ Receipt No.: C Page lof4 J TYPE OF SEWERAGE DISPOSAL Swimming Pools L, Tanning/Massage/Body Art Public Sewer Well Tobacco Sales �� Food Packaging/Sales E I! Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracts with r ist red co ractors do not have access to the guarantyfiend Signature of Agent/Ow e ure of contractor Plans Submitted ❑ Plans Waive Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY , INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ r COMMENTS FIRE DEPARTMENT - Temp Dumpster on site .yes no Fire Department signature/date 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 Driveway Permit Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use Parc 3 uF4 Doc:INSPECTIONAL SERVICES DEPARTMENT:13I1FORM05 Created JXIC.Jan?006 I' I I 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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 DEPARTNIEN'r:BPF0R14105 Page 4 of Location - Na —?Y r Date TOWN OF NORTH ANDOVER \ . � ;�� }• % . Certificate of Occupancy $ . # Building/Frame Permit Fee $ Foundation PrmR Fee $ { /2 Other Permit Fee $ {` TOTAL $ w { Check * K 19746 : . a - Building Inspector �< { . vkORTH TO" Of 771 - Andover No. 0 3 over, M ?00,0 10 C1 "*0 as !Sep COCHICHEWICK 0 ATED % WARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT 4 ...... .............It ............. Foundation ,L***'**'*'**"**�**"**'**"****'*"**....** has permission to erect.. . ......................... buildings on./,7?**'r --&-wee......M�.................... Rough Chimney .....�w.....r...........4AM..A.~� . . .... to be occupied as...A A- provided that the person accepting this permit shall In every respectto the terms Wt6- p'iiiiion on file in Final 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 ai PERMIT EXPIRES IN 6 MONTHS n � T ELECTRICAL INSPECTOR UNLESS CONSTRU ON S S Rough Service ....... .............. ................................................................................. BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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 IeL Street No. SEE REVERSE SIDE Smoke Det.