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Home My WebLink AboutBuilding Permit #435-2016 - 19 MAYFLOWER DRIVE 10/6/2015 BUILDING PERMIT of No DT b qti TOWN OF NORTH ANDOVER 02 F APPLICATION FOR PLAN EXAMINATION - ell �` '� (� n1 : h Permit No#: " / 4"I Date Received J" i �•4 A�RAren�ea�,(5 1 SSACHUS Date Issued: I IMPORTANT:Applicant must complete all items on this page LOCATION f iQyf'�otyB� bje• 64-o/ .3,<J Print PROPERTY OWNERe vim, &c Print 100 Year Structure yes no MAP /D? PARCEL:Oa 6 ZONING DISTRICT: le Historic District yes o Machine Shop Village yes C�i_b TYPE OF IMPROVEMENT PROPOSED USE Resid ntial Non- Residential ew Building k6ne family ❑Addition ❑Two or more family ❑ Industrial [I Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ¢ Septic D Well ❑s Floodplain 0 Wetlands ❑ Watershed District DESCRIPTIgqN OF WORK TO BE PERFORMED: �r�SJ'�Gj'�ov! o� S,'.�d�' �•�m,L,! a /1 G��e � GGod� t�,0�AO Identification- Please Type or Print Clearly OWNER: Name: �. ',we mac• Phone: !f7''643 Address: D ZrG# paw" Contractor Name: t&i t�'- "04010 Phone: 6-NY 3AR -eyo Email: e ,ee, Pe,,A Address: 91 OV G s ae, ovo �J o/8'f/S Supervisor's Construction License:-C S 07330 Exp. Date: Home Improvement License: Exp. Date: , i ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.001 PER�S.F.�c�Z7�5 T D r Total Project Cost: $ _� y � `7 FEE: Check No.: L I-] / Receipt No.: �1 p I NOTE: Persons contracting ith unre ist�d contractors do not have access to the gu my fund hn'n ran Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL r Public Sewer ❑ Tanning/Massage/Iiody 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 Reviewed On Signature_ COMMENTS . I i CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments 7kWater& Sewer Connection/sinature & Date Drivewav Permit DPW Town Engineer: Signature: :FIRE Located 384 Osgood Street � DEPARwTRMEIVT f.yTernp Dum{�'J�'sfer onssitef lV }' (y(r�` Y ted at 12' 'seY Y :031._. a .,.y. iJ��::.J t .Hvx.'..w .dn, _ �tiLoca e�j. _ 4IUIainStreet, [ T-�Qb gnafure/date� f -C®MMENTxS. L 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: lies No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) i i ® 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. 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 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) iL 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 Doc:Building Permit Revised 2014 LG4 15 Location -2- -�` • No. ` 3h — '�C�{}' Date 'U (p . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ wU E Building/Frame Permit Fee $ Foundation Permit Fee $ _ iA � Other Permit Fee $ TOTAL Check# �/ r Building Insy'ec or