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Home My WebLink AboutBuilding Permit #385 - 19 SAMUEL WAY 12/9/2008 BUILDING PERMIT of N°DTH qti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ,ys R,T.o'P"��y. SACHUS� Date Issued: /1 IMPORTANT: Applicant must complete all items on this page r -T r LOCATJON ?` !t 1 ' P- L nnt a= v . l PROPERTY OWNER - _ l '`'°t `` .,1:�. "�'�U � r Print ' MAP'NO PARCEL: ZONING:DISTRICT,:--. ' Historic District R yes Jono =M6 hine S;hbb ,illage _yes TYPE OF IMPROVEMENT PROPOSED USE Resid Non- Residential New Building One family Addition I wo or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other ". Se tie :Floodplain Vlletlands= Watershed District ' �W�ater/Sew r r . - .W 41 Al CRIPTION OF WORK TO BE P EFORMED: t� Luty 1 -- t4�-C>e-4 �-- Identification Please ype or Print,Clearly) OWNER: Name: Phone�76 Address: CONTRACTOR Nerve: Address w. Supervisor's Construction License 5 V 9 _Exp. Date:O?I 1 20/ Horace Ir provenient.License. z _ - •moi ��i�Mi� RCHITECT NGINEER Phone: 0)7 37/ 77 Address: M TALs�t-r��' SC��/ � Reg. No. D R 4 FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �� L- 1'2 fc40V FEE: �lJ 2 •� Check No.: Receipt No.: .4 / 7 -/'5K NOTE: Persons contracting with unregistered cq> tTct redo not have access to thegm signature of,Agentl Signature of contractor` M_ 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 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on S Signature y COMMENTS V HEALTH Reviewed on Signature COMMENTS s Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comment Water & Sewer Connection/Si natur D DrivewayPermit DPW Town Engineer: Signature: _ Located 384 Osgood Street 'FIRE DEPARTMENT Tome DtApsteron site- yes no s.L�acated-at 124 Main Streets a ,f= T Fire Dep�r merit-sianatuire/date; ,- COIVIMENTS Dimension Number of Stories: 1- 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 j DANGER ZONE LITERATURE: Yes No 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 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 ❑ 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) 1 ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o 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 offce 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 Application Revised 2.2008 Ij r Location No. Date TOWN OF NORTH ANDOVER ; , t Certificate of Occupancy $ `a '��i ;.�'• Building/Frame/Frame Permit Fee $ a �!• 9 Foundation Permit Fee $ / U Other Permit Fee $ TOTAL $ Check # 21744 ,wilding Inspector i q.1ORTH c Town of- ower ..L \o• 4 - C, o dover, Mass., T O �- LAKE ^. COCMICMEWICK A�RA7E0 PPS\ `S BOARD OF HEALTH Food/Kitchen . � PER M, IT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ . .........................: Foundation ............................... ... .... has permission to erect....... g .... .�� r �� ' ......................... buildin s✓on . �.:. . .... ......... .�;.................................. Rough / �' rf �'r �r r°i' Chimney to be occupied as................::..........:... ..........:......:.:...:........:................ ... .............................. provided that the person accepting this permit shall in every respect conform to the terms of the application 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, And PLUMBING INSPECTOR VIOLATION of the Zoning or, Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS �T . -T7 g� ELECTRICAL INSPECTOR. 'UNLESS V LESS CONST RT TC 1 ION STARTS ' Rough ...,� �:..;sc ' =: .:' � : .... Service BUILDING INSPECTOR Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina, 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. I , . �9assachusetts - Department of Public $A'0N Board of Building Re-ulations and Standards { Construction Supervisor License License: CS 99769 Restricted to: 00 AARON SASSEVILLE 24 BUFFUM STREET SALEM, MA 01970 Expiration: 7/24/2011 < nuni.,aiuicr Tr#: 99769