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Home My WebLink AboutBuilding Permit #655 - 1915 GREAT POND ROAD 4/9/2007BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ` Date Received Date Issued: C" r p tt�e° �6�•ry� pop OWNER: Name: DESCRIPTION OF WORK TO BE PREFORMED: Please Type or Print Clearly) ARCHITECT/ENGINEER Phone: Address: - Reg. No. - .() FEE SCHEDULE: BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 00() FEE: $ Jf! Check No.: % Receipt No.: C;2 6// 0 NOTE: Persons contracting n unregistered contractors do not have access to the guarantyfund i Signature of Agent/Owne"A�IA Signature of contractor C,' 0 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEYELOPIIi'IENT ❑ DATE APPROVED av COMMENTS .. , /!�. �,,, 4 4,,, , CONSERVATIO ATE REJECTED DATE APPROVED COMMENTS/, u.i DATE REJECTED DATE APPROVED HEALTH COMMENTS ■❑ 0 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 ❑ Zong Board of Appeals Planning Board Decision: Conservation Decision: Variance, Petition No: Zoning Decision/receipt submitted yes Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street 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.s100-s1000 fine NOTES and DATA — For department use ❑ Notified for pickup - Date ......................................................................................................................................................................................................................................................................................................................................................................................................................................................... ....................................................... 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 Addition Or Decks o ,Building Permit Application O Certified Surveyed Plot Plan ❑ Worker-s-G6mp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract _o—FlooriC ossection/Elevation Plan Of Proposed Work With Sprinkler Plan ,Arad-Hydfaafie-Calculations (If Applicable) ,—Ness-Gheek--Energy Compliance Report (If Applicable) -Q--E-ngi*reeTjng-Affidavits for Engineered products 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 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 2.2007 Locaiion No. Date TOWN OF NORTH ANDOVER f, 20'110 Buil ing rnspector Certificate of Occupancy $ MU Building/Frame Perm it Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # f, 20'110 Buil ing rnspector E i W O A'V 0 W ��?Co V)41 o u G G U w a a a W a UW W O 501 w O O EM4 O O .3 w Q., O CD ■ CD Z p. O y G c CD cm C C O■� VDCD p C40) O O ._ m m o CD CD O� di Cc O d S Q o =� c ev •v = O CD ts c Z CD �..� GG O c c •� •� C cc y p Ul U) o� W W 19 W H lx - 67 Date ...... ..... A'114 O --R1 - 12 - �-71 �-� 4. TOWN OF NORTH ANDOVER 00 This certifies that PERMIT FOR PLUMBING has permission to perform -- r --------- - --' plumbing in the buildings of— at A?X5 . . .......... . Fee.�RO .'. . Lic. No .......... Check # "� ;z 7393 North Andover, Mass. I ................... ING INSPECTOR MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location �cj I`� cz��-t- %n 4 owners Name �oc- � 1 Type of Occupancy New Renovation Replacement ❑ FIXTURES r) +( Date 3 �� Permit # 729 9 j Amount AD - Plans Submitted Yes ❑ No (Prinor type) Check one: Certificate Installing Company Name 7� L F4 �I - Corp. Address Z, -A. TrEe-f— ❑ Partner.' Business Telephone p Firm/Co. Name ofLicensed Plumber. L WC! V1 Insurance Coverage: Indicate the insurance coverage by checking the appropriate box Liability insurance policy Other type of indemnity Bond Insurance Waiver I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three ' surance Signature Owner Agent ❑ I hereby certify that all of the details and information I have best of my knowledge and that all plumbing work and istal compliance with all pertinent provisions of the Massac ITrtle D (OFFICE USE ONLY in above application are true and accurate to the rf it Issued for this application will be in end 5�iapter 142 of the General Laws. Type of Plumbing License a�- License um er Master Journeyman ❑ Date ,40RTH 0*"". 41 0 Ak TOWN OF NORTH. ANDOVER 0 PERMIT FOR GAS INSTALLATION . .. ........................... This certifies that . . . --/ . . has permission for gas installation--'--<� .. ........... in the buildings of 0 -U-5 ..... C ..................... ................. ..... N th Andover, Mass. at . t Fee/4V . Lic. No ........... . . . ... . . . . . "&�� ............ Gi;:I�N46C�OR Check # 6000 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations I q IS �d► �'�� Owner's Name New,Renovation Replacement Date A Permit # Amount $ Plans Submitted 11 (Print or ty ) j Name /G�SGR� ?"b 1 P?,q Address C k one: Certificate Installing Company Cff Corp. 11 Partner. Firm/Co. _ Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE k one: I have a current liability Insurance policy or it's substantial equivalent. Yes c� If you have checked ves, please ind'cate the N0❑ Liability insurance otic hype coverage by checking the appropriate box. h' policy _ Other type of indemnity 13 Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit app:::heck aives this requirement. Signature of Owner or Owner's Agent one: Owner 13 Agent I hereby certify that all of the details and information I have submitted (or ntered) in above application are true and accurate to the best of my knowledge and that all plumbing work apd installations o d u r Pe it Issued for this application will be in compliance with all pertinent provisions of the Massachusetts ate G o nd C e General Laws. 13y: '15Tgnature of Licensed Plumber Or Gas Fitter Title 13 Plumber City/Town/) 5-ec) Gas Fitter (cense Numner aster APPROVED (OFFICE USE ONLY) 1 Journeyman SUB-BASEM E BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR STH. FLOOR Z $ z F (Print or ty ) j Name /G�SGR� ?"b 1 P?,q Address C k one: Certificate Installing Company Cff Corp. 11 Partner. Firm/Co. _ Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE k one: I have a current liability Insurance policy or it's substantial equivalent. Yes c� If you have checked ves, please ind'cate the N0❑ Liability insurance otic hype coverage by checking the appropriate box. h' policy _ Other type of indemnity 13 Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit app:::heck aives this requirement. Signature of Owner or Owner's Agent one: Owner 13 Agent I hereby certify that all of the details and information I have submitted (or ntered) in above application are true and accurate to the best of my knowledge and that all plumbing work apd installations o d u r Pe it Issued for this application will be in compliance with all pertinent provisions of the Massachusetts ate G o nd C e General Laws. 13y: '15Tgnature of Licensed Plumber Or Gas Fitter Title 13 Plumber City/Town/) 5-ec) Gas Fitter (cense Numner aster APPROVED (OFFICE USE ONLY) 1 Journeyman SUB-BASEM E BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR STH. FLOOR (Print or ty ) j Name /G�SGR� ?"b 1 P?,q Address C k one: Certificate Installing Company Cff Corp. 11 Partner. Firm/Co. _ Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE k one: I have a current liability Insurance policy or it's substantial equivalent. Yes c� If you have checked ves, please ind'cate the N0❑ Liability insurance otic hype coverage by checking the appropriate box. h' policy _ Other type of indemnity 13 Bond 13 Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit app:::heck aives this requirement. Signature of Owner or Owner's Agent one: Owner 13 Agent I hereby certify that all of the details and information I have submitted (or ntered) in above application are true and accurate to the best of my knowledge and that all plumbing work apd installations o d u r Pe it Issued for this application will be in compliance with all pertinent provisions of the Massachusetts ate G o nd C e General Laws. 13y: '15Tgnature of Licensed Plumber Or Gas Fitter Title 13 Plumber City/Town/) 5-ec) Gas Fitter (cense Numner aster APPROVED (OFFICE USE ONLY) 1 Journeyman