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HomeMy WebLinkAboutBuilding Permit #459 - 196 ANDOVER STREET 1/15/2007BUILDING PERMIT 16 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION F Permit NO: .� Date Received -VL 1 e TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building One family ❑ Addition ❑ Two or more family 0 Industrial k'Alteration No. of units: ❑ Commercial k Repair, replacement ❑ Assessory Bldg ❑ Others: 0 Demolition El Other o Septic 0 Vell U [] Floodplain , j ❑�UVetlands ❑+ Watershed District z 0 Wates -Sewer Plc 0/11'11 I'1TI��• � __ �►=�.,r�ir 1 fUN Ur VVUKK 1 U BE PREFORMED: ���►� tJaL. a�Z�R�-rtioNs Identification Please Type or Print Clearly) OWNER: Name: 1 L� Phone �t7 r1 8133 _ i `i 1.,1 FEE SCHEDULE. BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $_"7 1,OW i FEE: $ Check No.: Receipt No.: d Jq `;OTE: Persons contracting with unregolered contractors do not have ac ss,to the mare, r. Location Mj� .S' f— ,! No. S Date t10RTM TOWN OF NORTH ANDOVM ' OL Certificate of Occupancy $ (Jl{ Building/Frame Permit Fee $ Check # 55- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ U Building Inspector 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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS 4 DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED 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 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.$10041000 fine nv i tb ana UA I A - (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 uilding Permit Application Workers Comp Affidavit ❑ oto Copy Of H.I.C. And/ r C.S.L. icenses 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 o 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) ❑ 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 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. 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