HomeMy WebLinkAboutBuilding Permit #158-111 - 196 MAIN STREET 8/24/2010 BUILDING-PERMIT of "°RoT�{
TOWN OF NORTH ANDOVER 02
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
' SACHUS�
Date Issued:
/IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more•family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification PIease Type or Print CIearly)
OWNER: Name: Phone:
Address:
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ARCHITECT/ENGINEER Phone:
t
Address: Reg. No.
FEE SCHEDULE:BULD/NG PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$123.00 PER S.F.
Total Project Cost: $ -000 d• « FEE: $
i Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have a cc ess to the guarantyfund
enrux�eT _, _:. P= anauTeco � ,:.
Plans Submitted Plans Waived Certified Plot:Plan Stamped Pians
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/MassageBody 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 Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Ztning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/ ermit
DPW Town Engineer: Signatiire:
Located 384 Osgood Street
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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.$100-$1000 fine
NOTES and DATA— (For department use)
❑ Notified for pickup - Date
i
Doc.Building Perrot Revised 2010
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
n Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ "ass 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
❑ !r I lif led 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
i
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 2008
Location�� 111141,1 S I,
No. Date
TOWN OF NORTH ANDOVER
0 • • AL -�
• k
• ; . Certificate of Occupancy $
Building/Frame/Frame Permit Fee $
s+cMuse 9
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
L
Building Inspector
� NORTIy
ToVM of
0
No. _ v
0 o dover, Mass.,
0 LAKE
COCKICMEWICK
�.
7�S RATED PP�,��y
BOARD OF HEALTH
Food/Kitchen
.PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT
Gd.......zez;'0�1
Foundation
has permission to erect.................................... . buildings on ...... ........ %/ � .... /.. .............................. Rough
to be occupied as...........,J� �1.�- -...... 1..... ........ ,r.�.....4.d}!!,�. V.�1. �... . ....�. ........ Chimney
provided that the person acceptingthis permit shall in a respect conform to'the terms of the applicatio" 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
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRU O TARTS - ELECTRICAL INSPECTOR
Rough
.......... ...................... Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Ocatpy 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
Street No.
SEE REVERSE SIDE Smoke Det.