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HomeMy WebLinkAboutBuilding Permit #Exception - 199 STONECLEAVE ROAD 5/1/2018 pORT11 BUILDING PERMIT 01* 4,L.ZD ,6Atio TOWN OF NORTH ANDOVER 3? -�` °� APPLICATION FOR PLAN EXAMINATIO Permit NO: Date Received t p0RATl0 �SSACHU`��� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION .Print ,._ PROPERTY OWNER Print = MAP.NO.. : PARCEL °ZONING 1STRICT H stonc-DJstrict .yes pie} Machine Shop Village yes n- i 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 a _ Septi V11e11 Floodplain 1Netlands UVatershed-District ater/Sewer _ , DESCRIPTION OF WORK TO BE.PREFO"ED- Identification Pleao Type or Print Clearly) 14 OWNER: Name: gjfdtelyk-/ Phone: Address: C CONTRACTOR NaOt- rte., fE=/rda Phone,``; Address , Sperviso:r°s Construction License: Exp Date Hm oe Impro ifnent License: Exp ljate ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 5igraature of Agent/Owner � gnature of contractor it 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 i,( �J� Signature COMMENTS OU l 10,-/ak 0(-"C� HEALTH Reviewed on VL­jDg Signature COMMENTS . _'�V©v 4. z_-Kc_ c? 1, / L � , s•�r- 7 0 111'�5t 12 � 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 DPW Town Engineer: Signature: I Located 384 Osgood Street FIRE EPARTMENT -Temp Dumps#er4°on site yes no .:Located at'1.24 Main Street:, �; - r . Frre,Dj artmeritsfi6ture%4a#e =s. COMMENTS 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 2 1 A—F and G min.s100-s1000 fine NOTES and DATA— For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 I �I Building Department I 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 o 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 o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o 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 �1 New Construction (Single and Two Family) i ❑ Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report o 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. 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 2.2008 or /99 STOI✓JE C,L E PV k /Q CERTIFY 7'NAT 7HE?e/S7'/ - NC Dw�1.J./n/C 15 .LGCF7TE'D RS S-To WE'RS AS.>0C/f7T.Zs l /y er rN -zON/NC � O-v/RX/�xNYS F / /�,EG ,L NNV SvpwzyoRS Or NORTH /�NDOYkR 1✓/TN.RESYd� f7PR». 240 /`>,FTNu N, I"JFaSS. 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