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Home My WebLink AboutBuilding Permit #436(Trailor) - 200 CHICKERING ROAD 3/25/2003 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING M OTHER THAN A ONE OR TWO FAMILY DWELLING g+ya�' .3%E"� 1 R � ro '•Ee�.:: � .# ".'� �'3us�,-� ='k�` '' 4tS+ ..�,.7 3 3 .4 k„_ � N Fwyx ,. _ This Section for Official gT3e®n1 , . , a is BUILDING PERMIT NUMBER: DATE ISSUED: Iq-r LrEtL 2om3 Z SIGNATURE: Bulldln Commissloner/I or of Buildin ate 1.1 Property Address: 1.2 Assessors Map and Parcel Number: bZ o c�:) d-kk 1.t��!u Gt 12n�O Map Number Parcel Number A 1.3 Zoning Information: 1.4 Property Dimensions: v Zoning District Proposed Use Lot Areas Frontage(ft) m 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal On Site Disposal System ❑ 2.1 Owner of Record Name(Print) V Address for Service: m Signature Telephone 2.2 Authorized Agent t Name Print Address for Service: Z 0 Signature Telephone Z 90 3.1 Licensed Construction Supervisor Not Applicable ❑ Address License Number 0 ~ Licensed Construction Supervisor: Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name'. Registration Number M r Address r Expiration Date Z Signature Telephone F Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea.......❑ No.......❑ s�cT>EON s >P>�v��r�a�.��>��lvs�tt�cac>l�N�� >��l »�s ANS►s �r�»s a.��r'pro G`ONSTI�IIG1I[tBN T OII "TSD�8Q l tt 16( N A N M� ,, C F d3 E C'L 1S1 ]m PA 4 5.1 Registered Architect: Name: Address Signature Telephone _�.2 ReSterec�:�'t�►Ye$st�»>� $ {� . . x Area of Responsibility Name: Address: Registration Number Expiration Date Signature Total Not applicable ❑ Name: , Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number ` Signature Telephone Expiration.Date tY Not Applicable ❑ Company N ame: ' 6n Z,,077Oj7a17 _4Q4/CIO ,01 L Responsible in Char' of Construction °:5�t�'!` ,i�;�!� ''T1►1+��l@'�� O „��eck all,appjaeable),� ,« y New Construction 0 Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition El Accessory Bldg. 0 Demolition 0 Other ❑ Specify Brief Description of Proposed Work: USE GROUP Check as applicable) CONSTRUCTION TYPE ` A Assembly 0 A-1 0 A-2 0 A-3 0 IA ❑ A4 0 A-5 0 113 ❑ B Business ❑ 2A 0 C Educational ❑ 2B 0 F Factory 0 F-1 ❑ F-2 0 2C ❑ - H High Hazard ❑ 3A ❑ IInstitutional ❑ I-I 0 I-2 ❑ I-3 ❑ 3B ❑ M Mercantile 0 4 0 R residential ❑ R-1 ❑ R-2 ❑ R-3 0 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft 71071 Independent Structural En . eerin Structural Peer Review Raluired Yes ❑ No 0 SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date ,a. I, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date Item Estimated Cost(Dollars)to be Completed by permit applicant ` 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from(6) 3 Plumbing Building Permit fee (a)x(b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number r- 5 MOW,, '11,1111,11 F n'rs'Y rr''!'�r. .- 4T a,'`� �':1 � 7 1 t ,� ,. ' N t ��' r �. ✓ iv ' yF NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlVIBERS 1ST 2ND 3 P SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DM ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING jX MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ggggvg �.� �., t OC-NORTH Town Andover..... . No. (4 (0 (tM%itam) plff A L A �o dover, 1liMass., M&C . 2'S. 200 COC MIC W �.9 DRATED P? C7 S BOARD OF HEALTH od/Kitchen PEMMIT T D Se tic System • UILDING INSPEC R THIS CERTIFIES THAT /�/!liQ..1.: V /�' Imo/..... ♦E, ... ...........:........ ..................................................................�.�..W........................................................ Foun tion • has permission ........................................ on ...?W."..444 4 c. /..11�( .... 0.��....... Rough to be occupied as.....v.% . ..... !!e `�T.iy.� ,�� ,� 00--M. , � Chimney provided that the person accepting this permit shall in every respect conform to the terms of the apoli`cation on file in V 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. Tviii:µ%%t— iNPLUM GIN PECTOR WS VIOLATION of the Zoning or Building Regulations Voids this Permit. � W 6,' Rough Final PERMIT EMPIRES IN 6 MONTHS UNLESS CONSTRUCTION T.AR ELECTRIC A INSPECTOR Rough Fr ................... .............. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building G INSPEC R Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burne RE DEPARTMEN Stree-No. SEE REVERSE SIDE smoke Det. NORTLj Tovm of � E � Andover ,...' 0 . _ s O A LAny dovea�, Mass.,, /r11 . 24_ 2003 �o�� W ORATED S BOARD OF HEALTH PERMIT T D od/Kitchen Se tic System ' • UILDING INSPEC R THIS CERTIFIES THAT...........:... N DN /1'�T��h9'/l� •.i+.l �, '='�u C. ................:....................................... Foun tion has permission ................................ n ... 0... 4`�. �. .. 0. ....... Rough to be occupied as.... -h�4. .....�;rPl!a�l •7.i�y.T�/ ►Lt . . �,� 1 � e1Sy/� chimney provided that the person accepting this permit shall in every respect conform to the terms of the a0lliCccation on file in V this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Final p Y � 9 p Alteration and Construction of. Buildings in the Town of North Andover. �,�,�' �scf�i�� y,j j PLUMIlffIN, PECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ` Ion t�R�rr1 Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION TAR ELECTRIC INSPECTOR Rough .......... .. ..... .......... ......... ........ ....................... .............. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building G INSPEc R Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. RE DEPARTI�IEN Burne Stree No. SEE REVERSE SIDE smoke Det.