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Home My WebLink AboutBuilding Permit #264 - 200 CHICKERING ROAD 11/13/2002 (3) TOWN OF NORTH ANDOVER BUILDING DEPARTMENT " m APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING rj This Section for Official Use Onl 17r;. - 'E=* .�-i.-.:.y..`Z. a:+',.."`..L+•?t 3C. �,.-Fs`' d.�.E: BUILDING PE ER: DATE ISSUED. �7, ..i Z i IC Buildii Commissioner/IRor of Buildingsto .W I L '2� 1.1 Property Address., 1.2 Assessors Map and Parol Number: (� °'— Map Number Parcel Ntimber 21 �a 1.3a,,4oning Information: 1.4 Property Dimensions: Z.7 � t Zontn Distric -i;r Pr used Use Lot Area(so Frontage ft M . 1.6 BUILDING%SETBACKS(ft) 7: Rear Yard Required/` : Provide R airedovided Required Provided A _ 5. Float Zane information:/ 1.8 Sewerage Disposal System: W 1.7.Wat7 S°ppyM.G.L.C:40:- ..SS) Public Piivate,- ❑ Zone Outside Flood Zone Municipal X On Sitz Disposal System ❑ 5BC�I€h� FIOP>eRY Q�4,NIER ! �id7,EU AA1,F`I` r 2.1 Fwnerof Record /' �/ ( \ Su-i'oMt . tree T 1 �. doK e� $`!S Ol Na Pri / ;:' A dress for Service - _ 91 � 69'1 -6k00 m Signature Telephone X 2.2 Authorized Agent �^ v Gt Chanre Ad iI corporalQ Vrlve Name Pri Address for Service: Z ✓far 601- GLI- R 0(?Q O Signature Telephone M m 90 3.1'Licensed Construction rvtsor Not Applicable ❑ N 404 1�� o C S 6 V � Address License Number \Al-t Ca At Cori - 63341 Licensed Const cti r: D `)-1 _0''� > Expiration Date �- 603-9-15- 8381 Sign re Telephone 3.2 Registered Ho Improvem ntractor Not Applicable ❑ RECEIVED �S Company Name Registration Number N 0 V 0 7 2002 r Address III r Expiration Date T. Z Signature Telephone Q SECTION 4 WORKERS CO (ImmC,15Z 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.......❑ SECTION.5-PROFESSIONAL DESIGN AND CONSTRUCTION SERVIM FOR BUI7AIl�tGS A1!ID STRUC'IURES SIJB3ECT TO CONSTRUCTION CONTROL-PURSUA�TO 780 CMR 116;CCONTAININO MORE:�D 35,000 C F OF ENCLOSED SPACE) 5.1 Registered Architect: I ' l�es`Cy o,� a c h � �,FiEQ Aq�,�l Name:: �g 41'f6 d N $5 Address TON.of , Signature Telephone 5.2 Registered.Professuat Engineers - f.t.M41 SS�1r. 5P.,Lt--- k 141Ht)U1 Area of Responsibility IA OF Name: 7 HOSS \ 336 `\ SALEW, AU1UM►� ' `S�`• g $�`2TSV-1 t,LS , �N C'1.380 i Registration Num STRUCTi-. Address: No.38367 • _ .6 3-- 4,3-3- 00632 X 265 Expiration Date Sig Total ��>J� 30, -,M,(t Not applicable ❑ Name: Registration Number Address 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 5-3 Gene t"oatracfox Ui cl( Pec-1-tee ;CO)y ✓uc ,oiv CDr p.^a�,8pc Not Applicable ❑ Company acme:Responsible in Chargb of Cons tion SEC I IQI 6 DESCRIPTION OFPR `YORK;'(c.I►eck.all applicable) New Construction �W Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition 0 Accessory Bldg. 0 Demolition 0 Other ❑ Specify Brief Description of Prooppsed Work: I �n�i'�YNc1 U.Nc�h �tOt�v a �� liv1 S RSA �c..t.i�� ` ��✓��l �0'dSdIN `SECTI<QN Z US)8 GRbU'P Al!ID Cd1�iSTRUt;"I'ION'T�PE �' USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly 0 A-1 ❑ A-2 0 A-3 ❑ 1 0 A4 0 A-5 ❑ 1 B 0 B Business 0 2A 0 C Educational 0 2B 0 F Factory 0 F-I ❑ F-2 0 2C 0 H High Hazard ❑ 3A 0 IInstitutional 0 I-1 0 I-2 0 I-3 0 3B M Mercantile 0 _ 4 0 R residential 0 R-i ❑ R-2 R-3 " 5A 0 S Storage ❑ S-1 ❑ S-2 0 5B 0 U Utility 0 Specify':'• .6 M Mixed Use ❑ 1,,'Specify: S Special Use 0` Specify: r 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) _''ROPOSED Number of Floors or Stories Include Basement levels ,Floor Area per Floor(st) Total Area(so RIObSF Total Height ft 3/V4, Independeni Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 10a Owner Au+horiza+ion- TO BE COMPLETED WHEN OWNERS-AGENT OR CONTRACTOR APPLIES FOR BUB-DING PERMIT ,. I, k MCI-i c w c c� `, as Owner of the subject property Hereby aut orize\ 1 arNe A o �``� to act on �My behalf, inIl ' atters relative o work a orized by this building permit application Signa of Owner Date 4 a.r, i .�. �r � • I, I.Akfqe v 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.,-,,\ S igned under thepains ;penalties o duty 14 EA nt Na n Signa r/ ent Date 5E, >11ttfltl` t}� . Ite if Estimated Cost(Dollars)to be r �) 7GI�4IUSE QNlf,�€ Completed by permit applicant ' 1. Building' N' (a) Building Permit Fee I S Multiplier 2 Electrical (b) Estimated Total Cost of Construction from(6) 3 Plumbing Building Permit fee (a)x(b) 4 Mechanical(HVAC) 7SD 5 Fire Protection 6 Total (1+2+3+4+5) 1 u S Ch k Nber �a 4 Co 'S ern► 01" A , NO.OF STORIES SIZE BASEMENT OR SLAB L SIZE OF FLOOR TIMBERS 1sT 2'o 3RD SPAN DEMENSIONS OF SILLS :1 DEMENSIONS OF POSTS s. DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION U� THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Location No. l' r -rte%re� Date TOWN OF NORTH ANDOVER 3 O ALA Certificate of Occupancy $ sACMUs t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ �+ TOTAL Check #6 ZO` 16020 � - Building Inspvator Location �K �4�t�Yc.,1J(r (OR) C '�C �J No. Date Jn,N�w3 -zZ-o3 "CRT" TOWN OF NORTH ANDOVER F R �� 9 • + i ;•� Certificate of Occupancy Its cNu" Eck' Building/Frame Permit Fee $ 3 2v"o s A1� O4 iG oao Foundation Permit Fee„_,g.,$' – 5 -- Other Permit Fee $ —� TOTAL $ Check # 0400¢1 16125 BuiIdinglnspector OPECHEE CONSTRUCTION CORPORATION 040041 I DATE INV # COMMENT AMOUNT DISCOUNT NET AMOUNT 01/21/03 012103 Kittredge/410/1000 35, 350 . 00 . 00 35 , 350 . 00 ��HECK: 040041 01/21/03 Town of North Andover CHK TOTAL : 35 , 350 . 00 TERRA PROPERTIES LLC 1078 CONSTRUCTION ACCOUNT Town of North Andover 1/24/2003 Rennie's Development Costs:Permitting 1,320.00 f Construction Acct-BankNo 1,320.00