HomeMy WebLinkAboutBuilding Permit #305 - 200 SUTTON STREET 10/14/2009 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: &06— Date Received
Date Issued: O
IMPORTANT:Applicant must complete all items on this page
LOCATIONc�Tt'cx �-
Pdnt
PROPERTY OWNER
P'nt
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes n
Lachine Shop Village yes no
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
Septic Well Floodplain Wetlands fWatershed District
Water/Sewer f
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: 'qt r- .(G 1/,U-S:1 'V AeT-1F-�.— Os Phone
4
Address: foo 5uH2N
CONTRACTOR Name: Phone
Address:
Supervisor's Construction License: _ Exp. Date:
Home Improvement License: Exp.. Date:
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: $ ;7 06,O FEE: $ a
Check No.: Receipt No.:
NOTE: Persons contractingi registered contractors do not have access to the uaranty fund
Signature of Agent/Owner —27
7-t ha of contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Poolsw
Well
Tobacco Sales Food Packaging/Sales r
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
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:
Located 384 Osgood Street
FIRE DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signaturefdate
COMMENTS r
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
Doc:.Buitding Permit Revised 2008
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
L3 Workers Comp Affidavit
❑ 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
New Construction (Single and Two Family)
o Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
Li Copy of Contract
L3 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. 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: Doc.Building Permit Revised 2008
Location 6,o
No. Date �/U
NORTH TOWN OF NORTH ANDOVER
F 9
Certificate of Occupancy $
SACNUSEt� Building/Frame Permit Fee $ -.---- "'
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #.�rJ
22564 � Building Inspector
NORTH
ToVM of .rAndover,
No. `,:' �
dover, Mass.,
c Oc HIC HE WICK
S RATED
BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
ABUILDING INSPECTOR
THISCERTIFIES THAT.........L-9v .�.�.......... ...................��........................... .........................:............................ Foundation
has permission to erect ....................:................. building ..... .... ............................ Rough
t0 b8 Occupied as...... , ..................................... ..................:::....:...:....................;........:................. Chimney
provided that the person accepting this permit shall in every respect c nform to the terms of the application on 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 CONS U O T TS ELECTRICAL INSPECTOR
Rough
.......... .................................................................:....... ................... Service
BUILDING INS - OR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
gh
Display in a Conspicuous Place on the Premises — Do Not Remove F nal
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. Burner
FIRE DEPARTMENT
Street No.
FE SEE REVERSE SIDE Smoke Det.