The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #161 - 21 BONNY LANE 8/30/2006 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o`No oT 6 q~o 9 6 Permit NO: Date Received oRATio Date Issued: v� �9SSgCHU$�� IMPORTANT: Applicant must complete all items on this page LOCATION ?l /w/✓Ny 6VI'lle Print PROPERTY OWNER 41L1 7�fNY A�7110116' Print MAP NO.:_ �_Z PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ 'Iteration No. of units: Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED dentification Please Type or Print Clearly) OWNER: Name: /Q�7/o��/✓tY �r�37'`I��r/l p Phone: alllo—f?fir Address: �/ ��N/✓y C�S/yL° CONTRACTOR Name: lPph&P - 11)W �hle, �r P`nollp zkLw „� Phone: 9/91— Address: �� />i�a,/S' L'�9�✓�" S'� Q�I�oLC /I/ �� Supervisor's Construction License: ��5�� Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost ::$ 1Z)d Q FEE:$alO Check No.: 15W.3Y �&s-- Receipt No.: Page I of 4 Location a 9Q In � -L to No. - Date O li �oRT� TOWN OF NORTH ANDOVER f 9 at Certificate of Occupancy $ �'+ss •°'t<�' HU s Building/Frame Permit Fee $ •�c Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 19532 Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ F1 Tobacco Art ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS I DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Temp Dumpster on site yesno Fire Department signature/date TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ F1 Tobacco Art E]Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED SHEALTH ❑ ❑ 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 Temp Dumpster on site yes_no Fire Department signature/date I J 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 Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ 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) j New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified 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 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:BPFORM05 4 Noe 4 of4 T40RTH � TONM Of 4Andover 1 �1 0L. . - : -rV0 ..., No. CA o dover, Mass., COCMICMEWICK y1. AOR4T6 7S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........AvUi;Rj......... ..... .,N ... ....................................................... Foundation has permission to erect. ... build' gs on a'N........�.O.A.01 Y.......Af'o C........... Rough �7 to be occupied as...... .................... .. Ci .../ .. Chimney provided that the pe on accepting this per sha in ev respect conform oche 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 4&® PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUC S TS Rough . ........................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. lie toam�ma�u�le�� a�'�-'j/lao:uzr-�euaella BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR rRs Number: CS 072583 r Birthdate: 05/07/1967 x- - Expires: 0510712008 Tr.no: 24458 Restricted: 00 ROBERT E KRISTIANSEN JR PO BOX 2353 ?; SEABROOK, NH 03874Commissi0=nwG : M1'k 4. �LR+ t + 'et t t •�i t z xk r4% �c .y 1 R?C ,afi:r