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HomeMy WebLinkAboutBuilding Permit #431-2016 - 210 ROSEMONT DRIVE 10/6/2015 S4C4wA1E D /0916`is- t Scpr✓nye-D bUILUINU F LKMI l "'I Iws >+, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION � . Permit NO: � �'-�G sG Date Received �' °4 �uM �• � Date Issued: �9SSacHus IMPORTANT: Applicant must complete all items on this page LOCATION t'Et/ t/ P int PROPERTY OWNER LCC? LA t OA1 _ Print MAP NO: Q-31 PARCEL:0()2_ZONING DISTRICT: � �` Historic District yes .AO Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ I ew Building ❑ One family Qo'Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑.Floodplain ❑Wetlands ❑ Watershed District ❑ Water/Sewer bus es^ 76 `X `f, Vo A4% Identification Please Type or Print Clearly) OWNER: Name: LEO t/+Fb"b Phone: q7T (0'7 q_3 F(c7�5 Address: Vq �/ C'L16fi2�SC�rc1 CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp, Date: Home Improvement License: Exp: Date: ARCHITECT/ENGINEER STCC-V lJ I05"TL)2— Phone: Address: L/9' 1-16—Ybpintj i-t1 jl�c'�• /9 A� ° f��l� 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: $ 60--- 41 Check No.: �17G Receipt No.: � �- 10 NOTE: Persons contracting with unregistered contractors do not have access to the guarality fund Signature Agent/Ow - Signature of contractory ry t �e. FORTH BUILDING PERMIT °�t�`E° TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * �. Permit No#: Date Received �gssacH�s���y Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no i MAP PARCEL: ZONING DISTRICT:_HistoricDistrict yes no Machine 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 _ — '�' �0^�11Uatershed ®ism t Septic, 1�Welll'4 -- - d Flo©dplair% WefFands; Q � O Water/Sewed DESCRIPTION ` OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly "TOWNER: Name: Phone: Address: Contractor Name: Phone: Email: 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: $ FEE: $ w Check No.: Receipt No.: } NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund °-moi c 4 -—r,£`6 F. - - -- 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 O Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING DEVELOPMENT Reviewed On Signature COMMENTS o Signature ature CONSERVATION Reviewed on l0 � COMMENTS t -HEALTH Reviewed on Si nature 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 AFIRE DEPARaTN1E TempDump ster-0on situ •� x 6 Loeated at 124 Main Street,�o e `Y "^. CL'jf1"'+Yf �i`�i���` � f�+�t' ;° aK". e ♦m.�f ,y,'+'... °t tau , Fire Dep' .- d artment Signature/datea�:� t 4 �r sY ,. , `a.� .• i, _ *tag y�.' y ; ' �i.....'sx3+1.� 1C;-ha_su�rLj�,,y s' •rT"�.+' � -�1y,j?v.r�i f,,7�_.+2" �' r�fw.. ,+4�, •'�Lr•,.,: r -tfHfi �`i'. k �. w •s, t. x{r3 �r+,�W,' .• .. ,.* ,..c. Z 77:,3„ �s e S •« � 4 44 '� GQMMENTS r t 'yo r>. LfS rf E��' it .�^"{ . 6 n r1,� rYLi .-.-r,�dr4.r+t+e..k, ..c a.>....Xoz r. *.k.x±•.,✓.t ....,i. �- i .. fj{{ - .s a •,_..M s4 �.t:.i.., k, ."a4 !..•a.�..:...rw`.=i5c!e::....,'..<. _.�.,.rf.::,L��+,k„�5: 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.$1oo-$1000 fine NOTES and DATA— (For department use) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 4� 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 dEngineering Affidavits for Engineered eered roducts OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4. Building Permit Application Certified Surveyed Plot Plan 46 Workers Comp Affidavit 4, Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses 4> Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 I t' Location �� ,rI�' �U 14(11, No. 73� — G/6 Dated F T: • - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee $ —� Foundation Permit Fee $ � Other Permit Fee $ TOTAL $ Check# Vu ding Inspector,