HomeMy WebLinkAboutBuilding Permit #Exception - 228 DALE STREET 5/1/2018 NORTH
BUILDING PERMIT
TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION
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Permit NO: Date Received
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Date Issued:
IMPORTANT:A licant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ne family
❑Addition ❑Two or more family ❑ Industrial
aeration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
emolition ❑ Other
DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name:-,
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Address: A
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AR^ e�-iEf4G i kR NA1trY1 " k2AC16 afs Phone: �7a�`-�"? 7 19
Address: -, )3P_40KcG)1M&eg. 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: $ 04 FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor
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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 ❑ ❑
COMMENTS
�)(�,�- DATE REJECTED DATE APPROVED
C0NSERVAiON ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑ o�U q .
COMMENTS ,
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑
Food Packaging/Sales ❑ i
Private(septic tank,etc. Elpermanent Dumpster on Site El
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
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Conservation Decision: Comments
Water & Sewer Connection/Si- nature& Date Driveway Permit
Located at 384 Osgood Street
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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
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
o Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
Addition Or Decks
❑ Building Permit Application
❑ Certified 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)
❑ Engineering Affidavits for Engineered products
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 Applicablej
❑ Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
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:BPFORM07
Revised 2.2007
TOWN OF NORTH ANDOVER
DIVISION OF PUBLIC WORKS
384 OSGOOD STREET
NORTH ANDOVER,MASSACHUSETTS 01845-2909
J. WILLIAM HMURCIAK,DIRECTOR,P.E.
Timothy J Willett f NORTp 7 Telephone (978) 685-0950
Water&Sewer Fax (978) 688-9573
Distribution Superintendent
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July 24, 2007CH"Ss" 5 t�
NCMU
Mr. Edward Morgan
288 Dale Street
North Andover,MA Ol 845
RE: Sewer Connection
Dear Mr. Morgan:
As you are aware, a new sewer line has been installed in front of your residence as part of the town's
Phase 3C Sewer Project. The sewer lines have passed all required testing. The only outstanding item
preventing us from declaring the sewer"active"is the As-Built drawing. The contractor will be hiring
a professional land surveying company to create the As-Built Drawing within the next month or so.
Provided that the As-Built Drawing demonstrates that the sewer line has been installed according to the
construction plan as we expect,the sewer lines will then be ready for house connections.
Very truly yours,
Timothy J. Willett
Water& Sewer Superintendent
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