HomeMy WebLinkAboutBuilding Permit #858 - 25 CASTLEMERE PLACE 6/16/2011TOWN OF NORTH ANDOVER
APPLICATION FOR PLANEXAMINATION
Permit NO: � � Date Received
Date Issued: ` /
IMPORTANT: Applicant must complete all items on this pag
LOCATION 2� sc(2L4 c� E'
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MAP NO: 27,q PARCEL•• a� ZONING DISTRICT: r Historic District yes
Machine Shop Village e Y es "IPY
TYPE OF IMPROVEMENT
SED USE
C-
RpsidentLal
Non- Residential
❑ New Building
XOne family
❑ Addition
❑ Two or more family
❑ Industrial
Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
.®Septic (].Well'
odplain Wetlands; ��.
iWaterslie D strict: '
wgter/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
�-
(Identifica ' n Please Type or Print Clearly)
OWNER: Name: �G� `� C f1 n� Phone: P5)w94 GjB�
Address: c- s , 4 �f tom- 1 _ 4n+&� W1,1-- d
CONTRACTOR Name:
Address:
Supervisor's Construction License:
Home Improvement License:
15� °VLle—
)Exp. Date:
Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: ` Reg. No
Phone:
FEE SCHEDULE. BULDING PERMIT. $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ 1 bU o ` FEE: $_ 2 -
Check
Check No.: Receipt No.:r��"�
NOTE: Persons contacting w,Rh un�egis�Yed con tr ors do not have access to the guaranty fund
r
Location@'�� CC�S-
No. 9
Date
Check #
2 4� 6U
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Building Inspector
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 ❑
Private (septic tank; etc. ❑
Permanent Dumpster on•Site ❑
THE FOLLOWING SECTIONS FORiOFFICE USE ONLY
INTERQEP,ARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
DATE REJECTED DATE APP OVED
El
ZAo0 _
Reviewed oni�C
Reviewed on, r <// Signature
r
COMMENTSI� S�
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board•Decision: Comments
Conservation Decision: Comments
r
Water & Sewer Connection/Signature & Date ` Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Located 384 Osgood Street
yes no
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. i.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
NOTES and DATA — (For d
LI Notified for pickup - Date
Doc:.Building Permit Revised 2008mi
ent use
No
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
❑ 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
NOTE: 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
❑ 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
❑ 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 2008mi
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Interstates Horizontal Datum: MA Stateplane Coordinate System, Datum NAD83,
— Interstate Meters Data Sources: The data for this map was produced by Merrimack
— Major Roads �ORT1t Valley Planning Commission (MVPC) using data provided by the Town of
Roads 3?Oe tt``o /o,~OOL North Andover. Additional data provided by the Executive Office of
C. Easements Environmental ANairslMassGIS. The Information depleted on this map Is
for planning purposes only. It may not be adequate for legal boundary
Trails O .-- — Ie definition or regulatory Interpretation. THE TOWN OF NORTH ANDOVER
Q MVPC Boundary MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING
C3 Municipal Boundary 41 ♦ THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY
s e ♦ OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT
O Parcels # °oma y ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF
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