HomeMy WebLinkAboutBuilding Permit #683-2017 - 25 ROYAL CREST DRIVE 1/3/2017 (3)Permit No#:
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BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
No Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
\ Repair, replacement
❑ Assessory Bldg
❑ Others:
`61 Demolition
❑ Other
a.
Septic o 1Nell
Floodplain El V1/et(ands-
UVatershed District ..
D aWatw-Sewer : -
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OWNER: Name:
Address: 50
Contractor Nam -
li
Oro L
irn - Please Ty
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(-V to
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ne:
Supervisor's Construction License ,f
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Homey ifiRNO ement Licenses
px r Date 45
ri.f�afip
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT: $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COSTBASED ON $925.00 PER S.F.
,I"®tal Projecfi C®� FEE: $
__
Check No.: 'f u Receipt No„ 3 f 9
NOTE: 145eF ons ' g with unregisteredcontractors do not heave- access to the guarantyfund
:�innafiitra,` ner tiTV, ininPr Sk nature of contractor
Plans Submitted ❑
Plans Waived Certified Plot Plan ❑ Stamped Plans ❑
OF SEWERAGE DISPOSAL
c Sewer ❑
F
Tanning/MassageBody Art ❑
Swiin" pools ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc. ❑
permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR. OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On Signature.
COMMENTS
CONSERVATION Reviewed on Sianature'
COMMENTS
HEALTH
COMMENTS
Reviewed on
Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planing Board Decision: Comments
Conservation Decision: Comments
Wafer & Sewer Cort flection/Signature & Date Driveway Permit
DPW Town. Engineer: Signature:
FIRE DEPARTMENT'- Temp Dumpster on site yes
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Located 384 Osgood Street
no
-)imension
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 -
DANCER ZONE LITERATURE: lies No
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
Doc.Building Permit Revised 2014 _-
I
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
o Building Permit Application
❑ Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
o Floor Plan Or Proposed interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
o Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
o 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
'MOTE: 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
❑ Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
act
❑ Mass check Energy Compliance Report
o Engineering Affidavits for Engineered products
DOTE: 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
Doe: Building Permit Revised 2014
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