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Home My WebLink AboutBuilding Permit #540 - 250 CLARK STREET 3/8/2010�j C� Permit NO:✓ Date IssuJ�/ U TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received -2— Z� _ fo IMPORTANT: Applicant must complete all items on this page LOCATION C._- )arI rP-e-+ PROPERTY OWNER �fl + L. k Print MAP NO: 2y PARCEL: ZONING DISTRICT: Historic District Machine Shoa yes 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 Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: CDynSfrvc-con t� �'ye (.5) ogces in +k e'xi +,n�, b1niIG<i✓Iq �lNd �i� add ii-i►�r1 � o� � � � �hGt�+`bD(h � �Gi � -�i nn ah c.P IrQ10�1"I7 on O� 3 tv ridows 'to 4k 2Xikr�arWqJ1, Identification Please Type or Print Clearly) OWNER: Name: % Phone: c17g" 68d-776 Address: 2SD 1arK 5+reed' /U, Andaycr /VIA 4o /2 -i -6p, CONTRACTOR Name: Lear�eve)6efyVAt C-4 Phone: 978.661-/,-1. 7`/ Address: ' _St�aerf�tHi i0a3d► j Supervisors Construction License: Exp. Date: S/ 1h,013 Home Improvement Licen 6 )6S9 ExD. Date: r� 11711AR ARCHITECT/ENGINEER ',�CAfN4 'D. Sm & Phone: S52 -367' �qaO Address: 35 �94rmi Lrt� (A). narr+S+-gUe,AAReg. No. ' g387, FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ ql, aSU..� FEE: $ /by5, 00 Check No.: 3 U3 o-� Receipt No.: 2 v NOTE: Persons contracting with unregistered contractors do not have access to th u r and Signature of Agent/Owner Signature of contractor - ti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:5-Ofd 'Date Received Date Issu IMPORTANT: Applicant must complete all items on this baize LOCATION rX SCS t.._ IUrK 5+reP-+ Qn PROPERTY OWNER r] it h j L,,Jdn c� MAP NO: �-1 PARCEL: Print ZONING DISTRICT: -I- a Historic District yes no 2 Residential Non- Residential Machine Shop Village yes CL TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: - Commercial Others: Repair, replacement Assessory Bldg Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: C 0 fl S+NA C-+; on t2E ��Ve CSS a,cps in ik 2x�Si,�►� btnI' Nina One C) ba4r,6bm ,Add cQ V el oCvi-F,`on (,i� � �Ad � ►1 d Ot^I t Vl \ 17� Q.Xi�ri,�r )q� I ' Identification Please Type or Print Clearly) OWNER: Name: _ rkh� Landc4g Phone: 0179- 68d-7767 Address: GlarK S re -e -f /. And yu, /A /2i -1a CONTRACTOR Name:_ Lecr 7eyeIoetrerl� C4 Phone: 978-66'-/ (o7q Address: IN W_ / Supervisor's Construction License: -Sa� ferfaHl¢ Exp. Date: S1 i1 a013 Home Improvement License: ha qerfavl'k �9Exp. Date: 7 oidia ARCHITECT/ENGINEER �TaN' D. SrIn ifk Phone: S62 -367- �qaO Address: 3S rNO-i lt::�AN,+ W, Rarvl.s-a61e�MAReg. No.. 8387, (0 FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ q1, U. FEE: $ I oqs, 6b Check No.: 3 U3 o-� Receipt No.:22f y() NOTE: Persons contracting with unregistered contractors do not have access to th u r fund Signature of Agent/Owner Signature of contractor 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. X Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments, Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood ' Street FIRE DEPARTMENT - Temp Dumpster on site yes 10 Located at 124 Main Street Fire Department signature/date See oc-Ke COMMENTS 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. X Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS T HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes x no Located at 124 Main Street Fire Department signature/date see- OJ46 CQ COMMENTS Dimension Number of Stories: I Total square feet of floor area, based on Exterior dimensions. ), 050 S� Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No NO DANGER ZONE LITERATURE: Yes No /Iib MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 Dimension Number of Stories: l Total square feet of floor area, based on Exterior dimensions. )) 050 Sr Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No NO DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine No /1i0 NOTES and DATA — (For department use ❑ Notified for pickup - Date ...... _...... _...... ....... _........................................ _._..... _....... ._................................................................. _..... _................. _......................................................... _.............................................................. _..... _._.... _._................................................................ ........ --............ ---............................................... Doc:.Building Permit Revised 2008 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 VPhoto 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 2008