HomeMy WebLinkAboutBuilding Permit #646-2011 - 254 GREENE STREET 3/29/2011TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: �/ 6 'a 0//
Date Issued /2 9/
IMPORTANT: Applicant must
LOCATION Z)7l1
Date Received
T
all items on this
Print
MAP NO: �'� PARCEL: ZONING DISTRICT: Historic District 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
El Others:
emolition
❑ Other
ESepttc OkWe_ 11
®+Floodplaui QWetlands+
; '0' Watershed=District -
6
' {
DF,SCRIPTION
OF WORK TO BE PERFORMED:
OWNER: N
Address:
CONTRACTOR Name:
Address:
ation Please T
Jype orPrint Clearly)
-CL
ti S
cAe
C4 C 1 (, Phone:
Supervisor's Construction License: 3 (� Exp. Date:
Home Improvement License: T I Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. N
FEE SCHEDULE: BULDING PERMIT: $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ gbui ,( V FEE: $ op—
Check No.: // 9f6 ' Receipt No.: 25/000
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Plans Submitted ❑ - Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
PE OF SEWERAGE DISPOSALlic
Sewer ❑
F
Tanning/Massage/Body Art ❑Swimming
Poolsll
❑
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
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:
Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site yes
Located at 124 Main Street
Fire Department signature/date
COACVMNTS
Located 384 Osgood Street
no
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.$10041000 fine
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
❑ 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)
❑ Muss 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
DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
Lust be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
Location,�q5l/
No. 6 416 )0//
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee Y(4w,( ) $ /Of—
TOTAL
Check#
24UUO /Building Inspector
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Massachusetts - Department of Public S;tfet}
i Board of Building R�ulations and Standards
Construction Supervisor License
c
License: CS 31830
Restricted to: 00 ;
DOUGLAS J AHERN.
PO BOX 802 -
ANDOVER, MA 01810
` Expiration: 9/21/2011
Tr#: 3328
!I {'unmiissiuncr
Town of North Andover
Building Department
1600 Osgood Street
North Andover MA 01845
Tel: 978-688-9545 Fax: 978-688-9542
DEMOLITION OF BUILDING AFFIDAVIT
-3ll18
OWNER'S NAME & ADDRESS'S -s" c n
NORTH
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T o LANE 1
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SSgC HUSH
LOCATION OF PROPERTY TO DEMOLISH
DESCRIPTION- i C (SP_ 1�js c h V� I Ci�•fG
CONTRACTOR'S NAME &• ADDRESS
i�
DEPT. OF PUBLIC WORKS - WATER: //,�
DEPT OF CONSERVATION
31 ��
HISTORIC COMMISSION
GAS
ELECTRIC
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ENT IGN-OFFS
/ fr S WER:
EALTH DEPT-Septic------We-fl---X`1-
,
EPT: Septic -----We- l----X"L
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FIRE
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EXTERMINATOR
DUMPSTER - ON/OFF STREET �' I_ (ty
DIG SAFE NUMBER �
DATE REC'D
Doc.form demolition of building affidavit
BLDG. INSPECTOR
From:Naticnal Grid 17815221061 03116/2011 0810 #528 P.0011001
nationalcgrid
40 Sylvan Rd
Waltham MA 02451
March 16, 2011
Doug Ahern
254 Greene St
North Andover, MA
RE: Service Removal for Building Demolition.
Dear Mr. Ahern,
This letter is to confirm that, per your request, National Grid has confirmed that
there is no electrical service going to the building located at 254 Greene St North
Andover, MA as of 3115/11. If you have any questions or need further
assistance, please feel free to contact me at (508) 357-4519.
Sin erely,
Z4ge4liceutAler
Order Processing Representative
Customer Order Fulfillment
ph # 508-357-4519
fax # 315-460-9149
angelic.butier@us.ngrid.com