HomeMy WebLinkAboutBuilding Permit #674-12 - 26 DARTMOUTH STREET 3/23/2012Permlt N0:
TOWN OF NUK i n t1l" . m .
APPLICATION FOR PLAN EXAMINATION
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Date Received
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a3 PARCEL:-��— ZONING DISTRICT:. _---Machine Shots Village
Mme'
NC• -- -- _----
TYPE OF IMPROVEMENT
❑
New Building
❑ Addition
Iteration
Repair, replacement
f
OPOSED USE
identialOne familyTwo or more familyNo. of units: Assessory Bldg
Other
Non- Residue
❑ Industrial
0 Commercial
❑ Others:
Demolition �.,;-: ensu a . -
0 ,it SRT_ 1p.� oQdp a$s.�;,yIJ:,1l1!,- ,.._u.. `I. .
511
0 Wtiter/Set?ver_.....:._.._.- .' ION Oi� �OuK TO BE P E
DESC _--
yes
yes
�UJVhC
r ' , __--
nt clearly)
dentilication -Rica e or PriPhone:
OWNER: OA G\,;e'y `
Address: phone:
CONTRACTOR Name:
ess: �
Addr �-t C
. 3 0 Exp. Date:
Supervisor's Constructionucense: Ex Date:
. — p
Home Improvement License:
CTIENGINEER ('YV1�Mt V
Phone:
ARCH 6"CIV, G 1 b iy Reg. No. _
Address:
ULDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL PSTlMATED COS7gAS.�D ON $125.00 PER 5.F.
FEESCHEDULE.• s FEE: �
Total Pioj
ect Cost: $
Receipt No.:-- .� f :2 Z '
Check No.: with unr istered contractors do not have access to the great anty fund
Off• Persons contracting - — —
N _i 6 1
Location
No. r
5,%4-1—/2
Check #
25122
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $,4U
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Building Inspector
r
Plans Submitted` Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer TanningMassage/BodyArt ❑ Swimming 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
COMMENTS
CONSERVATION Reviewed o
COMMENTS
HEALTH
COMMENTS
Reviewed
DATE REJECTED
DATE APPROVED
Sionature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/recelptsubmitted yes
Planning Board'Decision:
Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature &Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS
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 or
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 966 Section 21A—F and G min.$90o-$1000 fine
DomBuilding Permit Revised 2008mi
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
MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Pear
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 Perm!
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
o 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.BuUdingPermitRevised 2008mi
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