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Home My WebLink AboutBuilding Permit #890 - 26 DARTMOUTH STREET 6/13/2012BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION j Permit NO: Date Received I 1� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Q�4,�1.lC �67�NO 0 P' PROPERTY OWNER - 0 r Print MAP NO.Oz3—PARCEL(Il� ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building wo!or7mor!efamji1bIndustrial Iteratio No. of units: Z Commercial Repair, replacement Assessory Bldg Others: Demolition Other Se ti Well - Floodplain Wetlands_ Watershed District ater/Sewe DESCRIPTION OF WORK TO BE PREFORMED: i &AAS�f� CUM /k4 "o0 4 _c& /, o,Q~ s t s e -A.. Ide 'fic n PleawJype or Print Clearly) �� ^� OWNER: Name: �' f� L Phone: Address: V'i �i • U �S �d� i/� CONTRACTOR Name:, Phone: Address: Supervisor's Construction Licenser Exp. Date: _ a s Home Improvement License: Exp. Date: ARCHITECT/ENGINEER G Uwe �� I� Phone: Address: �� '�� &LC)aAk�CWV Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: C�N NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor I Location @� �� OA4— No. Date Check # I imly 25403 TOWN OF NORTH ANDOVER Certificate of Occupancy $ - - Lj Building/Frame Permit Fee $ :7 Foundation Permit Fee Other Permit Fee TOTAL Building Inspector 1� Plans Submitted Plans Waived Certified Plot Plan Stamped Plans T WERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools We 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 •uu CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Siqnature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comm 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 of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 nt 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 H r= ® o w v a Cf)w CO2 LL uiW_ a�' U w 44 w°' w �2 cn G w w iz. W zco cn Q cn H r= ® Q CO2 LL uiW_ CC W w y z H o � C h C2 C •dam CL C ev o C ;= O o E Q c . 0 d y C .oma :w CD dC iCcc :+ to � o ; 3 y' C m O O C N cc t" y m E� CLU y.. •/t C O Q act 'CO3 h0yo. tip.ci Z coo a y.0 C CD d= O cc C W = m •H dL C .E v-�cm O t0- CL.,.. Co y L O y C a R C Q! C m 0 cm c N m Z r-. O Z cm g C) zoo P-4 T R.� 2 0 0� ai ' • L 0 Z °D CL O h CD cm I � � O■� CO3 Q CD coCD •� m m C3 CD •r 3 0 m 0 d CL laa c CO3 � c vCc J •fl CD .0 Z ts CD V CD CLy � C C C _c Irk. CO3 is cl r� 0 (A cc W LLI 19 LLIW U)