The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #082-13 - 26 MAIN STREET 7/31/2012 BUILDING PERMITcF pORDT1{ qti TOWN OF NORTH ANDOVER o� APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 7 �DRA7ED 4`� �SSACH�1`�� Date Issued: MPORTANT:Applicant must complete all items on this page LOCATION - r s'" t (A) --� Print---, PROPERTY OWNER Co �v 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 R cement Assessory Bldg Others: Demolition Other Se Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: r Identification Ple Type or Print Clearly) OWNER: Name: -� C' iv Phone: C(7�- 9" 7 Address: -7 A AkA&,Le v CONTRACTOR Name: 7NRVi�AS . A kV," Phone- Address: E' 4 6r`1� Supervisor's Construction License: C -31 10 Exp. Date: 9L Home Improvement License: Exp. Date: ARCHITECT/ENGINEER CCAS�IPhone: -7 10 d Address: A114,, Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ v'. FEE: $ dam Check No.: /_� �� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own_ 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. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS 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: Located 384 Osgood Street FIRE DEPARTMENT - Temp'Dumpster onsite 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 No MGL Chapter 166 Section 2 1 A—F and G min.$100-$1000 fine 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 o 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) Li 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 Dor.INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location No. t./ �2 Date 2 • - TOWN OF NORTH ANDOVER ,t .„ " Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee,�Fo TOTAL Check#O✓ L 7 25564 /du'ding Inspector NORTH own of t E : ., b ndover No. - h 40 h ver, Mass, 711111 t COCNIC.IWICK QDRATED ►P�`�,(5 - S V BOARD OF HEALTH Food/Kitchen PERM, 1" T T D Septic System THIS CERTIFIES THAT ..............��G �� BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on ............................................................................. 7 Rough to be occupied as ........... ..�: !f o..... ...........ly..` :�.q''.................................................................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TARTS - Rough Service, U........ ....... , ... .. ...................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Town of North Andover NORTf.I Building Department �0 I-ED 16 it �o 1600 Osgood Street - North Andover MA 01845 i� Tel: 978-688-9545 Fax: 978-688-9542 7,77 AL L a 7- 0t O coc"Ic twice( V� DEMOLITION OF BUILDING AFFIDAVIT SACHUS DATE �- OWNER'S NAME &ADDRESS ('7iy rJ r r LOCATION OF PROPERTY TO DEMOLISH MA S eare DESCRIPTION. ivio Q1 L uUi0VII USC CONTRACTOR'S NAME &ADDRESS o be Ae 4\(vn j,P. b DEPARTMENT SIGN-OFFS 4 DEPT. OF PUBLIC WORKS -'WATER: 6VA SEWER: A-112L ll DEPT OF CONSERVATIOdij 4C' HEALTH DEPT: Se ' e ;t, p1a / HISTORIC COMMISSION I v c GAS ko i ELECTRIC TELEPHONE (' f CABLE ( S) te.;i TAXES(��AMJUGl PW/_Cd I 71aqlp POLICE{r �aY/off FIRE EXTERMINATOR DUMPSTER-ON FF TREET r e � - DIG SAFE NUMBER I/t•)I I f•e�. u C�i � DATE REC'D BLDG. INSPECTOR Doc.form demolition of building affidavit M 11 s iPv�lh�nm S 62 Pkaftm 8304 iftL 125 gym,Im1W Me" F1�11s�Zt,M11Y on MOM" FilK 00 30 GM5 RODENT CONYROL REPORT BAITING PRIOR TO IDEMO L ON PROPERTY ADDRESS: / COMMERCIAL: YES / NO RESIDENTIAL: YES ✓ NO PROPERTY TREATED WITH CHECK ONE OR MORE TALON G INDIVIDUAL PACKETS EPA 0 C 100-1057 BRODIFACOUM CONTRAC BAITING BLOX EPA# C 12455- 79 BROMADZOLONE INTERIOR 13AITING EXTERIOR BURROWS DUMPST ER _ PLANTERS OTHER AREA CLEAN YES V NO ACTIVITY SEEN YES NO t/ MICE RATS COMMENTS FROM TECIINICIAN TECMUCIAN NAjA-- DATE �= I I