HomeMy WebLinkAboutBuilding Permit #673-12 - 262 RALEIGH TAVERN LANE 3/23/2012TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: 7 _ 2 Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
Print
MAP N0: % 06 C-PARCEL:S� ZONING DISTRICT: Historic District yeso
Machine Shop Village yes no
100 year-old structure 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
❑ Others:
❑ Dpmolition
❑ Other
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❑
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DESCRIPTION OF WORK TO BE PERFORMED:
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(Iden 'fication Pleas a or Pri t clearly) C:
OWNER: Name: \'�\t~�" t�S Phone:
oo ��Address:
CONTRACTOR
Address:
Supervisor's Construction License--
Home
icense:
Home Improvement License:
ARCHITECT/ENGINEER
Exp. Date:
Exp. Date:
Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT: $92.00 PER $1000.00 TAL ESTIMATED COSTBASED ON $925.00 PER S.F.
Total Project Cost: $ � `'= E: $ ��
1
Check No.: X60 Receipt No.: 471
NOTE: Persons con act g th unegistererl c ntractors do not have access to the guaranty fund'
innati'i'ra;nf Anent/C�wnPr. D . Sianature;of�contractor. 1 1
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer El'
Tanning/Massage/Body Art ❑
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc. ❑
PermanentDumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed
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:
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. 1
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
NOTES and DATA — For department use
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2011 June/mi
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
o 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
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.Building Permit Revised 2008mi
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AU l c)1 n
S' x 16' FLOOR PLAN #5 VINYL
SHOWN WITH OPTIONAL ARCHITECTURAL
SHINGLES AND FLOWER BOXES
THIS TRULY UNIQUE STYLE HAS
TIMELESS BEAUTY! THE HISTORIC
COLONIAL IS THE PERFECT
CHOICE IF YOU LOVE THE CHARM
OF THE AMERICAN CLASSIC BUT
NEED THE FUNCTIONALITY OF THEAwaitAwk
TRADITIONAL GAMBREL. TAKE -
FULL ADVANTAGE OF THIS STEEP
ROOF PITCH BY ADDING ON AN
OPTIONAL LOFT TO MAXIMIZE YOUR
STORAGE POTENTIAL. BE SURE TO
ALSO REVIEW ALL THE STANDARD
-
FEATURES CURRENTLY AVAILABLE.
AVAILABLE IN ALL SIZES RANGING
FROM 8' X 8' TO 1 2' X 201.
do10'
x 12' FLOOR PLAN #7 VINYL
SHOWN WITH OPTIONAL ARCHITECTURAL
SHINGLES AND FLOWER BOXES
-
THE VICTORIAN COTTAGE AND GRAND
VICTORIAN OFFER THE ULTIMATE IN
STYLE. BOTH VICTORIAN MODELS HAVE
A TRANSOM WINDOW ABOVE THE DOOR'
ON THE GABLE END, EXTENDED EAVE
—
OVERHANGS AND LARGERNow,
gig"
NAM
WINDOWS WITH DISTINCTIVE TRIM.'
_--.r
THE GRAND VICTORIAN HAS AN ADDED
mom
m°
ROOF DORMER AND FULL-SIZED .
GARAGE DOOR. (SEE ON PG 4)
THE STEEP ROOF PITCH MAXIMIZES
a-
OVERHEAD STORAGE SPACE AND COM-
PLETES THIS ONE -OF -A -KIND DESIGN.
THE VICTORIAN COTTAGE AVAILABLE IN
SIZES 8' X 10' TO 12' X 20'. GRAND
VICTORIAN 12'X16' TO 12'X20.
Location �?6 "? ► ��� `7 -,7aa6-, x a s
2 3 3Ii
No. ; 7,f - / Date
0 . TOWN OF NORTH ANDOVER
9 �aY'��, I,�U 1�q�` •
e
�,• _.d- Certificate of Occupancy $
Building/Frame Permit Fee $ (6• o0
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # -�70 471,
25121 uilding Inspector