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Home My WebLink AboutBuilding Permit #114-13 - 267 CHICKERING ROAD 8/9/2012 i BUILDING PERMIT o "°oT"�ti TOWN OF NORTH ANDOVER s� h�..'`- _` �.'° �0 APPLICATION FOR PLAN EXAMINATION10 Permit NO: r Date Receivedc Q�NA7ED�.Pp` S 1SSACHUSE Date Issued r IMPORTANT:Applicant must complete all items on this page LOCATION 6 j t PROPERTY OWNER 99 . / �rsL Pnnt MAP NO: PARCEL: ZONING DISTRICT: Historic District yeno Machine Shop Village ye( 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: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WOR TO B PREFORME . &nd'dl dwtuo t"al z Identification P ease Typeo Print Clearly) OWNER: Name: �/�.s�wrw �u Phone: Address: 16 L) o 44;,ol Aut LA ✓- J CONTRACTOR Name: lei rc� C Phone: '/ r 733 jj Address: -3-7 Supervisor's Construction License: ,::�-S —0-7-793K Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $-lUp G�la�a FEE: $ Check No.: p G Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfunii Signature of—Agent/Owner ' _ �ignature of contractor I Location No. Dated! • - TOWN OF NORTH ANDOVER � Certificate of Occupancy $ t � Building/Frame Permit Fee $ � q Foundation Permit Fee $ Other Permit Fee t $ TOTAL $ Check# 25599 Building Inspector 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 i 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 on site yes no Located at 124 Main Street - Fire Department signature/date COMMENTS I 4 i 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) V-\ t ❑ 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 ❑ 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 Applicable) If Report A P ( PP ) ❑ 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 o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 4�- Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 � NOR'PH Town of ndover 0 , . No. I - h ver, Mass, • cocN�c«ew.c� 1. ATE0 U BOARD OF HEALTH PER D Food/Kitchen i Septic System THIS CERTIFIES THAT4BUILDING INSPECTOR ... ........ ............ ..................................... has permission to erect " �!� Foundation .......................... buildings on . . .. ...... .........� .... • Rough I 4� 2- _.. j A to be occupied as ....... ....... ............. ................ ............................. 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 INJAPONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU T N S IMRough —4"z) Service w....................................... ....................... Final BUILDING INSPECTOR - GAS INSPECTOR Occupancy Permit Required to Occupy Buildinga - - - 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 NOR P1.r Town of _ At., sAndover No. LANE h ver, Mass, • COC NIC Nl WICK AoR�reo ,PP•�,t5 S U BOARD OF HEALTH PER4 . T LD Food/Kitchen Septic System A THIS CERTIFIES THAT ...................... BUILDING INSPECTOR . .... ............................ Foundation has permission to erect .......................... buildings on ......� .. .... ......et 4 �. �. Rough to be occupied as ......�....... ............. ............................... ............................ 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.- - ONTHS ELECTRICAL INSPECTOR 1aO " UNLESS CONSTRU T N S Rough —Z) Service .......... ........................................ .:.............:`:..... Final BUILDING INSPECTOR GAS INSPECTOR t 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. [F Smoke Det. SEE REVERSE SIDE