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Home My WebLink AboutBuilding Permit #384 - 27 SAMUEL WAY 12/8/2008 Vk- i 7-L050-= BUILDING PERMIT o NORTF/ TOWN OF NORTH ANDOVER c? 4 ''- ° �°�, APPLICATION FOR PLAN EXAMINATION Permit NO: 0 Date Received �gsSgcHus��q� Date Issued: IMPORTANT:Applicant must complete all items on this page 0 AT, ON 2:; 7 "Print PROPERTY;OWNER , 4 Print '. MAP410`:-� ' PARCEL: "ZONING DISTRICT: /--4Historic`Distnct - ,-.:Yes_ no Machine Shop Village yes r=°- o° 9` .TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 4ew Building One familyI ddition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg _ Others: Demolition Other Se 1NP fi ApticeWetlands VatershedDis#recti Water ewer 41 DESCRIPTION DESCRIPTION OF WORK TO BE PREFORMED: Ldi-T kT Identification Please a or Print Clearly) OWNER: Name: =' Phone. -77n,7 �J Add ress:P:E::>_7�j C' _'r" —�`�a� `�- T—I CQNTRACTQRName. ` 1 �•._._ '' ;Y�. Phone. a " �I A71 ddff ress: o `Supervisor's Constriuction.License. C S Exp: `Date: a7.�yA� Home"Irimprovement License: " Exp: ,,Date: ; ARCHITECT ENGINEER` r� �� Phone:�� -7 ® 7� Address: � ¢� Reg. No. �r Z-- FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000 00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 5L/P( X t'i i000 1-2DO FEE: $ Check No.. ) % /L Receipt No.. NOTE: Persons contracting with unregist ed ontractors do not have access to the uar n Sinature of A ent/ 'V gi g. ofcontractor': nature LL Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL =PublicSewer 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 �Q COMMENTS rO CONSERVATION Reviewed on /C;�' .S 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/Si nature Date Driveway Permit i DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPART�P7 Temp Du pster ori -77-77 tte yes ono -- Located rat�24 Alitn treet ` EfreLDepartments �gn tuieldlate At, 'IDOMIVIENTS Dimension 1 Number of Stories: ` Total square feet of floor area, based on Exterior`dimensions. Z.o;& .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.$100-$1000 fine NOTES and DATA— (For department use) i ❑ Notified for-pickup - Date ........ _...-...........................-._........................__..._......... -----......_............_...--— L:...._......_....---- -......_._..............................................................----- 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 Li Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work o 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 o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li 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 o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses Li Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o 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 I Doc:Building Permit Application Revised 2.2008 Location,�,7 No. Date f u �pRTh TOWN OF NORTH ANDOVER p:� � e .•14.0 Fie..•_ _ _ • p' T. ' Certificate of Occupancy $ Building/Frame Permit Fee $ - o Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 21742 Buil"ding Inspector Massachusetts - Uclrir-trncnt of Puldic Safct% Board of Building Rcuulations and Standards r. Construction Supervisor License License: CS 99769 Restricted to: 00 a, AARON SASSEVILLE 24 BUFFUM STREET SALEM, MA 01970 Expiration: 7/24/2011 ( uuni i uicr Tr#: 99769 t4ORTH c TO" O0 f -ti 0o dover, Mass.,L4 E 1 ` COC MICME WICK V C �d�oRAtED 7�7 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.................. .......... Foundation hasp .. buildings on . .. ... ..... . .CC g permission to erect...................................... v� � ,�.f...°:'h.L.�.�'.,,�!....C=J...��........................ Rough t® be occupied as...........1!.`a.e�C�......*..(!�!' �.¢`.... �f �./. .........:..... .�� C:. ...�thpplication ................................ Chimney provided that the person accepting this permit shall in every resp conform to the terms of on file in Final this office, and to the provisions of the Codes and By-Laws rela ing 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 CONSTRUCTION, TS Rough . ... . .::°-cv`....................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy'Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises = Do Not Remove Final No Lathing or Dry Wall.To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.