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Home My WebLink AboutBuilding Permit #105-11 - 28 JERAD PLACE 8/4/2010 (3) L NORTy BUILDING PERMIT TOWN OF NORTH ANDOVER i APPLICATION FOR PLAN EXAMINATION _ Permit NO: / s �l Date Received Sys R�TEo (� SACHus Date Issued: IMPORTANT:Applicant must complete all items on this page 17 °I?R®PERsTY OINNERA - _ ,..; TOM t _ P21'00 - rPARCEL- ZONING'DISTRICT xHistoncDistrcti eyes` :� rlVlachire�Sho ,Villa9e-.i Y"..eS_ Pte. A� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne famil dditio more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other r "Septic Well , Floodplaint1 :1111at,ereD, str�"ct�s elLi/Sewer ;4 . _ DESCRIPTION OFWORK TO BE PREFORMED: `'�C► c-t� ►s' Qo 2�c ccs r o`�Cr 2' W t n i FLx--r fl-u K e CrL rLeo F '17 W(,4-c.c - `z�isTC�c� ce Let- Identification Please Type or Print Clearly) OWNER: Name: '-TE'Pti&A 1 Phone: I Address: 25 30L^ V C —i H 1 g`TRCTOR`;Name Phone Mlt T06b 9t �Supeniisst Construction Lic b i Exp t®ate�dm. Yr 3 Home�llm Movement License �_.. __ ..t° _.�;�_ � _. `04-6, ARCHITECT/ENGINEER Phone: it Address: Reg. No. s FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. ag �'l �� Total Project Cost: $ � % FEE: $ Check No.: 0 Receipt No.: �` 3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund t Building Department artment 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 Permi 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 Anc 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 Perrr In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appea. that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recordi must be submitted with the building application Doc:Building Permit Revised 2008 Dimension j 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 droprequires q approval of j Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.s100-s1000 fine NOTES and DATA— (For department use) M i i ❑ Notified for pickup - Date I Doc.Building Permit Revised 2010 J Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/MassageBody 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 I PLANNING & DEVELOPMENT COMMENTS i CONSERVATION Reviewed on Signature i COMMENTS HEALTH Reviewed on Signature , .. `r 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: Gated 384 Osgood Street FyI.RE,DERAR�TMEN-T Temp, -umpster}onssite gess; ` _ ,nF ,sL' "' ! �' ..`,. r x `, -v �*r s i`• !" "�-_."i - +Locatetl at=124�Main St�eetr ~= - '�---t-.�'6`---^r.`�w' s-t �Fi�eDepartrnents�gTnaturefdate � � 'r - -- —._ 00 � O O 28 JERAD PLACE ROAD - _ ASSESSORS MAP 106A, PARCEL.. 9 — -R 43,621 S0. FT. 11 \ 1 z � CA d' o cncq O co BENCHMARK.: TOP RIG - BOTTOM F RON_L EP. Lj i 00' BUFFER ZONE :Y C X/ ) Fyoom rvG ev f W �o(�S r J / 1500 GAL!ON / SEPTIC TANK f1 � OF WETLANDS 0 +, / D i A2 � ;' � _ _ _ -- -- DISTRIBUTION BOX 7 l TP co Cp l °Cuj / lr i IM11 01 SAND i I r 'N I - iP 4 N N i 5 ZONE • • 82.00 .. / = RICHA C. .05 � ,� TANG 28 PRESSURE WATER •`lAp,� SERVICE SS�ONA r o Q 0 co O O � 28 JERAD PLACE ROAD ASSESSORS MAP 106A, PARCEL. 9 -�c 43,621 SQ. F-T. f z co CD d cn �t o c O 1 BENCHMARKS TOP Ril. BOTTOM FRONT STEP. 1 UU' i3UFFER ZONE y - 2 � / V) 11 ;,,oOv ,.F-N L6 S/(.1, G � i 1500 CALLON SEPTIC TANK OF WETLANDS `/ •, ;'Ei l ,/ i I o��I I I. ( I - DESITS TR IBI.TIGN BOX Tp 3 -A/A3 co �rill . SAND 0j +I,� Limil yI �nNG `' 4 B I , i 5 ZONE ' i�E G B2.QO „ ... 5050,34 SB i ! rrzo C. 5 / TANG --- ESSURE WATER ..AoF "I.PTE !'R 1.28 �� - SERVICE 4101VA