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HomeMy WebLinkAboutBuilding Permit #744-2011 - 286 RALEIGH TAVERN LANE 5/4/2011TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: � ' vIt Date 4 Date Received I— I E&ORTANT: Applicant must complete all items on this nage --1 LOCATION `Ir SAA&a&&40? �Av Z. Print PROPERTY OWNER P#4 0&!7 4 v Print MAP NO:%U 714 PARCELZONING DISTRICT: Historic District yes no Machine Shop Village yes no OF IMPROVEMENT PROPOSED USE 711Addition Residential Non- Residential w Building ❑ One family ❑ Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg 0 Others: ❑ Demolition ❑ Other `(❑Septic 'F®Well}x y{ `0'Rloodplainu�©pWetlands '`©yUatershed�District �4 �r ;fa Y `t. ;♦� �-7' f 3 t iS ti '� '.''1., 1 " {v r� �• S � � o > �' - DF,qCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: i514 A f A ry Phone • .• t $tg Address: lis 5-X ANa64.1 ,(a,�� CONTRACTOR Name: Phone: (� Address: ZlU �iw �1G0 • ��%. Supervisor's Construction License: Home Improvement License: Exp. Date: Exp. Date: ARCHITECT/ENGINEER Phon Address: Reg. No. FEE SCHEDULE. BULDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925,00 PER S.F, Total Project Cost: $ 2�6 FEE: $ �G Check No.: �2 06r Receipt No.: ;� <;/-/ 2 - NOTE: NOTE: Persons contracting with unregistered contractors do not e a ess to the guaranty fund Si a ii _. n t rµ oritr cfor:: _Sinnafi�rE?'�if�Adent/OWnerq-°• ... ---- ---....._9......_...._.._ ..___..---------.....,...-._._.._._...._�.,..,--..�_! Plans Submitted ❑ - Plans Waived ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Well ❑ Private (septic tank, etc. ❑ Certified Plot Plan ❑ Stamped Plans ❑ Tanning/Massage/Body Art ❑ swimming Pools ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEVELOPMENT ❑ COMMEN DATE APPROVED El CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decisionfreceipt 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 COA4MENTS 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 21A—F and G min.$100-$1000 fine 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 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 ❑ 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals AL the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording ist be submitted with the building application Doc: Doc.Building permit Revised 2008mi O z. W rA Cd w PQ o O V. Cf) v C/) O pO w €O G a p G O W w a p w' y cn G w o t7 O oG m G w w w v G w z cn - Q o cn I ^� W O L O Z � d O y D � CO CM C C O• CO) 0 'fl yO .O •a m m CD 0 CD CD cmO O i e_cv o a CL a co R C O CJ J -0 EL O •ca Zts CD V y O C C■� C _� 0. y LU LU W W 09 LLIW W c o €O as c ; F4 c� ;W O Q V C R ^ m C O : cc O CDCA GQ E a ,.CFCly :..• +- n C3 C3 0 cm n= L v CD UL Ltiz y y `? 3 Cn Q1 z CO) O CD O y cm �r C.D. ss n :Mo� Q CO) •O m W 0 H O C3 Z O cc Icm C O n C � m C •O = m m C N O nom O W a.+ N O y ■ -0 _ •H y... C O •m ELCD C' Ca o •y � Z O CWi Ca f � ® F Q' C* _ O .- 0:6 ` y•5 J O nSm� I ^� W O L O Z � d O y D � CO CM C C O• CO) 0 'fl yO .O •a m m CD 0 CD CD cmO O i e_cv o a CL a co R C O CJ J -0 EL O •ca Zts CD V y O C C■� C _� 0. y LU LU W W 09 LLIW W North Andover Building Dept 1600 Osgood Street Bldg 20 Ste 2-36 North Andover MA 01845 HVAC PERMIT FOR THE INSTALLATION OF AIR CONDITIONERS, BOILERS, EMERGENCY GENERATORS, FURNACES OR ROOF TOP UNITS. The undersigned applies,/for a permit to install the following at: LOCATION y9 6%gyA4!5iv `i4rvY DATE Il �U 3 DSD J OWNER OF PREMISES 91&-- 4!Td +y ADDRESS qX w4ew. /►A"`y A CONTRACTOR NAME Rg' iC .41 S / �y ADDRESS eZ/D 4A L, S� 1�i0 �l�i•�� PREMISES NAME MATERIAL OF BUILDING TYPE OF FUEL CHIMNEY � NO. OF FLUES CHIMNEY THICKNESS DIAMETER HEIGHT LINING SIZE IF STEEL STACK LOCATION DESCRIPTION OF HEATING APPARATUS TYPE OF HEATER/FUEL HOW MANY MAKE BTU INPUT LOCATION IN BUILDING PROTECTION AGAINST FIRE AS REQUIRED HOW PROTECTED ROOF TOP UNITS OR EMERGENCY GENERATORS (See the State Code pertaining to chimneys, smokestacks and heating apparatus.) DINIENSIONS: LENGTH LOCATION ON BUILDING SIZE OF ROOF RAFTERS SPAN OF ROOF THVIBERS PROTECTION AGAINST FIRE AS REQUIRED HOW PROTECTED BTU INPUT/OUTPUT WEIGHT WIDTH HIEGHT HOW SUPPORTED MATERIAL DISTANCE ON CENTER FUEL TYPE APPLICANTS SIGNATURE �" DATE 3 cza `/ Location No. 7'/-/ - �2 c'" Date MORT1TOWN OF NORTH ANDOVER f 1h 9 e ; : Certificate of Occupancy $ Building/Frame Permit Fee $ �r Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # .? 0(_4 £i ,241.E f% Building Inspector