HomeMy WebLinkAboutBuilding Permit #535-14 - 288 GREENE STREET 1/13/2014TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: .�,35'f�/ Date Received
Date Iss
IMPORTANT:A
icant must
all items on this
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EMAP'NO'; ��_- �PARCEL;.�..... ZONING`DLSTRLC
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TYPE OF IMPROVEMENT-
PROPOSED USE
Residential
Non= Residential
❑ New Building
&One family
❑ Addition
❑ Two or more family
❑ Industrial
AAlteration
No. of units:
❑ Commercial
`®=Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
V -Sceptic WeIP� ' N _ ~ ,
❑3Floodplain ❑Wetlands.
❑ 1NatershedGDistnct s
f 01Nater/Sewer;._
- -
DESCRIPTION OF WORK TO BE PERFORMED:
�ME1.9`6' Xa i R G Its Ruck &U'ARIA;r— AuW L.MAT, /l.lia4)
REP1 CF71-I416 TILT )W NMFD b , flblSHEb �.,C/�►t,��A�Y
Identification Please Type or Print Clearly)
OWNER: Name: `D N ►rs Phone: Li P1k-coff- 000 (—&J
Address:608 Vti'� A W QT JJD , AN8 MW. 01 elc �"�8 - ��� ��
C,QNTrRACTOR•'Name !)% _ --
Address
Super isor s Construction -.License `,�5$ . _ Exp Date.
-
Home Improvement License ___ �, _ /-V Exp Date `
ARCHITECT/ENGINEER Phone:_ X12
Address: �12� Reg. No.
FEE SCHEDULE: BULDING P MIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ `�®� FEE: $
Check No.: %, Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Plans Submitted Okrns Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
Plans Submitted ❑
Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
-TYPE_O'F°. SEWERAGE DiSPOSAL
Public Sewer ❑
Tanning/Massage/Body Art ❑ ..
.Swimming Pools ❑
Well ❑
_Tobacco.Sales ❑
Food Packaging/Sales ❑
Private (septic tank, etc._: ❑
=Permanent Dempster on Site ❑
THE- FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED: DATE:APPR-OVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
a
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Comments
g
Conservation Decision: Com
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Toga Y EngWeer: Signature:
Located 384 Osgood Street
FIRE DEPARTMVNT Tenip Dumpste_f on site no
�.
Located at -124 Main Street
Fire Departmet signatureldate 'k f 4 x• ,#, .,, _ �, x;� ., �s �, k .,
COMMENTS
-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.Z®NE LITERATURE: Yes NO
MGL -.Chapter 166 Section 21A=F and G min.$100-$1000:fine
NOTES and DATA — (For department use
El Notified for pickup - Date
Doe.Building Permit Revised 2010
C`
Building Department
The foL6wing'is a list of -the required -forms to be filled out for the appropriate permit to .be obtained.
Roofhhg, 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
(VOTE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
o Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
Li Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
Li 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
o Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
Li 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
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 apw al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submAted with the building application
Doc: Doc.Building Permit Revised 2012
Location
No. ,�� ��1 Date
Check ol—Ao
27218
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $.S�v
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
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288 Greene Street
North Andover, MA 01845
Rehab Items Basement
Repair sheetrock and paint $1650.00
Tile Laundry/Bath 475.00
Carpet
925.00
Ceiling Tiles/replace 300.00
Bath Fixtures 1350.00
Total: .......................................... $4,700.00