HomeMy WebLinkAboutBuilding Permit #436-15 - 29 MAGNOLIA DRIVE 11/5/2014 t%ORTH
BUILDING PERMIT °`tsLE° gtio
TOWN OF NORTH ANDOVER
FOR PLAN EXAMINATION
APPLICATION
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Permit No#: Date Received
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Date Issued: Y
IMPORTANT: Applicant must complete all items on this page
LOCATION __ q-- LQAO`k0—DA—),C-
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PROPERTY OWNER. _ L.pY (-�.�COLI�t�-/ f __
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Print 100 Year Structure yes d
MAP' PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building [Zne family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
epair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain: El Wetlands 0 Watershed District
0 Water/Sewer.
DESCRIPTION OF WORK TO BE PERFORMED:
12 CSC
Identification- Please Type or Print Clearly
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OWNER: Name: n sCa.canci i Phone: �l7� 5Q .!�S
Address: a9 1� (�1 �� �l� / j��7
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Contractor NameI�I •S(c�1 __ . - _ -_ �°��
Address.-- sk _0,)A- k _ I r4f, A0�6ff
Supervisor's Construction License: _ �1�J 3 Exp. 0ate:__Jc1_-16i S nr
Home Improvement License ___ ID-4__1� t0 Exp. Date:
ARCHITECT/ENGINEER Phone:
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Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST 8 ED ON$125.00 PER S.F. T
Total Project Cost: FEE:
$
69M 01
Check No.: ��L& Receipt No.: �
NOTE: Persons contracting with unregistered contractors do not have accessto t _e guarantyfund
Signature of Agent/Owner Signature of contractor
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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/Cross Section/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 pp 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
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
Doc:Building Permit Revised 2014