The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #356-11 - 30 MAPLE AVENUE 10/24/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: w Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 3d ^a Print PROPERTY OWNER Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village no 100 year-old structure es no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ®Septic 0 Welly q)Floodplan 7 t 0 Wet and s $WateTshecilDistnc ❑;Water/,Sewer � DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: JJe CONTRACTOR Name: 2�1�I �� ILI— Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: cPOD 5 ReceiN t No.: NOTE: Persons contracting with unregistered contractors do not have access to 4e uarantyfund Signature of Agent/Ownei# . . �: Slgnature_of,coritact yF . e � i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ 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 i PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Con nection/Siqnature& 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 ature/date p � 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 i DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi I 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 1 ❑ 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 (VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) I I ❑ Building Permit Application I ❑ 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: Doc.Building Permit Revised 2008mi NORTH Town of _ Andover '.. . No.3,rfo o , cover, Mass., COCHICHEWICK ��`• �O)Z?ATE D �' '`� V BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR �� ... THISCERTIFIES THAT............... ..... ........111................. ....................... ..................................................................... Foundation has permission to erect.............:...........:... .......... buildings on ............................ .....� �, .. �1! • Rough to be occupied as. .... .............. .. .... . .. ........... 0............................................... Chimney provided that the p son pting this permit shall in every respe conform to the terms of the application on file in Final- this inalthis office, and to the provisions of the Codes and By-Laws relating 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 7T c 7 ELECTRICAL INSPECTOR. L'1�I LESS CONSTRUCT ONST V CT TS Service Rough .............. ........................................................... 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 (Mall To Be Done FIRE DEPARTMENT. Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. Commonwealth of Massachusetts Sheet Metal Permit Date: l(J � Permit# J Estimated Job Cost: $ S ; 0 6)G .G Permit Fee: $ Plans Submitted: YES NO ✓ Plans Reviewed: YES NO Business License# Applicant License# Business Information: Property Owner/Job Location Information: Name: c1 4yr�1 &A C-1''ct�`� Name: Street: Street: 3d- T City/Town: Md116 �� City/Town: /y( 0- Ah Telephone: Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES NO �cted Staff Initial J-1 / I J-2 /M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family V Condo/Townhouses Other Commercial: Office Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq. ft._over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: ✓ Renovation: HVAC V Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done::— V, 4-2 ��4z in INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes❑ No❑ If you have checked Yes,indicate the type of coverage by checking the appropriate box below: A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments Final Inspection Date Comments FType of License: By El Master Title ❑Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ Check at www.mass.gov/dpI Inspector Signature of Permit Approval Location No. Date �pRTot TOWN OF NORTH ANDOVER 00 • s 4 Certificate of Occupancy $ CNUS<� Building/Frame Permit Fee $° Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # V�d 24746 " Building Inspector