HomeMy WebLinkAboutBuilding Permit #711 - 30 MASSACHUSETTS AVENUE 5/26/2006�jo1`'O 4• •hew
o TOWN OF NORTHANDOVER
= • APPLICATION FOR PLAN EXANtINATIUN
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�`% Date Received:
Permit NO: /
Date Issued: -c2 G 6
jN1PORT.XNT:.\pplicant must complete all items on this age
LOC.N.TION
PROPERTY OV►'NER
Print
NIAP NO.: PARCEL: ZONING DISTRICT:
TYPE AND USE OF BUILDING
HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential
New Building _; One family
=
-,Two or more family = Industrial
Addition
Alteration No. of units:
Assesso Bldg
-Commercial
r
-_ Repair, replacement g
Aie Demolition Others:
Movin (relocation)
-Other
= Foundation onI
DESCRIPTION OF WORK TO BE PREFORMED -
La
Identification Please Type r Print Clearly)
ZA14 J.+M Phone:OVI NER: Name:�"
,address: 3a
CONTR.NCTOR Name: � °��
Phone:
Addre,ss.
Date: i ; �
of Super% isor's Construction License:, OS �Z 3� Exp.
'n d
j l o S� Y Exp. Date:_7 •� �� Zoos- _.
Ilome Improvement License:
RCI- VFEC f' ENNCINE ER \imc: 1111cnc: -
j Reg. No. �
\dress: �
FEE SC'HEDL LE: Bt LDIAG PE RMIT:.s10.%30 FE•R Si!lllll.i?(l GF THE TUT IL ESTI.tI, ITED COSTS, ISED D,N "1=S.OlI
x 10.00=FEE:$ �
Total Pro ect Cost :$..._-/
Receipt No.:
i
r
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
V-oofing, Siding, Interior Rehabilitation Permits
Building Permit Application
Workers Comp Affidavit
a Photo Copy Of H.I.C. And/Or C.S.L. Licenses
j Copy of Contract
:I Floor Plan Or Proposed Interior Nkork
Addition Or Decks
Building Permit Application
Surveyed Plot Plan
o Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydra
Calculations (If Applicable)
a Mass check Energy Compliance Report (If Applicable)
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
o 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
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board
%ppeals that the appeal period is o%er. The applicant must then get this recorded at the Registry of Deeds. One cop3 a
proof of recording must be submitted with the building application
>ur: I`.' I'I.l`I'IoN 1L til:R\ U 1•a DEP % tI?IF" I:ilI)"AI`M5
TYPE OF SEWARGE DISPOSAL
Tanning'Nlassage Body .\rt _ Sti imming Pools,:
Public Seme.r _
Tobacco Sales --
Well i
Food Packaain�`Sales `
_
Permanent Dempster on Site
PriNate (septic tank, etc. _ Electric Meter location to
_ project
NOTE: Persons contrrrcting with unregistered contractors rto not hmle access to the gitaranty fund
Signature of Agent; Owner - Signature of Contractor
Plans Submitted °`' -Plans aived Certified Plot Plan
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
Stamped Plans
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑
❑Water Shed Special Permit
EJ Site Plan Special Permit
- J Other
COMMENTS
v i DATE REJECTED DATE APPROVED
CONSERVATION
a
COMMENTS
DATE REJECTED - DATE APPROVED
HEALTH
COMMENTS . ,
Luning Board of Appeals: % ariance. Petition No:
Zoning Decision receipt submitted � es _
ilimmin; Boud Dccisiim: -- ----Comments
l mscr\;&cn DCCT"IUn: �i?Illnlcnts
'1;�tur � S�a�cr connection si,,naturc �f �atc —_-
i mp Dempster rn site ; cs_ no _ faire Department i nature 'ate
Building Permit Appros.cd and Issued by:
:4
Building Setback (tt.)
Front Yard
Side Yard
Rear Yard
Required
ProN ided
Required
Provides
Required
Provided
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DIMEMION
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
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