HomeMy WebLinkAboutBuilding Permit #653 - 315 SOUTH BRADFORD STREET 5/29/2009BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Y" �3
Date Issued: -0
Date Received
;ant must compl
Pant
°,, `Print
MAP NO 16 G PARCEL: i J ZONING,DISTRIGT:'
_ R
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
'New Building
One family
Addition
Two or more family
Industrial
Alteration
No. of'units:
XCommercial
Repair, replacement
XAssessory Bldg
Others:
Demolition
Other
Septic Well
Floodplain Woliands
U1/atershed District
Wat4/Sew4
_
�w
r�
a4s�'i C �Pc�
♦ f � 5
OWNER: Name:
Address:
CONTRACTOR ,Na
DESCRIPTION OF 1
wl',r,107 1 F -14 c,"
f
RK TO BE PREFORMED:
woe .
De or riot dearl
„t .Phone:
m
Address:-_7�✓%` ..
g
Supervisor's Construction License: Exp$ .Date:-%_
Home Improvement License. :exp, °Date:
.ARCHITECT/ENGINEER /xo vii Phone. %90 y 2ll
frac, c o d -e, 7a 2
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT. $12.00 PER 1000.00 OF T,[lE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ FEE: $ 0
Check No.: 4 7 Receipt No.:
NOTE: Persons contracting iVith unregistej ed contyactors do not have access to the guaranty fund , /J
'hone: 6K— �— O
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
PLANNING & DEVELOPMENT
COMMENTS
J CONSERVATION Reviewed
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
Dimension
Number of Stories: 1 Total square feet of floor area, based on Exterior dimensions. IS G
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
NOTES and DATA — (For department use)
❑ Notified for pickup - Date-
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
11
o 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)
NOTE:
❑ 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
Li Engineering Affidavits for Engineered products
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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
Location
No. i�, 53 Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
CHU
Foundation Permit Fee $
Other Permit Fee $
TOTAL
Check #/
22068 V"R-
Building Inspector
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