HomeMy WebLinkAboutBuilding Permit #604-13 - 32 MAY STREET 3/13/2013TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: , �i ,3 Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this age
LOCATION r^ a�ic3l'?Ve1� D1
_ Print
PROPERTY OWNER t -
Print 100 Year Old Structure yes ono'�� MAP NO: PARCEL: ZONING DISTRICT Historic District yes Machine Shop Village yes
TYPE OF IMPROVEMENT
PROPOSED USE
Residftntial
Non- Residential
❑ New Building
U,6ne family
❑ AAdition
❑ Two or more family
❑ Industrial
OA ration
No. of units:
❑ Commercial
epair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
0 Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
denti
OWNER: Name:
Address:
CONTRACTOR Name:
kjf�
Address: g 00 JSP <
Please Type or Print Clearly)
/1:0 PhnnP-
Phone: / /2 X
0 M�
�a-.lays
Supervisor's Construction License: Exp. Date:
Home Improvement License: y( h 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: S �? � FEE: 2 /(r
Check No.: K5_�- Receipt No.: o� 40�
NOTE: Persons contracting with unregistered contractors do not have access to ranty fund
0
;Signature of Agent/ Signature of contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
41
f
P
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
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: Comm
Water & Sewer Connection/Signature & Date Driveway Permit
DPW 'Town Engineer: Signature:
Located 384 Osqood Street
t-IRL UEPARTMENT - Temp Dumpster on site yes no
Located at'124 MainStreet
Fire Departinerit signature/date
COMMENTS Y
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Dieter 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
El Notified for pickup - Date
Doc.Building Permit Revised 2010
Building Department
The fol€owing 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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
o 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
❑ 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 subm;tted with the building application
Doc: Doc.Bui?ding permit Revised 2012
Location 3—,7 Vy\ j, Ig r—
No. �,o Date,3 - IS - 4
Check# (AT
26206
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee $
Foundation Permit Fee
Other Permit Fee
TOTAL $
e7:� ?�I� -
1 Building Inspector
V
Location
No. 51 t�-- I I
mi
Check #1 2-',�q
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ tb
Building/Frame Permit Fee $-
Foundation, Permit Fee
Other Permit Fee
TOTAL
duildin'
g Inspector
o� MORTH try
M i
♦ off^ ... �� �
S-1 CHO,
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 515-13 on 1-15/2012 Date: October 10, 2013
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 32 May Street
MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER
REGULATIONS AS MAY APPLY.
Certificate Issued to: Allan Cuscia
32 May Street
North Andover, MA 01845
Fee: $100.00
Receipt: 27012
Check: 7229
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Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
Construction Supcn•isor
License: CS -083945
KEVIN J GRASSO-`�
29 MSTINE I.N,'
HAVERHILL Mk 01$ `
a
;
Expiration
Commissioner
11130/2014
3 a fv\a�, SI-4-
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ 26,500.00
m
$ -
$ 318.00
Plumbing Fee
$ 39.75
Gas Fee 100 comm.
$ 100.00
Electrical Fee
$ 39.75
Total fees collected
$ 497.50
32 May Street
604-13 on 3/13/13
Additional Work Original Permit 515-13 on 1/15/13
Bath Remodel, Drywall all walls, list in file
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