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HomeMy WebLinkAboutBuilding Permit #192-15 - 34 MAYFLOWER DRIVE 8/22/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: I IMPORTANT: Applicant must complete all items on this page LOCATIONK/CO x Print PROPERTY OWNER Print 100 Year Old Structure yes rio MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential "Iew Buildingne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands Watershed District ❑Water/Sewer DESCRIPTION,91F WOR TO PERFORMED: Koorrl o � . 'a�p, or�0e�t•�' d��. Identification Please Type or Print Clearly) OWNER: Name: KQ' Y "ud. .ir7ic , pp Phone: Address: /O �i�l�`ci¢ ZJ���� ����ddt�e I'J?�¢ m/Y4e3 CONTRACTOR Name: Phone: 6-09 ! 'O Address: 601 ©�� /�LG, /�JO��d>0�'CL, ^4 B/8 cs / o Supervisor's Construction License:_ G S -7 ,30�., Exp. Date: >a �rhr Home Improvement License: Exp. Date: ARCHITECT/ENGINEER)t1WAW49�DAfiU Phone: Address: be�Dw.t , 41.4 Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 0 Total Project Cost: $ FEE: $ — Check No.: ® Receipt No.: 2-19 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agewripr lg nature of contractor , Plans Submitted 'e P s Waived ❑ Certified Plot Plan ❑ Stam ed Plans - 'Plans Submitted L'7 .'Plans Waived-0 Certified Plot Plan [] . Stamped Plans ❑ T-PE OF';SEWERA:GE.DtSPOSAL _ .. Public Sewer Tanning/Massage/Body Art ❑. Swimming Pools ❑ Well .Tobacco.Sales E] Food Packaging/Sales ❑ Private(septic tank,etc.-. = .-Permanent Dirtnpster on°Site 11 THE-.FOLLOWING SECTIONS FOR OFFICE.USE ONLY INTERDEPARTMENTAL SIGN_OFF - U FORM :.. DATE. REJECTED DATE:APPROVED PLANNING & DEVELOPMENT ❑ COMMENTS I ICONSERVATION Reviewed on <T )o 1 Si` nature COMMENTS -� _ �� — Q M�� s�f VA sem,.\� c��.� HEALTH Reviewed on Signature COMMENTS ` Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision: Comments Conservation Decision: Comment o, ('f WaterSealer Connection/Si nature& Date 1 Drivewa Permit G DPW Tow 0; Engineer: Signature: r _ Located 384 Osgood Street :FIRE-DE PARTIll1�`NT.-.Temp�Dumpster onsite yes no Located-at 124,Mair, Street `Fire Departure►it signature/date-T -- ' • - ,-. • . * • COIAM.ENTS _ -Dimensim Number of Stories: Total square feet of floor area, based on Exterior dimensions. -_Total land-area,-.sq. ft. ELECTRICAL: Movement_of.Meter location, ro ast or service drop requires approval of Electrical Inspector Yes No DANGER.Z®NE LITERATURE: Yes No MGL-.Chapter 166.Section 21A-F and G min.$100-$1000fine NOTES and DATA— (For department use B Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fol-) is'a list of the required.forms to be_filled ouf.forthe appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C..And/0'r C.S.L Licenses ❑ Copy of Contract n ❑ Floor Plan Or Proposed Interior Work o 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) ❑ 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 apo,,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Bui?ding Permit Revised 2012 Location � �� � �- +e � � ,c ) No. 2' > Date 22 t . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ W•VD Other Permit Fee $ TOTAL $ Check Building Inspector � NORTf•� Town of ndover No. _ 1 W4- h ver, Mass, COC .41 CKt W#CK 1 o �d RATE D S U BOARD OF HEALTH Food/Kitchen PERMIT T`` LD Septic System THIS CERTIFIES THAT ............ . ....l:),..(..:? (.. -:.... .?l.�—........................ .. ..... ...... BUILDING INSPECTOR . . . ..... .. .. .... .. .. y j has permission to erect .......................... buildings on _3 .. .. �U F....................... .......... Foundation . Rough to be occupied as ................. p ..... . ...... .�t..6.Q,ls'....0.�.... ................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this 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 MONTFLS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO Rough Service ........................................... ...................... Final B ING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. NORTF{ Town of . � E 1. Andover Alt LAKE�o -h ver, Mass, 1 coc"Ic Ml WIcK a• �ls RATED `,`,�5 U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System C ``.T.. �„ L ..... .. BUILDING INSPECTOR THIS CERTIFIES THAT .............. .. ...r ....f�. (....:.... <................................. ............... �l�a ��o, )F Foundation �^— has permission to erect .......................... buildings on -3.-//................... .. .... ... .......................... .......... / Rough to be occupied asO C/� O ................. ..................... .�1. ..OvV.....:..�...�................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file In this 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 MONTRS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO t I Rough Service ........................................... ..... ...................... Final B _ ING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. I i I Board of Buil ding Reg!jjati. Cnmtru :ti,?,) S:rd 1 ..icense CS-075302 BENJAMIN C(61 001 D � 3 69 OLD VIII A AF'.t, NO ANDOVER AA, 0.1w .t i�C4C, v rs F l ii r. 12/®412014