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Home My WebLink AboutBuilding Permit #237-2016 - 35 BOXFORD STREET 8/26/2015 r OF %40RT1� .q BUILDING PERMIT ~ � o TOWN OF NORTH ANDOVER t APPLICATION FOR PLAN EXAMINATION Permit NO: �" Date Received Date Issued: o `�`� �7 �9SSACNUS IMPORTANT: Applicant must complete all items on this page { I Y p TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 'One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial YRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other t Jw I 1'ref��4�v�Q�►�. C✓�yJcjC?�.I elJt� cSt�ycy� C �Gti s Identification Please Type or Print Clearly) Y) OWNER: Name: g, /i4Phone: S s- /9o2O Address: IN b ] R � .^� as op, SJ� 0175t ICS �� rf'l� �\ "�� r ✓ a y ' A' Yci 711 Ir f6-A se:. 14 I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �i a�O `� FEE: $ 64 Check No.: Receipt No.: C) 5,;2- NOTE: ,;2-NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund re i BUILDING PERMIT 0 NORTH tt`'eo ib N TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 70 nO OH Permit No#: Date Received �9A�RAreo SSACHUS Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes 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 0 Septic ❑Well ❑ Floodplain. ❑Wetlands 0 Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone:_ Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: e Address: Reg. No. n 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.: Receipt No.: _ NOTE: Persons contracting with unregistered contractors do not have access to the -- ► �. �Sianature of Aaent/Owner Signature of contractor �Z:.N�. �., -- 1. Locations No. C? 3 2 0 Date • - TOWN OF NORTH ANDOVER PLED,,r�A • Certificate.of Occupancy $ 4� Building/Frame Permit Fee Foundation Permit Fee $ 1-1� Other Permit Fee $ � TOTAL $ R Check# � �} Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified fled Plot Plan ❑ Stamped Plans F1 TYPE OF SEWERAGE DISPOSAL _ I Public Sewer ❑ Tanning/Massage/Body Art ❑ Swin"iig Pools ❑ Well ❑ ❑ Tobacco Sales Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on_ Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes PlanningBoard Decision: Comments Conservation Decision: Comments `'Aster& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: -� Located 384 Osgood Street FIREDEPY�iR� NkT TferrpDumpsferontsite_` �` nY�� 5 eafed at 12$4 Main �signatur�e,clate EN�TSy 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 DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine I NOTES and DATA— (For department use) I I ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 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 OTE: 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And j Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) ;rR Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) i 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014