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HomeMy WebLinkAboutBuilding Permit #501-11 - 35 CHADWICK STREET 12/22/2010NoRTy BUILDING PERMITOF"Y�Eo TOWN OF NORTH ANDOVER c APPLICATION FOR PLAN EXAMINATION 3 0 Olt) R° "y Date Received l/ S0'ATE° Permit NO: rPE 1 D ACHUS Date Issued: JU � 2 � IlVIPORTANT: Applicant must complete all items on this page LOCATI0- Ica,, I Priht PRQ 'ERTY-OVVNER -a✓/Je/1 ���� 65. ��� .. . ' Print MAP 210... PA.RCEL:.dOa.. ZONING DISTRICT_;Historic;District, yes. - Machine Shop.Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building PWne family ❑ Two or more family ❑ Industrial ,Addition No. of units: ❑ Commercial Alteration ❑ Others: ❑ Repair, replacement ❑ Assessory Bldg Demolition �. Septic Well ❑ Other p Floodplain Wetlands . 0.. VVaterstiecl District. yON6terlSewer. n�cr��ip r�nn1 (1F 1NnRK TO BE PERFORMED: _ Identification OWNER: Name: e or Print Clearly) 42 - Address: . -r/1- +P./- 3-- J`5.. CONTRACTOR Name ®4 i� Phone•- � f Address: l�dX �- �� �e�� S /y`..:�•,�f�.. ei� moi' .. - Supervisor's. Construction License: Exp:Date;..:Le %.104Z Hom6*mProvernent License`: �ia�� Exp. Date:: ARCHITECT/ENGINEER Pho Address: 11 FEE SCHEDULE. BUL JNG PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON 16 !- / :2.7 0 $925.00 PER S.F. Total Project Cost: FEE: ¢ Check No.: r`p Receipt No.: o - NOTE: Persons contracting y h=unregistered°,contractors do not have access to the ar r ty Signature of Agent/Own Signature of contractor TYPE OF IMPROVEMENT ❑ New Building Pddition AAlteration ❑ Repair, replacement JK Demolition 0 Septic d Well OWNER: Name: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received 0/9 U a o(rI PROPOSED USE Residential P,One family ❑ Two or more family No. of units: ❑ Assessory Bldg _ ❑ Other D Floodplain ` 1Netlarids ❑ DESCRIPTION OF WORK TO BE PERFORMED: Non- Residential ❑ Industrial ❑ Commercial ❑ Others: Identification Please Type or Print Clearly) Uatersfied Disi Phone: rr Address: CONTRACTOR Names 5e Phone- ��3 Address: 6dx .S %l��-•Madam `i .. . za- 12 Supervisor's. Construction License: S3 a .-Exp. Date:... Hoino.Jtnproverhent License �6�� Exp. Dater ARCHITECT/ENGINEER Phone: Address: Reg. FEE SCHEDULE: BUL91YGP ERM1� 92.00$ $1 PE.00 R S.F. THE TOTAL ESTIMATED COST BASED ON Total Project Cost: FEE: Check No.: " 1 ( _ Receipt No.: NOTE: Persons contracting h, UnregisteredsOV,,rractors do not have access to the ar ty Si nature of Ag`e`nwn Signature of contractor 9 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received l/ 3O 0�Old TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building .One family Pddition ❑ Two or more family ❑ Industrial Alteration - `_ No, of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: Demolition ❑ Other rSeptic p Well ---R-Wa"ter/.S6wer. D Floodplain . d Wetfarids �' Watershed District. . , ...... ' Dt-bL;Klt' 1 1uN VI- vwumm 1 v Csr- rr-rcrvniviaw. ® OWNER: Nam Identification FleaseZ e or Print Clearly) A d- 17-1140p-ff// . Ai Address: CONTRACTOR "Name, 5e/ Phone: Address 6dX i,7 ��.. ��•/�� S %��..��r�f�. 8i� Superyisor's.Con struction icerise: S 3 Exp:Date:... Home..lrrrpro'vement License: �6�� Exp. Date:. ARCHITECT/ENGINEER Ph Address: ME. r 9 ,r' I - FEE SCHEDULE: BULLI G PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON / s�' / .2 5-0 $925.00 PER S.F. Total Project Cost: FEE: $ Check No.: �� �--� Receipt No.: NOTE: Persons contracting h.unregiste �ractors do not have access to the ar ty Signature of Agen wn > "`'� Signature of contractor Location 3C ��'l� �ifC S C No. — Date TOWN OF NORTH ANDOVER �. 0 a Certificate of Occupancy $ Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check t tr Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans$ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/MassageBody Art ❑ Well ❑ Tobacco Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site ❑ Swimming Pools ❑ Food Packaging/Sales ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS_ n r n� r 1�,. - ad CONSERVATION COMMENTS Reviewed on %' -I l 3 I 10 �1EALTI-1 Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Zoning Decisionlreceipt submitted yes DPW Town Engineer: Signature: FIRE DEPAR-jjMENT --Temp Dui Located at 124 Main` Street .Fire Department signaturelaate on site vis COMMENTS. l ` . . 384 Osgood Street no Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans$ EWell WERAGE DISPTP-Tanining/Massage/Body Art❑ Swunming Pools co Sales ❑Packaging/Sales ❑ Food tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS Reviewed on t D-1 13 DATE APPROVED El gEALTH Reviewed on Signature CO e - Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Drivewav Permit D -PW Town Engineer: Signature: cated 384 Osgood Street FIRE DEPARTi�iEiVT -Temp Dumpst on site no Located at 124 Mair" Street .Fire Department signature/date f`F.111A11AE111Tc� Dimension Number of Stories:_ Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 4 52% 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—t- and G min.$100-$1000 fine Doc.Building Permit Revised 201010ctober 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 DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — For department use r" 1 ® Notified for pickup - Date Doc.Building Permit Revised 201010ctober 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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks q Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers .Comp Affidavit ❑ Photo Copy of H.I.C. And`C.S.L. Licenses ' ❑ Copy Of Contract ❑ Flo or/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 ®TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Il_n 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 2008 the folio \ olri h f o IQ4i/cyi /Ne�/ to®e o C oto Cs Com �tgpp/i �a�i//t��, a°`'tforgh° e�� ®i . o /oo y °� Co 1' odaVi ti°h®h �e p� . appr°ar;ag° A/ 17tr • /. C / q �er�;� go gifjeera/� Cry ct ,qhd/ p be °�� �dcl' psterpe�gq��� posed/ r C S < w a��°a ®h®� mets reg4�;ts for �ter1or L;cehses SU DOoA-s re s%gnkn�e °rk o/cy� off fr ere4, O Cer1`if� 9 Aer °m FirePro d4c o p °rker d SUriieltgpp/i �eparits � o Co °to co •Com Yed p catlO17 o ,b p p q /ot me�tpr/or t F/ k p/. y o did A/a o is by °r/Cro C°htr y�C. aVit n sUance o o � dra4/i ssecti act qha C f ag p ��; o Fhass Che Ca/c4/ e� S <. <Cmz i er�ii s �epsterper9.q ff4,rgY CO (/�qb p/�-Ot' IV . �t ' fo ahce /e� dos O t �cl®® ire si Fn9'i Re - o �Ui/ain (S®fig/ g� off foeereap `(/fqp rk h S o phrti /e permit e ��� �� m Fire 1) dOct plicab/e) pr�n�/er p o, or Oto Of r°,boss pp/icat' ®�a� ' parti�en /an qnd T�'o ser' CO . 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Crt... ..� .y c.t cv c Z = *.m •- v O mo m� c g VC' i m 2 0:2 _ amo o0)a o *Z n� mJ f Wr as 0 E 0 5 Z a O � y C i �cm o.- CD E mm cc CD CL 0 CD t 3� O C cco CDa o a o- �a c o P. -O C ccC:L CD CDcc CO2 C ts CD CL V y c C C— C Q. CO2 0 Y+ LLI U) W W ce W U) N° FD 7607 This corrifies that ...... TOWN OF NORTH ANDOVER RECEIPT has paid ... n. C) for Receivedby ....... ......................... 1,57 Department ......... .................................................................................... WHITE: Applicant CANARY: Department PINK: Treasurer