HomeMy WebLinkAboutBuilding Permit #208 - 356 APPLETON STREET 9/24/2008 NORTF/
BUILDING PERMIT c�'J'URD
TOWN OF NORTH ANDOVER °
APPLICATION FOR PLAN EXAMINATION * ,�
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Permit NO: Date Received �4"�q,T.o$6
4CHl1
Date Issued:
IMPORTANT:Applicant must complete all items on this page .
LOCATIONzc
Print =
'PROPEF2TY ONUNER
Punt y
°MAP NC?: PARCEL:' ZONING DISTRIDT.: � Histflric!Oistrict 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
:Septic Well Floodplain Wetlands `Watershed.District'
s � .
:Water/Sewer
DESCRIPTION OF WORK TO BE PRE MED:
4LO Ue
Identificati* se Type or Print Clearly)
OWNER: Name: z Phone-C 79- "(Z 3 S'�o 3
Address: r
lcoNTRACTOR Naime. L £ phone:"i !R'
Address:
Strpervisor's'Construction Lloense p Exp Date:
aT
Marne Improver-eent License � � wExp.re TJate
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PEWIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$1250F.
Total Project Cost: U C) FEE: $
Check No.: J >a' 1 c Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access tot u a u
ignature9of ."gent/Owner Signature ofcon'tractor
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
j ❑ 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
i ❑ 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
Li 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
u 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 submitted with the building application
i
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2008
I
Location �� �
No.
O Date / r
�aRTM TOWN OF NORTH ANDOVER
3+ : • '• off
F 9
Certificate of Occupancy $
�'s'•"°,�� Building/Frame Permit Fee $
AC MUS '
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
19 3d 1-
21 562 �-
v Building Inspector