HomeMy WebLinkAboutBuilding Permit #Exception - 356 REA STREET 5/1/2018 BUILDING PERMIT t%ORT,
TOWN OF NORTH ANDOVER 3 `'LED
APPLICATION FOR PLAN EXAMINATION0
Permit NO: d
Date Receive
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Date Issued: SSgcHu
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, eplacement Assessory Bldg Others:
Demolition Other
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166d"Septic < Well
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DESCRJPTION OFWO PREFOR-___
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Identification Pleas Type or Print Clearly) 33
OWNER: Name: !---Phone: -3
Address:
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ARCHITECT/ENGINEER __
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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: $ 010 FEE:
Check No.: Receipt No.:
NOTE: Persons contracting with unre2 W* d contractors do not have access to th ar n und
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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
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THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
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A) 5� DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on4� ® Si nature
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C ENTS OD
HEALTH Reviewed on—:7 . Signature /
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature&Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Os ood Street
RE-DEPARTMENT ,""T-mp pumpster ori site .yes
Located at'124"Main Street �. >`� '�;�;,��,. ���s � •} �. f � ��� Ay. �t x•
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1177 epa m6fitsignature/date = _ _
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COIVIMENTS)=
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total landarea, 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.$1o0-sl000 fine
NOTES and DATA— (For departmentartment use)
❑ Notified for pickup - Date
Doc.Building Permit Revised 2010
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 tatlon Permits
❑ Building Permit Application
❑ -Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
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❑ 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)
❑ 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 submitted with the building application
Doc:Building Permit Revised 2008
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