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Home My WebLink AboutBuilding Permit #418 - 360 WINTER STREET 11/21/2006 TOWN OF NORTH ANDOVER �10RTh APPLICATION FOR PLAN EXAMINATION . 10 of t,•° , 1ti // s Permit NO: Date Received //��` � r i Date Issued: "*■° ty 1SSACHUSE� IMPORTANT: Applicant must complete all items on this page y LOCATION-160 W;n fi�P Print PROPERTY OWNER �ON)(e.� (�, -NA0MAr Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building YrOne family 'XAddition ❑ Two or more family ❑ Industrial Alteration No. of units: Repair, replacement ❑ Assessory Bldg ❑Commercial Demolition L Moving(relocation) ❑Other ❑ Others: '2 Foundation only DESCRIPTION OF WORK TO BE PREFORMED Ni2 n ff� e��e.�sioN Identification Please Type or Print Clearly) OWNER: Name: t7ag;e/ G, l o/4s Phone Address: 3 I 0 CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/_ENGINEER �,S A NO Name: Phone:_22-03—//93 Address:Z ��1L1C'ev /(/kd( YeA Reg. No. FEE SCHEDULE:BULDING PERMIT.•512.00 PER$'1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ ;'� ,� a FEE:$ Check No.: Receipt No.: '�q, 3 Page lof4 .r' TYPE OF SEWERAGE DISPOSAL r- Swimming Pools C Tanning/Massage/Body Art Public Sewer —� Tobacco Sales ❑ Food Packaging/Sales E Well Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fiend ( ' Signature of contractor Signature of Agent/Owner Plans Submitted Plans ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS r no T 1~` FIRE DEPARTMENT - Temp Dumpster on site yes Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Sihnature& Date Driveway Permit Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided / / Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use Page 3 of d I' Doc:INSPECTIONAL SERVICES DEPARTMENT:BPPORM05 Created AIC 1an._006 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 Addition Or Decks ❑ Building Permit Application ❑ 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 ' p p Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) 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 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:INSPECTIONAL SERVICES DEPARTMEN'r:BPFORN105 Page 4 of 4 ti n In �,�.b r► S 1"' Loca o , No. Date NORT1y TOWN OF NORTH ANDOVER �- f 9 ' Certificate of Occupancy $ ,SSACMUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ —� Other Permit Fee $ TOTAL $ ` Check # `1982; Building Inspector ector f3