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HomeMy WebLinkAboutBuilding Permit #434-2017 - 37 KIERAN ROAD 10/24/2016 r- �oRrk BUILDING PERMIT o�,zLEo ,6�tio �i TOWN OF NORTH ANDOVER 02 y, '` ° APPLICATION FOR PLAN EXAMINATION '- Permit No#:Y3�-( Date Received �� - �'t� 'o1 01 ArED Date Issued: 0 - )-d l� �gSSacHus���� IMPORTANT:Applicant must complete all items on this page �I�L®CATI®N1 !37 -- =� Ping/ ' PRORERrTY OWNER' ✓� Ac�.SS- _ . -- t t I 3 e �1 �r1 s Pn Years ye II/IAP' O O rARCEL; ro, ,, _ <3 _ f ZONING DISTRICTHistort D s ct sa ` r fMachme�Shop - yesLn V r illa e TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ane family D AOition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial D Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �. ®,Well, D'Floodplam - P r. .- d -y q Wetlands © Watershed - _ D�Water/Sewer: ` DESCRIPTION OF WORK TO BE PERFORMED: !� � f S`I Civ tit_ CyNS�/"�L>' ';7 _-Identi icatio�9J7.4; lee Y�e or Print Clearly 1 X OWNER: Name: J,4 �fPhone: / � -0� 9 �� .� 3 I Address: 3� li A0 Contrad tor'Name . � R. ,. Phon&L5.7E G7� Email Address Supervsor's`Consruct�on . . ExpLeense �A Horner Improvement License Exp- Date / _ 1 ARCHITECT/ENGINEER WA- Phone: Address: r`ti'" 2� 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: $ `�, FEE: $ q �� Check No.: Lf l-s-(® Receipt No.: 3 I 0 NOTE: Persons contracting h unregistered contractors do not have access to the aranty fund Signature Of Agent/Owne_r - ignature of contractor i i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer P Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent 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 n No: Zoning Y Decision/receipt submitted es Manning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con necti On/S.ignature& Date Driveway Permit DPW Town Engineer: Signature: Located 3 4- good Street 4FI0EDEP�AR2TMENTTempDum ster n,slt 4 p , s,L+`oc^�atetl�,at'124FMaintSt�eet r 7 A L f FireDe a ,partmentisignatiare/tla eK -COMMENTS,: x _ 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 NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Buiilding Peimit Revised 2014 i 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 o 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 o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o 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 o 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 2014 Location t No. a I Date 9-31- W MORT" TOWN OF NORTH ANDOVER 3? ' 0c � p • i # Certificate of Occupancy $ Building/Frame Permit Fee $ a ' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 33& 1 3 7 1 3 Building Inspector