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HomeMy WebLinkAboutBuilding Permit #702-13 - 39 HIGH STREET 4/25/2013TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: AM --PORTANT: Applicant must complete all items on this page +� t 6 f`i C' f l N L- LOCATI.ONt S Print} w/ PR;OPERT�Y�0INNER� C, CS- j. 1 i L L L � �,-,. Pnnt? { 100�Year�©Id,�Structure� ,yes,.. no MAP-NO`� PARCEL. W � � ZONING0ISTRIGT'Misforic,Distnct� . y Machine,Shop;Village es no _ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition ❑ Two or more family ❑ Industrial El Alteration No. of units:i Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: Demolition 9lNell ❑ Other o DWetla'ndsSeptic, , WatershedDistrcf,Fodplain, -[!Water/Sewer. Exp: Date:= D GKIF' I IVIV ur vvuKn 1 u a rGRf'vl�m Lv. e-%--e_.r ,✓a -A ^-_ it l�1Lt, Please Type or Print Clearly) 7 1"7 -G Zs^ OWNER: Name• t viz,Ugz p.��c�- c'`1. I"�"�• l �, Address: v re r--- c.� "'"—�.�� Ko -L— UJ ` CONTRACTOR Name- - - �. �t L.� Address:' Supervisor's Construction License: c-.0 6 i, 3_ Exp , Date:. Z- ' Home,lmprovement':L'icense Exp: Date:= ARCHITECT/ENGINEER �l 1C' Phone: Address: � 6 -s Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ FEE: $ L6 0 Receipt No.:).., -6 Z Check No.: NOTE: Persons contracting with unregistered contractors do not have access t the guarantyfund 'Signature of Agent/Owne'r ignatu.re of contractor Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El 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 ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS DATE REJECTED 0 DATE APPROVED CONSERVATION Reviewed on Signature COMMENTS %:I HEALTH Reviewed on Signature COMMENTS 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 DPW Towp- ]Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no L%ocated at'124 MainStreet Fire Deparitmert signature/date COMMENTS r,. 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 Building Department The foliawing is a list of the required forms to be filled out for the appropriate. permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits u Building Permit Application Li Workers Comp Affidavit Li Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract Li Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Li Building Permit Application u Certified Surveyed Plot Plan u Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ® Mass check Energy Compliance Report (If Applicable) u Engineering Affidavits for Engineered products MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application u Certified Proposed Plot Plan a Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products 40TE: 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 appal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm;kted with the building application Doc: Doc.Building Permit Revised 2012 Locatior%-:.>7 Mvz�3w�M Check # Date TOWN OF NORTH AND>PVER Certificate of Occupancy 9° Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee $ TOTAL $ 26323 Building Inspector c�eQc�zss } 'V i : •a . 1i U v •a W L : Q. CL O i.. CO •j O J_ •• EO O L N m •CD J : d W O W yr �+ 1r� _ • `'' = c ;G H Z ; )O 1Q� N = Z w a E �0 a c�CD tA J , O V v V � vai o � _ H ,a c c -a ��a �' U) xZ ) O W O LL CLN� r- 0'ZCD CD Cl) Ma � O W 3 �� o c W J Q Z W 0 CL0. •� Z U •y o tm C C •O Q i L d Q, N N .r Ot:m w W O '2 =— O O N N C 4 O Li N v v ZO \ W •E r y ~ V N C O L 0 a> > NJ cn O O O ;�- LL H t m J J N N m O d W O t c t s u t v Y 0 = °3° is � 7 v O E ro O � �o C O v LL O t O K LL C' N N LL d' LL m N N to LL CC U LL i : •a . 1i U v •a W L : Q. 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