HomeMy WebLinkAboutBuilding Permit #717 - 393 MAIN STREET 4/10/2012BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
§
Permit NO: Date Received
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
El Addition
❑ Two or more family.
El Industrial
❑ Alteration
No. of units:
Q Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
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DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: % Phone:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASEDON $125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.:' d`� Receipt No.:%1'
NOTE: Persons contracting witreg4tered contractors do not have access to the guaranty fund
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 DATE APPROVED
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
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 Driveway Permit
Located at 384 Osgood Street
CONSERVATION
DATE REJECTED
❑
DATE APPROVED
❑ 0
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
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 Driveway Permit
Located at 384 Osgood Street
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
Doc.Building Permit Revised 2007
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
❑ 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)
L, 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
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BUILDING PERMIT
TOWN OF NORTH ANDOVER ti M1
APPLICATION FOR PLAN EXAMINATION
Permit N0: F Date Received
Sa.-wS�
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family.
❑ Industrial
No.
is Commercial
❑ Alteration
of units:
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
[]Other
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DESCRIPTION OF WORK TO BE I'KtruruvitU.
Identification Please Type or Print Clearly)
OWNER: Name: % Phone:
ARCHITECT/ENGINEER Phone:
Address: Reg. No
FEE SCHEDULE.- BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: 1'4-V7-0' Receipt No.:
NOTE: Persons contracting %�MlTweg4,tered contractors do not have access to the guaranty fund
Location'/ ��
No. /r Date
Check # Id 96
25167
TOWN OF NORTH ANDOVER
Certificate of Occupancy $$�-�
Building/Frame Permit Fee'-
Foundation Permit Fee ` $
Other Permit Fee $
TOTAL $
Building Inspector
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BUYER;1 � EC,4 4/AA 1�.D
TO TILEc �►�t�ovc,-?= T-�4-�J14 3 it�RTGItGE INSPECTION PLAN
-ITS TITLJtw IN/1f11E1eS.
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1 CIVITTFY 'THAT THE BUILMOS DiOYIN 00 P CONFORM TO SETBACK REQUi UUMTS Q
I.E. (FRONT. SIDE. At BEAR SETBACK ONLYd Of PJG'. 0 b=v a FL
NNFN CONSTRUOTED, OR ARE E)MMPT M&A VIOLATION ENFORCEMENT ACTION UNDER MASS. G.L
TITLE V% CHAPTER 4014 SECTION 7, 6iWESS OTtMWSE NOTED. MASSACHUSMS
0U,�-S-I PT:
1 FURTHER CERTFY THAT THIS PROPERTY IS � X LOCATED IN THE ESTABUSHED� FLOOD
NALM AREA, OOMMUNITY PANEL NO.: �4G��►- cac?� DATE: 6- Z- 73 DEED &;76
THIS COMPANY IS NOT RESPONSIBUE FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED BOOK
DATE OF THE LATEST DE® OF RECORD. PAIR:
V NE%U BUrDINGS ARE SHOWN LESS THATT ONE FOOT FROM THE PROPERTY LINE IT IS ADVISED CERT. H0.
THAT A MORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUREMENTS.
ARRIFICAT" 14 BASED ON THE LOCATIOQI OF SUR OTHERS. AND DOES NOT PLAN BK. PAGE
T A PROPERTY BURVE1f VERIFICATION OF AND OFFSETS, AS SHOW
MA K A6"PU*lED ONLY BY AN ACCURATE, IN y �l J, j�, :°uN DA IED
THIS CERTIFICA71ON TO BE USED F TCAGE PU ONLY. � o t-
OFFSETS AS SHOWN :: RCNGi11ATCi3�. ,
USED FOR THE ESTABL ISHM t_s R'>MOPHBRADFORD
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ENGINEERING CO.
���• ;`xrro, , P.O. BOX 1244