HomeMy WebLinkAboutBuilding Permit #730 - 409 BLUE RIDGE ROAD 5/20/2010Permit NO: DZ32
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
Date Issued: •
IMPORTANT: Applicant must complete all items on this pate
LOCATION f ~ f
Print /
PROPERTY OWNER
Print
MAP 210 PARCEL: ZONING DISTRICT:
Historic District
!Machine Shop Vi
A
yes no
yes no
TYPE OF IMPROVEMENT
PROPOSED USE
i
Residential
Non- Residential
ea
yes no
yes no
TYPE OF IMPROVEMENT
PROPOSED USE
-
Residential
Non- Residential
New Building
a family
—Addition
or more family
Industrial
Alteration
No. of units:
Commercial
Repair, replacement
Assessory Bldg
Others:
Demolition
Other
Septic Well
Floodplain Wetlands
Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED:
VA -0-- 6-r-6Nriz- Aa -a48 -
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTOR Name: c�ac-lam; �'�4.2-cG Phone:
Address:
Supervisor's Construction License: L�,S Exp. Date;_ GS`" //
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
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: $ q FEE: $
Check No.: I Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner - Signature of contractor.
Location
No. 23P Date
TOWN OF NORTH ANDOVER
n
Certificate of Occupancy $
,S1ACMUSE�� Building/Frame Permit Fee $
IAOI
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
23+1
Bulro Inspector
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
CONSERVATION
COMMENTS
R HEALTH
COMMENTS
DATE REJECTED
DATE APPROVED
Reviewed on Signature
Reviewed on Signature
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 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS
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 - 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 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)
❑ 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
t
1.
Doc: Building Permit Revised 2008
05/25/2010 22:23 FAX 7812463040 BUILDING TECH.
05/24/2010 14:18 l,A.'I 7812403040 BUILDING TECH.
NEW ENGLAND BUILDING & ENGINEERING
INC.
IGN OV 11,Ut.P:•:.NGIN1,Llt,'6R1.'1' 1,!Nc; Ciltlt:
�..?tl "C' I t;R U. ]NCPF(:n(, , s:ila :,il_L'1'
To the Building Commissioner:
Toam of North Andovcr Mas-whwits
Reference to residuntial bui!diL_,v permit P 575 dated Aprt17, ZOOS
John Carroll
Kattcher LLC
409 Blue Ridge Rd., Andover, MA
11001/002
Z001/001
CONSULTANTS
I cerdfy that I, o: my authmi&c4 Aquesctuatirep Dave reviewed the plans and associated documents
and have inspcetcd the work associated with the project at:
'04 9 S1'e_gi av Rd- N.. Ahdm.er, 4iA
And that to the bust of my knowledge, information and bchc4 the work has been done in accordance
with the plans submitted to your of ve and npprated by the Ttuildinb Dcparttr,cnt. All work
conducted its of th 6 ante conforms to the provisions of the :>'ilusexchusetts State Buildia; Code and
.dl other pertincnt laws and ordinances.
x ,/'
A I:NGIiYiER - .0%15 ,.AEG. NO, 25034
Oe
01JANDER P.
ww"11A
S1941CT4
Na. 7.=4
\wvw Fnl+lanld �, Build -ng- ��c.I.:Rneenng Consultant.. Inc.
COMPANY
artrlxe'. (',uv::.'�.'?.`uiie 1�:�_L'1►Uc�hufn fit; ritt;;it
ADDRESS
PHONE
In.pucuon Dares: y`ar 15, and *. 20. 211111 \roof i#-. ru:,ti tzasunp complete, rough plumbing and
etecmcal CompWou.)
.n�i 1Gi�;' � •• ••�:.� v11;,� • Ira: , � �.�;�ial'R�':, X11 "aK i
PRONr. . s .t.ta+,. • FAX: :r1 OR 7>; . ,_,• ;.,
2001-06-04 09:50 7812463040 Pagel
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