HomeMy WebLinkAboutBuilding Permit #248-2016 - 420 WINTHROP AVENUE 8/27/2015 BUILuiNu FLKml l
TOWN OF NORTH ANDOVER °
APPLICATION FOR PLAN EXAMINATION * -
Permit NO: �" l 1� Date Received
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Date Issued: L-i 11113 ss„`"asp
IMPORTANT:Applicant must complete all items on this page
LOCATION qao wlyArov ov-c
t
PROPERTY OWNER
Print
MAP NO: _PARCEL:��ZONING DISTRICT: Historic District yesnn
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ><One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
0 Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
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Identification
rP i Please Type o Print Clearly)
OWNER: Name: 1_tri & Phone: T7X-49 v-
Address:
CONTRACTOR Name: nn Phone:
Address:
P. ok � 1,
Supervisor's Construction License: ) Exp. Date: �_ 3
Home Improvement License: A) Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No. j
FEE SCHEDULE.BULDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 6, r7 56 FEE: $ t�-1 ��o
Check No.: nCa Receipt No.: 2..°%7_(.A
NOTE: Persons contracting with unregistered contractors do not have access to the
guarantyfund
Signature of Agent/Owner Signature of contractor
.l �O
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ ' Sfi6mped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanamg/MassageBody Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food PackagineSales ❑
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
ignatureCOMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
4
'Planning Board Decision: Comments
Conservation Decision: Comments
Wafter& Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
j. � Located 384 Osgood Street
�111�IREDEPARTMENT Temp, Dumpsferonsite %q , _ no
#,Lkocated�at�41h24MairiStreeta s'
1CQMMENTS, "`
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 chop 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
jDate Time Contact Name
E___....
Doc.Building Permit Revised 2014
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BUILDING PERMIT O ""Fo ,6y6'6
TOWN OF NORTH ANDOVER �,.
APPLICATION FOR PLAN EXAMINATION * ,�
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Permit No#: Date Received a, '`
�SSgATFD
CHus�`��y
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER
Print 100 Year Structure yes no
MAP PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two 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 PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
Contractor Name- Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date:
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: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
MS nature of Aaent/Owner z. Si,.nature of contractor -�
Location
No. `7d �j� Date
. - TOWN OF NORTH ANDOVER
Certificate of Occupancy $ R
Building/Frame Permit Fee $
Foundation Permit Fee $
�r S'- Other Permit Fee $
aY�� TOTAL $
Check# 3too
' f? Building Inspector
F NORTh
own o E F. ndove,r
0
� 0
A- Ji� _n
No.
Z y
h ver, Mass �1 A�
a
R.tTED F,
V BOARD OF HEALTH
Food/Kitchen
PER LD Septic System
t-i�TT
C4a ��.. BUILDING INSPECTOR
THIS CERTIFIES THAT ...............NU.. .....................................&I,
.......
Foundation
has permission to erect ...... .................. uildings on ....... .. ...... ...... ...... .. .,..
Rough
tobe occupied as ........ .. .......... ... � ....................................................................... Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONINS ELECTRICAL INSPECTOR
Q . UNLESS CONSTRUCTMN S T Rough
Service
........... ... ... .. ..................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.