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Home My WebLink AboutBuilding Permit #027-13 - 422 WAVERLY ROAD 7/16/2012 pORTH BUILDING PERMIT pFttteo �bgti TOWN OF NORTH ANDOVER 04 APPLICATION FOR PLAN EXAMINATION Permit NO: d� Date Received 0q�rE,,Pa �5 �SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page t it 1 . —"! { '".^n '"'F ''•-r.' "4 + �i*f♦ r � � Print t,PROPERTYQIIVNERvY�1 S }_ r �z -�.-< Asa.-�..®- _ g wr-�e'� {s w� ?�^� r•..r> 4.x +, ..c. t• I n Pp�nt f MAP N® Z PARCEL ZONING DISTRICT _ _ ty a a Histo�icjDistn`cf= �_ � < .6 ShopVill age TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Ad ' ' Two or more family Industrial Alteration" No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other ' �-Z �Y' �'o _Jad ,Septics Well �� Floociplam ��V1letlands~ * 41" - F r. .,,, iVUater/Sewers '= - DESCRIPTION OF WORK TO BE PREFORMED: se/ -e)7 i��' — 1..y 5 7146e1 .,0 eECV �5 Z Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: Fw!"..*+'�F..-a.,.-.r-n. 4�;.��i+�i�"'^r".."� e�'...�r��p��++ -+,.*++..€er-;;..k-+�t� �w.af+�c'.�-..r.�,e�-.�^�ra•�,�vF.s �._,-..=.�v;tit+Y+' �y�...z�a.^,p^+v�r+ �'i CONTfRAC�T®RrName �772� `k .�� Phone � d9- D/ Add essa Pt SuperviserssC�onstruction` License `� - lExp ,+DateXz 4 !,. `-' .. ! �� -a� -s :' ,a # `"� t` )x.r aC�1j 4 #�I 4 r F :i •.Y 'Y9 �Home�'IrmProvement�icense �•,�6.�..- ..��-�+��. z�.c .,_. ��.�Exp��,Da'te ,� �;�.i:�i .,�..�:� �.�y��..{'�, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ o aFEE: $G Check No.: d�Z' Receipt No.: NO Persons contracting with unregistered contractors do not have access to the guaranty fund ignature of Agent/Ownersj .:Signature -0-f Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL ' Public Sewer Tanning/MassageBody 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS 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 v. Y. e-"«..-r� H.' ,'r=i[ "Y''t�^F*,"c LST{{° 3° "lA' Yc t"S`?L��.1° �a'L '"f'}�i'!�' M74, -.M�EzY•. 'E` FIREDEPARTMENTTem Dumster:on site`'yesz .. � .;y Located ate 124n`S. tre�`_e`tk P p. .Ire Department signatureLdate :� � �x mom- " I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: i 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) cofV �v "(J 6v� o w v- -r, [vA �A1 ❑ Notified for pickup - Date C J Doc.Building Permit Revised 2008 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 levation Plan Of Proposed Work With 13 Floor/Crossection/E Sprinkler Plan And p 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 thenget 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 2.2008 Location 7 2 ��y •vim'/ No. � Date • - TOWN OF NORTH ANDOVER A ' �`�•w Certificate of Occupancy $_� Building/Frame Permit Fee $ Foundation Permit Fee $_ Fft Other Permit Fee $ r TOTAL $. Check ht 25503 Building Inspector r 1 NORT11 . b .c . . ver 0 No. ®2 I LA" h ti ver, Mass, �. coc..C.I.C.( y1. A�4AreD S U BOARD OF HEALTH LD Food/Kitchen PERMIT T Septic System THIS CERTIFIES THATr!'!` ........ M!VA t4$00................................. BUILDING INSPECTOR .....Cv.O.M... ............. qA. 'X ... Foundation has permission to erect .......................... buildings on ... ...... .. ...... ........ Rough 4L to;be occupied as ...��.....L.... ..... �r. ......... ......� T.:...�5>r� . . ... Chimney .♦. provided that the person accepting this permit shall in every respect conform to the terms of the plication 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 MDNTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC UTA Rough Service ....................... llxmmm��...................................................... 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. SEE REVERSE SIDE Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor - -� License: CS-026.854 ' PATRICK S CONI~` 104 BOARDMANTREETI r Haverhill _ MA 01$35 Expiration Commissioner 06/23/2014 r w