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HomeMy WebLinkAboutBuilding Permit #94 - 46 CAMDEN STREET 7/31/2009. BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page -1* LOCATION CAN CL T Print PROPERTY OWNER 0 J -IV Print MAP NO: PARCEL:. ZONING DISTRICT: Historic District -ShoD.Villaae Machine, yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One famjjy_- Addition Two or more-ra-m'ily Industrial Alteration No. of units: Commercial Others: Repair, replacement Assessory Bldg Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer L)tbL;Klll I 1UN OF WORK TO BE PREFORMED: o -� -0 C t - 00 , Id tification Please Type or Print Clearly) OWNER: Name:.. Ta -e Kkc 0 Phone: q)�--V7 Address: Q( 0,-6 CONTRACTOR Name: ', t Aridre-q,.q- 4 4u -�- &�ojev M/Y �Crz I T— I- Supervisor's Construction License: Exp. Date:. Home ImDrovement License: Fyn nnfo- ARCHITECT/ENGINEER— Phone: Address: Reg. No. FEE SCHEDULE. BULDING ERMIT.- $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: S' F,�5�tlOe FEE: $ V111 d Check No.: Receipt No.: -00A NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund- re BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must coihplete all items on this page LOCATION q Cjm� �, S -r Print PROPERTY OWNER 0 C, Print MAP NO: PARCEL: ZONING DISTRICT: Historic District Machine Shor).Villaae yes no yes no TYPE OF IMPROVEMENT '0 Residential Non- Residential New Building One famiLy yes no yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One famiLy Addition Two or more—faimily Industrial Alteration No. of units: Commercial Others: Repair, replacement Assessory Bldg Demolition Other 17 Septic Well Floodplain Wetlands Watershed District Water/Sewer urzay.pmir i iuim ur vvumr.. 1 u t:st: 1-mt:1-0ptMr=L): 7�� w) 0 t-0 �, 1, 1 cl q — CX) , Id tification Please Type or Print Clearly) OWNER: Name: T; S:—�- C-) Address: V( & , go kc-�— CONTRACTOR Name:_, Address: oue/v M /� � cr to Phone: 9 � )�--V7 I T - Supervisor's Construction License: ___Exp. Date: I Lo Home Improvement License: ARCH ITECT/ENG I NEER A Phone: Address: Reg. No. FEE SCHEDULE. BULDING ERMIT. MOO PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project C FEE: $ 00-� Check No.: Receipt No.:— NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund ��i— Signature of contractor gnature of Acient/Owner T I �� - /�O- c4myz Location 70 No. Date C-1 YN TOWN OF NORTH ANDOVER 0 Certificate Occupancy $ of CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#—qEt7 2 2 2/ 7 Building Inspeclor 14 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans DISPOSAL =ERAGE PublicSewer 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 DATE REJECTED I DATE- APPROVED PLANNING & DEVELOPMENT COMMENTS LPN, IN I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS cy-/ Zonin .,g 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: Locatea 364 USgood btreet FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 14 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans ERAGE DISPOSAL 7Publ '__7 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 DATE REJECTED DATE- APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Reviewed on Signature Reviewed on Sianature I . _rc' �,��YAj ) Zonin g Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con nection/Sicinature & Date Driveway Permit DPW Town Engineer: Signature: Locatea 364 USgOOa -jtreet FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total land area, sq. ft. loor area, based on Exterior dimensions. ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21 A —F and G min.$100-$160-0- fine No NOTES and DATA — (For department use) Ll Notified for pickup - Date ...... . . . . . . .. . . . .......... . ...... . .. . . ....... . . . .. . ......................... ...... . .. . ... . ............ . ......... . ..... . ........................... . ............................................. . .. . ....... . ....... . .. . . . . . .. .......................... . ............. . .......................... . .......... Doc.Building Pennit Revised 2009 111w"* " Number of Stories: Tot I Total land area, sq. ft.: floor area, based on Exterior dimensions. ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Insnector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21 A —F and G min.$100-$l 000 fine NOTES and DATA — (For department use) El Notified for pickup - Date . . ......... . ....... . . . . . .... . .................... .. . ..... . . . ......... . ... . ....... . ............ . .. . ..................................... . ............ . . . . .......... ........... . . . . . . ............................... . . .. . ................... . . . ....... Doc.Building Permit Revised 2009 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 Lj Building Permit Application • Workers Comp Affidavit • Photo Copy Of H.I.C. And/Or C.S.L. Licenses Li Copy of Contract u Floor Plan Or Proposed Interior Work Lj Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Depprtment 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 Li Floo r/C rossection/E I ovation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) • Mass check Energy Compliance Report (If Applicable),- • Engineering Affidavits for Engineered products --- I ' NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) u Building Permit Application u Certified Proposed Plot Plan Ei Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract L3 Mass check Energy Compliance Report u 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: 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 Li Copy of Contract u Floor Plan Or Proposed Interior Work b Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Depprtment prior to issuance of Bldg Permit Addition Or Decks L3 Building Permit Application a Certified Surveyed Plot Plan L3 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) Ej Building Permit Application L3 Certified Proposed Plot Plan Lj Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) u Copy of Contract zi Mass check Energy Compliance Report u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In aU 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: Building Permit Revised 2008 TN Town of North Andover Building Department 1600 Osgood Street North Andover MA 01845 Tel: 978-688-9545 Fax:..,978-688-9542 DEMOLITION OF BUILDING AFFIDAVIT OWNER'S NAME & ADDRESS C, 0 0, 0, -AuY FC4- ouev- MA - LOCATION OF PROPERTY TO DEMOLISH tqu- 11 R C, a W � ev '4V4 DESCRIPTION VN -2-e t I * tAORTH—%*%, 0 0 .1b 0 cocolic"awick 0 ArE 0" CHU CONTRACTOR'S NAME & ADDRESS 6V4V\M kWOAI I — ^,r 4 6t& M -A DEP DEPT. OF PUBLIC WORKS - WATERA DEPT OF CONSERVATION FS I,-zj,e97 V f /y, HEALTH DEPT: Septic Well / -/ DIG SAFE NUMBER .,�tn 0 ov DATE REC'D Doc.form demolition of building affidavit BLDG. 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