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HomeMy WebLinkAboutBuilding Permit #127 - 475 MASSACHUSETTS AVENUE 8/12/2009 NoRTf/ BUILDING PERMITc�.11 TOWN OF NORTH ANDOVER o? 46 APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 74p�Rreo'�`c� �SSACHUS Date Issued: 2 IMPO TANT: Applicant must complete all items on this page e _ r LOCATION A\JQ_ or+i' y)Jmn R_ 0f s u Print PROPERTY OWNER (0) �- ., Print, MAP NO PARCEL;ZONING DISTRLCT. Historic District yes no Machine Shop Village yes , no i 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, tTWatershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: a3 i)A 1 , 1 .pco o Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: on CONTRACTOR,-Name.--aPhone: - - Tx Address: l(' rtt 5 ( Superviots Constriction.Lice e: P-Exp. ©ate: � ,. Nome 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: $ 1 a.4 cc oo.0« FEE: $ I,50,0O Check NoJ J J '�� Receipt No.: 0 c;�3�z 2— NOTE: Persons contracting with unregistered contractors do not have accias to the guaranty fun Signature"of Agent%Owner � 5lgnature of contactor 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 P P 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 2.2008