HomeMy WebLinkAboutBuilding Permit #Exception - 48 CHURCH STREET 5/1/2018 NORTH
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received O"-�4 �
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
LEGATION w -
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PR .PERTY OWNER • .+ t ` "
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MAP NOS �AFZCEL;G ZONING DISTRICT: , Historic District yes no
r.
r, Machine,shop Village .: no
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
[I Addition [ Two or more family ❑ Industrial
16 Alteration No. of units: ❑ Commercial
Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑' Septic D Well D Floodlin l Wetlands D V1latershed,D!istrict
❑'Water/Sewer r.. .
DESCRIP ION OF WORK TO BE PREFORMED: /
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Identificatio Pl ase pe car Print Clearly)
OWNER: Name: �qw�e Phone:
Address: �'( �-i f .r
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CONTRAC '�7R Narrle
Phone: 7 _
f
Address: vi .�
S:upervisor's Cons#nation License
: Exp, Date: ,
rt P
z�� `Ex Date:
Horne Improvement License 1 p
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 gun`�gistered ntractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor
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
DATE REJECTED DATE APPROVED
PLANNING &-DEVELOPMENT ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ . ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/S9nature & Date Driveway Permit
Located at 384 Osgood Street
FIRE DEPARTMENT Temp Dumpster on pite 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 2007
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
Li Building Permit Application
o Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o 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
o Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
a Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
a 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)
o Building Permit Application
o Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
o Mass check Energy Compliance Report
D 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 2.2007
FLOORPLAN
Borrower: Marcia L. Thornton File No.: 4281331
'Property Address:48 Church St Case No.: 111780047
0.
City North Andover State: MA Zip'01845-2504
Lender.COUNTRYWIDE- FSLD/Landsafe Appraisal Services
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Storage
14'
22'
15' Kitchen 15' Storage
17'
5' V
CL
Full Bath
Dining Den Full Bath Bedroom
CL
20'
21' CL L Closet
I 5' Bedroom Living Room 5 Bedroom Bedroom
I
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11' 10'
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45 t _'�Jpt7 ptJnr
1st Floor
Sketch by Apex IVTM
Carmen
AREA CALCULATIONS SUMVIARY AREA IBREAKIDOAN
Code Description Size Net Totals Breakdown
Subtotals
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GENERAL CONTRACT
This Contract is made on �C-a -20 C;' ? ,between `+ 'M-�S /�•4 L
Party One,of �-L� �y_awr ,City of
State of and vt w� Party Two,
of Ytc� t ' City of
State of AA
For valuable consideration,the parties agree to the following:
Party One agrees to: ?A-1 :�O'
Party Two agrees to:
Any additional terms:
No modification of this Contract will be effective unless it is in writing and is signed by both parties. This Contract binds and benefits
both parties and any successors and assigns. Time is of the essence of this Contract. This document,including any attachments,is the
entire agreement between the parties. This Contract is governed by the laws of the State of
Dated:
Si ature of P4 One Signature of Party Two
Name of Party One Name of Party Two