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Home My WebLink AboutBuilding Permit #039-2016 - 5 GREAT LAKE LANE 7/8/2015 ,5 ( t„0T S BUILDING PERMIT �0e"0 oT";�tio TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION y Oy yyT C T O 1\ T Permit No#: -1��o Date Received-7 �pA0R,rEo ' gSSACHU`�� Date Issued: l I IMPORTANT: Applicant must complete all items on this page LOCATION Great take Lo-,7e- Print PROPERTY OWNER TkZ LLQ Print 900 Year St'eucture 'yes no MAP PARCEL: t ZONING DISTRICT:R3 Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential KNew 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: rk Z LLC Phone: q7$-$S?-c!D 2 Address: 7� (vreaf P01)6( 9"d , AAd OVA AV(j OC I ys TIAaNidt S_ Contractor Name: 7ZAa V4'-"I Phone: q7$- 852-y00 Z _ , Address:_7t 6reAO- Punot RQ 0Vf, - IV U Supervisor's Construction License: bu7 Exp. Date: Home Improvement Licenser - Exp. Date:- ARCH ITECT/ENGI NEER ate: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: $ FOciNDATzaN PE¢N►LT FEE: $ 100 • 06) Check No.: SS Receipt No.: 6 250 NOTE: Persons contracting with unregistered retractors do not have access to the gua •anty fun ,signature of Agent/Owner Signature of contractor Location No. � Date � • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ ._ Building/Frame Permit Fee $ j - Foundation Permit Fee $ %�' Other Permit Fee $ TOTAL $ ' r Check# C E Building inspector r e. tj k Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL i 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 PLANNING & DEVELOPMENT Reviewed On/ /5 Signature_ COMMENTS - , CONSERVATION Reviewed on /,S Signature COMMENTr HEALTH Reviewed on Signature 5 COMMENTS u Zoning Board of Appeals: Variance, Petition No: /" /�C Zoning Decision/receipt submitted yes Pl&,;,ning Board Decision: l` �� Comments Conservation Decision:—\\M 11H Comments Water& Sewer Con nection/si nat e& Da e�� Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street _ ._ !FIRE DEPARTMENT = Ternp iester site yes Located t 124;Main Street Y Fire Department sigriatu.reldate COMM'ENTS Dimension Number of Stories: d-- Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 39073 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) 1-ov(1do�}�pr> Permit Ooll ❑ Notified for pickup Call Email Date Time Contact Name 3 ------------ Doc.Building Pennit Revised 2014 I 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 o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks i o Building Permit Application o Certified Surveyed Plot Plan Li Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses a Copy Of Contract o Floor/Cross Section/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 o Certified Proposed Plot Plan L3 Photo of H.I.C. And C.S.L. Licenses ❑ 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 ❑ 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 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 2014 µORTH q Town of _� 1� Andover O '.�'•. .��• No. C% h ver, Mass, O COCMICNIWICK ��• �dLAKI A�RATEO ''? lS U BOARD OF HEALTH Food/Kitchen PERMIT - T D Septic System �I" �� BUILDING INSPECTOR THIS CERTIFIES THAT ............................ .......f..... .....Circa ..............:.......... ................................. ..1-f ��......., Foundation has permission to erect .......................... buildings on .... . . ..... .......... .... Rough to be occupied as .......... 0 IIIA1 .... ... ........................................................... chimney provided that the person accepting this permit shall in every resplconform to the terms of. f 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO ARTS Rough /� � ...................... Service .............. ..... ,�Y�"`"�'�"'.................... 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. I 5(4-0 3-0 7 - o zo Zc - o _ � 1_a io, y 1 I` = a — – i ' I c z � o r z 13-0 0 W I i 1 I d 12 -U' i ZB-o (0 0 5fv-O 6 �3-o ILI.v 2 Z2.o \ n-p