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HomeMy WebLinkAboutBuilding Permit #818-2016 - 52 CLARENDON STREET 2/10/2016Permit No#: U "..*, Date Issued: .Z- 11© LOCATION BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received RTANT: Applicant must complete all items on this A `v Print PROPERTY OWNERVI z a D� ou a Print 100 Year Structure MAP / PARCEL: ZONING DISTRICT: Historic District Machine Shop Village yesno yes no yes no TYPE OF IMPROVEMENT PROPOSED USE Resio6ntial Non- Residential ❑ New Building One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ 8yeraition No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic, ❑ Vllelle Flood .Iain ❑'Wetlands i 0 Watershed ®astnct. ❑ Wates/Sewer � ' DESC, RWMGN IF WORK TO E PE ORMED: 1 n ,�.. :-T x -z t /r 4•. 1 / FT, Identification - Please OWNER: Name: Address: Contractor Name: or Print Clearly Phone: i Supervisor's Construction License: Exp. Date: :7 1 Home Imarovement License: (-1 '%3 Exr). Date: 5;z x/,/-* ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ 1� FEE: $ :ZL Check No.: i� Receipt No. -- 0 NOTE: Persons contracting with unregistered contractors dol6o�haW aces to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL E Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools Well ❑ Tobacco Sales ❑ Food Packaging/Sales 0 Private (septic tank, etc. ❑ Permanent Dwnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature 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: T Located 384 Osgood Street FI,REDEPAR�TtME�Ii TempDumpster ontsite:�,)yes�a xz:; r'n`o:,�-;`"'''*-�.,s .tnt� : s,1 Located at 124IUIainStreet '� A'T i. + 1i°L. i a{ Ott �I r }4r �cF4fttF 4� •w. {;Fire Depart�ment4�ignaturoe/date, r t+"'' {#♦'. 't�,r • a r4 r� Y ... •iY4fwr tf4K C0 WMEINT. 5 . '� - � " .. - . •u.. ). s t• /. t af. • t .t '1~ ;�7 >.:�,` 2.ti +.t �t .lp , a : Sy°'i�:`' 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: lies MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 M 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 4� Building Permit Application 4. Workers Comp Affidavit a. 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4 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/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 IOTE: 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 4. 2012 IECC Energy code 4� Engineering Affidavits for Engineered products TOTE: 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 0