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Home My WebLink AboutBuilding Permit #Exception - 524 REA STREET 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCAT7777�I O Y ,PROPERTY OWNER + l�L Prat: D�str�ct y AistorciN 01STRICT? +eesS o:'Shop�/ilPgeac#i TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ane family /Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other eptic e11 tom p�airt ' lii✓etlands . ' 17aterslaed Djstfiict eter�Sewer � DESCRIPTION OF WORK TO BE PREFORMED: 9W4A Gr- . Identification Please Type or Print Clearly) t?f7X � OWNER: Name: 1b."/9 Phon Address: 6-,R* REA %_31 o DOVE �� r _4 CONT1 !t A_ N a a Mart S-mpervisor's .Construction License. Exp_ , M e A. JI iorne Jmprovement,L�cedst Ex . .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: $ r . 3 a FEE: $ 02g1 q() Check No.: Receipt No.: NOTE: Persons contracting with ,nregistered contractors do not have access to the guaranty fund " Si nature t�f=eontracfior _ �. Plans Submitted Plans Waived Certified Plot Plan Stamped Plans r -J 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 CONSERVATION Reviewed on ' !p Q Signature COMMENTS V r !1� EALTH Reviewed on 7 Si nature ' COMMENTS . S �.1% rye �-� t Zoning Board of Appeals:Variance, Petition No: y .7 Zoning Decision/receipt submitted yes Planning Board Decision: .- Comments Conservation Decision: Comments Water& Sewer Connection/S inature&Date Driveway Permit DPW Town Engineer: Signature: Located ,384 Osgood Street FIRE LI'EPi�RTMfIT T�erip Opstec cin si#e ;yes no A Located at� 4111iain Street 17. Fare Departra�e t tj naturelclate �� F �i a fs COMMENTS 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: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use I i ❑ Notified for pickup - Date f 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 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 Building Permit Application Certified Surveyed Plot Plant ❑ 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) o 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: Doc.Building Permit Revised 2008 f 'cam PROPOSAL Homes and Demolition PROPOSAL SUBMITTED TO: W RK TO BE PERFORMED AT: NAME_ n ' NAME ADDRESSy I C_ _ ADDRESS (, PHONE NO. I�t,�'(�- �J�I - S�`� PHONE NO. We hereby propose to furnish the materials and perform the labor necessary for the completion of rrm 6 Su l u+ C r � ��- Y" 3 I Vrl� • � � i1 '1 r I , i p &m eli 1 �., �r ," ) , i nor it,... 01'1'1 �L c I'�U`v IJ I r Urf r �� li� "k?> �tr3q* I fC C►CaS i ir1Alt v�Y1f f�c1C i f �►r �ti� Ir�� y-,e r All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted.for above wor4 and completed in a substantial workma8u manner for the sum of -Q { and i' OLD L� C�' �1 Dollars($ ) with payments to be made as follows. 0, 00 )1- 1' ��i `i Respectfully submitted '""�7 4 ` — GC� Per oAny alteration or deviation from above specifications NOTE -This proposal..Tay be withdrawn by us involving extra costs will be executed only upon written if not accepted withifv; - days. order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents,or delays beyond our control. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. „ Signature ZticC- Cid Date—,/L110 Signature