HomeMy WebLinkAboutBuilding Permit #49 - 53 HEPATICA DRIVE 7/19/2007Permit NO: -I
Date Issued: jq D
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATkONR PLAN EXAMINATION
Date Received
TOO'
TYPE OF IMPROVEMENT
PROPOSED USE
Resid al
Non- Residential
ew Building
ne family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
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DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Kgjj 1,`»7jj. ! e- Phone: 974? -(P2? -3 3l63
ARCHITECT/ENGINEER Phone:
Address:
No.
FEE SCHEDULE: BUL IN ERMIT-*ER $700.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. r.
Total Project Cos $ FEE. $
Check No.: l,"D Receipt No.: A,0 gj 14
NOTE: 'Persons contracting with unregistered contractors do not have access tot a guaranty fund
Signature of Agent/O_Qw4pQnature of contract
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
LANNiNG & DEVELOPMENT
COMMENTS /M
DATE REJECTED DATE APPROVED
,
T REJECTED DATE APPROVED
CONSERVATI ❑
COMMENTS
DATE REJECTED DATE APPROVED
�HEALTH
COMMENTS
❑ ❑
TYPE OF SEWERAGE DISPOSAL
'
Public-gewer El
Tanning/Massage/Body Art ❑
Swimming Pools t. ❑
Well ❑
Tobacco Sales ❑
`.
Food PAckaging&Ies ❑"
Private (septic tank, etc. ❑
i
Permanent Dumpster on Site ❑
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Comments
Water & Sewer Connection/signature & Date Driveway Permit
Located at 384 Osgood Street
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
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
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
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 Compliance Report
❑ Engineering Affidavits for Engineered products
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 2.200T.
Location n pc"o r ��' IG -
No. Date 7 S D
TOWN OF NORTH ANDOVER
3 •-. , • 0
� s
t Certificate of Occupancy $
C
y�wus
s'•E<�' BuildinglFrame Permit Fee $
s�
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 35��
Tvr,6P4+,6r
7
20
Building Inspector
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Location :`-wl I' U J
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No. 6 4k Date ���
V k,
�o RT :COWNQ&N TH ANDOVER
f � 9
rti e of Occupancy U
t?
sACMUS t ulldinglFrame Perml loo r
Foundation P rmit $ /00
(41 Other Permi $
TOT $ l
Check #_
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1 5, T/ 2
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