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Home My WebLink AboutBuilding Permit #587 - 53 MAY STREET 3/21/2006 ,&ORTII ° - 9 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,3'gACNUSEI Permit NO: ,� Date Received: �' = Date Issued: 2 ' IMPORTANT: Applicant must complete all items on this page LOCATION Yyl a � I-' PROPERTY OWNER �� o� t��l ""� Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building One family Two ❑Addition M or more family ❑Industrial ❑Alteration No. of units: epair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED Reewe a b.Q-ck Aad hqd ► bp- q yyaved fel $a/,tea , P Identificati n Please Type or Print Clearly) OWNER: Name: � Phone. r/ Signature Address: f CONTRACTOR Name: Uf ti- 6-4 ecat P7 Phone: Address: `[ 'Z C6d l � -Exp. Supervisor's Construction License: �'Q Date: h91 i Home Improvement License: 1 9-0 ` Exp. Date: it kzo 7 ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ `1 x10.00=FEE:$ Check No.: T Receipt No.: 0 Page]of 4 TYPE OF SEWARGE DISPOSAL Public Sewer Tanning/Massage/Body Art El Swimming Pools ❑ ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty f Signature of Agent/Owner Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ amped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS I DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMX.Tt NTS 1Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature&date Temp Dumpster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 of 4 1` Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA—(For department use) X 10 Z-hV-/k V/v(l� C 0 r N r1 a 1�v - 6a(r+ a n d I k PLO,-pwAo Ve kc/1 wa�- Page 3 of 4 i Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan2006 i 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 ❑ 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:BPFORM05 I Page 4 of 4 Location J MC-A`1 S r- No. t Date °RTM TOWN OF NORTH ANDOVER F w 9 �o Certificate of Occupancy $ CNUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # l '191 ,46 Building Inspector NORTH ANDOVER BUILDING DEPARTMENT ` Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant Fire Department Sign off: Dumpster Permit ry r1vo Date APR-26-2000 09:03AM FROM-- T-409 P.001/001 F-670 SWIM Record deed and asc,Ass0r1 s 1[ilan are no* "_n at!reeriento add�ti on per assw:PsQry s P101.0 b 9 - • G R.ass ST- i � 4 T' -x-- r.Xceptlon per asocasorvs .'plana To IK.<: c -----� motRTGAGE ImspEcTlow PLAN AND"I trir>Ii r,�sseaEi�3 ` Lc=AY m 94 11FY IMLIkT lLIN.DNOS t Cn'1Pir"L"iCl� 'f0 t.E1BAl�C Q�r I.C. 9:E7N7 Ld RFI O?iL Gtr Nva f r! +} R• an aR Am 00%wr„ i t1 � PljfR'1tim f1RTW-Y n1,AT Tib paopwv tc uoc>A o 1A1 F$M FtnoD KAZ&m Amj_00MMUNITY PANM No,2��-Ode3�GBATEn� 7�3 TB4 co►1Psr1Y 15 %oy i�ypGNSMO rM ANY WDETMPASs MA- 5J 70 TRC R�DOttOm RAS $ log @A:E OF '7rgS L4'1�3-1'F1t� 1 • i33 SUamw4os ARE swam Low -,"m am F04'f FwmA im QTY LSE iq IS ADNgD �FitT_ ND. T A MOM Pim 911NET 11E MMW-TO VOWY 1HkM ""Sy OawN O.[_ P� �ti71FlCA7AN 1s BAM IM ME 1 ►71oN eK 9L7RV6`Y MA16t'RS aF A!$1 oQea�lf71 PIJW q�gE0g1T A Pt�BiTY suRWv- v01�wZ10N Or SI tY e/ARfQ3�Its)>m AMD 0Fl7E18 A►1a1I1i. DAIW uw Ma AGOOMPIJ> M ONLY RV AM �uewrs, 1Ws71DJImiT StJR�rcY. DIOrE�M�!s ARE p� awl 't�'�IIS-t�Y1F1CAl1QN TO BE USE[) FOR MOR1%k&AE PUS OMta�ac��. �'�t•:. Vp ES A9NIEAn NT PROPERTY UNES�' tDC ;Jq srxr+' �'� .t'�• BRADFORD f1GINEERING CO. 7. N4pV@RRLL N/4 Q/8Si 4 6 pp d " � �east too O. t8200 l AIM o" + SOMb License: GQN�T OF BBIL.DIN Number. TION- Tye & GS Vi C t k Birth DAVID P Restritatp.Qp Tr. 5396:0- 1 428 P GULEZtgN a LEA�A�T ST , ANDOVER MA �4 tTy64� Co L