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HomeMy WebLinkAboutBuilding Permit #136 - 53 WAVERLY ROAD 8/21/2007 14ORTFI * BUILDING PERMIT 9 0 t6 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION 0 Permit NO: 0'�4710 0* Date Received SAc"U Date Issued:-2 IMPORTANT: Applicant must complete all items on this page L 'ATIO " OC ,TNZ �P n PROPERTY Ow- "p rEht — EL - DIST RIC 0 RIC IsT RIC' DISTRICTM . ' TYPE OF IMPROVEMENT PROPOSED USE Residftntial Non-1 Residential El New Building 't ; ne family 11 Addition 11 Two or more family 0 Industrial [I Alteration No. of units: 11 Commercial Lolloe"pair, replacement 11 Assessory Bldg 11 Others: 0 Demolition [I Other al z "ttl IR W- Mv Nil i R �So i 04 DES ,PRIPTION OF WORK TO BE PREFORMED: oer�W-&- Identifica on Please Type or Print Clearly) OWNER: Name: Phone: Address: 52 74- rfe. "I I 4i.0 CONTRACTOR Z q-'q& ga "--g- 'gam p�I TF ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ YJ FEE: $ Check No.: Receipt No.: � 0 -/,f NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/OwrLer Signature of contractor I Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM 5 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS TE REJECTED DATE APPROVED CONSERVATION��" A0� k .5;7, Aj i,- COMMENTS p VJ aOda U�/,I/t DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ i Private(septic tank,etc. ❑ :Permanent Dumpster on Site ❑ i I 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 Located at 384 Osgood Street FIRE DEPAR`tM�NT Temp C3umpster pII s1te2 ,yes no Lecatecf at;424 M61t Sheet FNres©epartment srgnaturetda# r � w CC3MMENTS , E t 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 0 o • i I ❑ Notified for pickup - Date ........................_.........._........................................................._....................................................--....................._.......................................................................................................................................................................................................................................................--..........._...._......_................................ 1 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 II' l ❑ 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 y! 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 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 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 2.2007 Location Iva a( il/4 �"� No. � Date ' I 01 f NCRTq TOWN OF NORTH ANDOVER 0L ►0. s a + ; ; Certificate of Occupancy $ b''••°''�� cMuBuilding/Frame Permit Fee $ st Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # f 205 'r 3 Btriilding Inspector .NORTH Town 0 _ Andover 0 No. 3 (p C% o , dover, Mass., 'to COC MICMEWICK V Ao Qa\ ,9RATED S P 'C BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... �.�4 PYGr ........................................ ..�................... ............................... ..... ................. Foundation has permission to erect........................................ buildings on .......... .... ,� ...................................... Rough to be occupied as �y � .. .. Chimney ............................. ................. ............................................................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 bo / PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTIONTS Rough ................... .................... ...... ............. ............. Service BUILDING Final Occupancy Permit Required to OcCuPy Building GAS INSPECTOR 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. 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