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Home My WebLink AboutBuilding Permit #Exception - 535 CHICKERING ROAD 5/1/2018 IJ I Kt f NORTH q BUILDING PERMIT a TOWN OF NORTH ANDOVER 3� b -' ° oL APPLICATION FOR PLAN EXAMINATION OPermit NO: Date Received pDq•7lD��` �SSACHus�� Date Issued: IMPORTANT:Applicant must complete all items on this page i ,ATION OCrc K X21 8 Pnhu VMNEIR �?.tarrt IA NO PAC 01 fhJG D STRICT" F�istor'icDistri:ct des A - a " Machine; fin pillage fres rio i TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration ✓ No. of units: Commercial Repair, replacement l" Assessory Bldg Others: Demolition t./^ Other epttc' INeli ; : Flo dp'la n "17ilirtlaracls 1i atersl%ed Distnct ' �Iater�S�wer- - / )DESCRIPTION OF WORK TO BEPREFORMED: 0 ?C/-� O-OfA U tA IdentificAtipn Please Type or Print Clearly) OWNER: Name: _ f'A'An 0- 1 S 0 Phone: Address: 0,Vi►C y,µ Pan -pg2'�ie-.� 2-3-1 LAI. +0tt CO1 Tl OR,N4*',e n J cf - c C ren > hfl 1e Address a � raris _1= .Date: ffl-affi l#ip ove ent� censer 1 j -3 �I exp. rate: ARCHITECT/ENGINEER' Phone: 7 �Wb Address: Z ' i f e 1 Reg. No. L FEE SCHEDULE:BULDING PERMIT:$12.001 W4 00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Notal Project Cost: $ FEE: $ 410 Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guara ty n _.. tgnatureof1g ne t/�auner Mature of contracor f Ite <J I l� l G � NORTH q BUILDING PERMIT ar b�tt`eD.„,6•,"oL TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 4L Permit NO: Date Received �� ,�/ 01r � Argo �SSACHUS Date Issued: IMPORTANT:Applicant must complete all items on this page t:OCATIOtV 'RO.PIIRT IER' C.�= jt. ail-e_ F. nn MAP 1�IOe �'A C 2' NIN 1-18TR`ICT,_ istoric D�striyes no )Vladl rin Sfio'Viliage„dyes no . 4 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration ✓� No. of units: Commercial Repair, replacement V*^ Assessory Bldg Others: Demolition ✓• Other Septic We l 3loodplain 1�1e#laradsi%atersied District Mater/Sew6r ESCRIPTION OF WORK TO BEPREFORMED: 'ell el�4 l r l'e�a wx — /V 0"W Caf4 t Identificoipn Please Type or Print Clearly) , OWNER: Name: e, &jy &_ >i S Phone: '-i c• Address: avvlckegoka Fan pgg.kte.s 2.3-i 'OO.NT:I CTOR Nanae_ . JVZ,-r.. t�� r„v�� .hone ,�� rf� � �?1417 Address: I7 Supervises eCc�rastrcti® l�acense: c�r �3 Exp,. :Date: ! _cJ/'C 4io e.lrnprovement.�Lice-nse: (7 3 �/ ,Exp....,,,Date. , /2- ()/ ARCHITECT/ENGINEER Phone: /2J- U7 �Ob Address: 2 r e Reg. No. � FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$104.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ A. Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guar n .. Signat re of Agent/Owner Signature-of contractor R OORTH •9 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date Received 0 "4o°"11c"" �SSACHU`�E� Date Issued: IMPORTANT:Applicant must complete all items on this page t.00ATION �t 2 G k,r rG! _ 122 ll-- Pin PROPERTY 011ERi`1,i ?rant 'MAP NCO. -RAR - ON1hIG I)=�Sl`R`ICT: Hlstor'ic D.lstrict des �o Machine Shop Village yes -no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration ✓� No. of units: Commercial Repair, replacement I/' Assessory Bldg Others: Demolition ✓ Other Septic 11e11 Floodplain 17iletlarads Watershed District Water/Sewer � ESCRIPTION OF WORK TO BE P FO ,MED: CSI l r ��-- � 5e12v ff14 � utA -- �� ►G: Identificoipn Please Type or Print Clearly) _ OWNER: Name: ��P� � t �!'�..f 0-L' S C� Phone: Address: avviC t lW S i,�. +0t4. CONT. CT1DR ulama- �SJZ�4- n �—h one ,� r '�7,?cJ 7 1 Ad-dress: e ) aperrislr"sCrasrc�n L�eerase� � �rC�3p_ ,Date: r�ve » ate:ImOrtZe. t E � 9/z� ARCHITECT/ENGINEER' Phone: ./21- U 7 Wb Address: 2 SM&ILe I Reg. No. �16 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$104.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaran n .. Signature:of Agent/Oner Signature of contractor -- t; Plans Submitted Plans Waived Certified Plot Plan Stamped Plans 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 r j � COMMENTS `�? �PfGt�� c�l�r C1 > Lit ► � iP c Xf L NSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Si nature / .Z COMMENTS II Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes � I Planning Board Decision: Comments I Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street �1EE ?AR ']111ENT Term Dt?rra�ster orrs�te` es� kno 3 Mata Street top atedat I Frqqp aentnatae7dae. COMMENTS Dimension ONumber of Stories: .Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: f ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No ,F DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use c� - �o /V 0 Notified for pickup - Date 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 0 o 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 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 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) O ❑ 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) o Building Permit Application ❑ d 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 o--Mass-ch-ark Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dum ster p permits require sign off from Fire Dep artment,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 0 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 r 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 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 Plan ❑ Workers Comp Affidavit u 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) O ❑ 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) ❑ BuildingPermit t Application ❑ -Gertified Pfep d 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 Energy Compliance Report P P ❑ 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 O Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 r I