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Home My WebLink AboutBuilding Permit #179 - 55 CORTLAND DRIVE 9/8/2000 (5) TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ° N°RTp F�S�eo #61 q.0 ° t° x Permit NO: / Date Received Date Issued: d® �9SSACHUS��y IMPORTANT: Applicant must complete all items on this page LOCATION SS' V� I a J �Q l -?2,. ) 6A— P! PROPERTY OWNER C Print / MAP NO.: /0t PARCEL: ZONING DISTRICT: R TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential >(New Building )<One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORME S'FR 13etc «9 -Fm-.A- rt,��La•e i Identification Please Type or Print Clearly) OWNER: Name: Phone: q - Address: Z N• AUre A CONTRACTOR Name: M � v4�nJ� Phone: Address: 1 L l CG Supervisor's Construction License: Exp. Date: 7 Home Improvement License: K"A Exp. Date: ARCHITECT/ENGINEER lJ Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 P R$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 1k Sf x IZS I ObQ X )Z• 66 C FEES Z9 9L ou � 1 ob i- 00 c !o Check No.: /9 6 7- Receipt No.: Page 1 of 4 ;U� AL Location S� ( Dr' �G"Y 4- /)"-r�" No. Z 7� Date 6 �ORTM TOWN OF NORTH ANDOVER ` Certificate of Occupancy $ /0U +Oo��o �ss,KMUS E<� Building/Frame Permit FeU 00 — Foundation Permit Fee $ / Other Permit Fee $ TOTAL Check # C, 136iidi g Inspector TYPE OF SEWERAGE DISPOSAL Public Sewer A Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site F1Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unre istered co ac rs do not have access tothe guaranty f nd Signature of Agent/Owner Signature of contractor Plans Submitted k1 Plans Waived El Certified Plot Plan 11 Stamped 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 2 DATE REJI(Et//"' DAT APPROVED CONSERVATION ❑ COMMENTS DATE REJE T D ATE APPROVED HEALTH ❑ ❑ COMMENTS 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 Temp Dumpster on site yes—no_ Fire Department signature/datd Page.4(W4 - — _— Building Setback (ft.) N I � C)f, V B r -�- Front Yard Side Yard Re uired Provided Required Provides Rear Yard � Req fired Provided Dimension Number of Stories: /�- Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.:_ 30,7 ,4<_ NOTES and DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERViCGS DEPARTMENT:QPEORMOS Created 1MC.Jan.2006 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 o Building Permit Application ❑ Workers Comp Affidavit o 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 L3 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 DEPARTMENTMFORM05 PaoP 4 nr4 t%ORT#q T 19 own of over 0 No. 9 _ 0 LA E dover, Mass., t�- OCOCHICH ICK % RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............... .... ..... Foundation Rough has permission to erect........................................ uildings on ... • Chimney . ..... .... . .... .... . . . ... to be occupied as..............................this .. �if tot to s the application. .. . ..o.n..file in Final provided that the person accepting permit shal 9 resp rcNonfoftrm , this office, and to the provisions of the Codes and y-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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIOT AR S Rough Service ... .......... B LDING INSPE 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. Burner Street No. SEE REVERSE SIDE Smoke Det.