HomeMy WebLinkAboutBuilding Permit #558-14 - 550 TURNPIKE STREET 1/24/2014 TOWN OF NORTH ANDOVER
PPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued: /
I PORTANT: Applicant must complete all items on this page
IF
LOCATIONa
Print_
PROPERTY OWNER
n
Print 100 Year Old Structure yes. o
MAP NO: =PARCEL: -- <<� ._ ZONING DISTRIC _-_Historic District yes
t Machine Shop Village yes n
TYPE OF IMPROVEMENT. PROPOSED USE
E Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
NAlteration No. of units: Z Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Wellp Floodplain , Wetlands ❑.Watershed District
}Fg
__..,�Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
�1�l U �� Ja CC I j1unJ v�+�Z i S 141)! n/rw r' C'7 F-7c,," t.v&ZL S Af r'(1z-
p�4'tl u .LNSf 2L G�/3jwv✓i.� �- �ytiTY-SGS t� c/C,T T7�✓� el::�-OoXJ
Identification Please Type or Print Clearly)
OWNER: Name: NbRi2-tfWS j2r 2vvl r4-7-z , Gr y Phone: 97e mgt
Address: 6,v 1IDv S . MobM JaA1DV1Jr(,(Z_ M Vt e)( •
f
CONTRACTOR Name ulAiL 1nl tf /YAN/� _ is+ILoiL Phone:
-
r
Address: Yy T%,,y//--y CT N..1&124,j)rCrZ_
Supervi'sor's Construction License: 0;, -o5:op - Exp. Date: _ 3131 Y
Home Improvement License: - . i l l p t _ Exp. Date: al zs' 11.
ARCHITECT/ENGINEER L)QF..t_5MA-M la-SSuc►✓�r5 Phone: Cp3 &-f
Address: f(.l FQ.D(tX*L- t +LL Ko, t+%LLlS 630�i9 Reg. No. opt Z
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ Z5-000 FEE: $___! �^ ---
Check No.: 241 - Receipt No.: O—+ g
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty—fund
Signature ofAgent/Ow e Sig=?ature of'confract
Plans Submitted Plan( Waived ❑ Certified Plot Plan ❑ Stam d Plans ❑
Plans Submitted❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
T- _OF SEWERAGEDISP.DSAL
Public Sewer & Tanning/Massage/Body Art ❑. . Swimming Pools ❑
Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑
Private(septic tank, etc. ❑ permanent Dinnpster on Site ❑
THE,FOLLOWING SECTIONS FOR OFFICE USE ONLY "... `
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENf ❑ ❑
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes- ,-
Planning
es ,-Planning Board Decision: Comments
Conservation Decision: Comments
Water & Seger Connection/Signature & Date Driveway Permit
DPW Tow;: Engineer: Signature:
Located 384 Osgood Street
• :FIRE DEPARTME-14 =Temp Dumpst �h::!,e
y s no
Located-bt;124 Mair; Street
Fire Departme►it signatbre/date `'
COMMENTS -�
I
-Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions._
Total land-area, sq. ft.:
ELECTRICAL: Movement of Meter location, rr ast or service drop requires approval of
Electrical Inspector Yes No
DANGER.ZONE LITERATURE: Yes No
II MGL-Chapter-166.Section 21A-F and G min.$100-$l000..fine
NOTES and DATA— For department use
b*_,eI
Nb C o
® Notified for pickup - Date
Doc.Building Permit Revised 2010
4 Building Department i
The fot��wing is"a=list of the required-forms to be filled out for:the appropriate.permit to-be obtained.
Roofing, Siding, Interior Rehabilitation Permits
u ` B,Uilding Permit Application
o Workers Comp Affidavit
o Photo Copy Of H.I.C. And/Or G.S.L Licenses
o Copy of Contract
o Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
o Certified Surveyed Plot Plan
o Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
u Copy Of Contract
Li Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
u 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)
u Building Permit Application
o Certified Proposed Plot Plan
Li Photo of H.I.C. And C.S.L. Licenses
u Workers Comp Affidavit
Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Copy of Contract
u Mass check Energy Compliance Report
u Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cans if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the apn,,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be subm.tted with the building application
Doc: Doc.Building Permit Revised 2012
Location
No. �SU Date
o - TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check#-S6 3 q
27251 Building Inspector
(A-t
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
$ 25,000.00 m
$ - $ 300.00
Plumbing Fee $ 37.50
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 37.50
Total fees collected $ 475.00
538 Turnpike Street
558-14 on 1/24/2014
Tenant Fit Up North East Dermatology
r - NORT11
r _ er
W. '. . �_ I.. And . �
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No. 666 '
C. h , ver, Mass,
LAKI
COCMIC"IWICK
Ab
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BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT ��,,, !1�} BUILDING INSPECTOR
. .. .. .... ..
..
has permission to erect.......................... buildings on ... ......... .. . .........� Foundation. ...........
Rough
to be occupied as ..... .. ...�.11�1�wr.....l�.V. � ......... ... .. ... .... 1 ��....�........... Chimney
provided that the perso cepting this permit shall in every respe conform to the erms of the application Final
on file in 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
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
• UNLESS CONSTRUCT10 A T Rough
Service
.................. .. ........... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final tlEl
No Lathing or Dry all To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
SEE REVERSE SODE
X Ma�sachuselts_
DePartme ublic" N
$oard of Suildin °f Safet
� • g Regulations and Y,
�' Construction Su Standards
�? pen�asor%
License: CS-055288
TIMOTHY R
j 1 ST.ONGE ��
+ Haver!>jll RItACE.! M 01830
Cotnrhisst-inner • r
` EXpiration
03/05/2014 `,,
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PROJECT LOCATION, ottft fUI.A
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Janet Udelstna�t M.ASSAGFUIT1` RCai i
STRATtO NIJMJLR BI f�I�,TN A,RECISTEIZE
PR fiESS3Z7NAL ,P RCIJITECT JIEI •I3Y CERTi•FYTIIAT 1 T1tl;; E PRk?I'A -E'b O'R I IKECTLY
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