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Home My WebLink AboutBuilding Permit #716-11 - 562 TURNPIKE STREET 4/26/2011Permit N0 -_7&__W_ Date Iss TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION MORI'ANT: 2- / Ci 1r Date Received must complete all items on this I Print PROPERTY OWNER o r nve.v kc Jis r-orx S , - Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no 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 ❑ Assessory Bldg ❑ Others: Demolition ❑ Other '0 Se tick ®Well t_ 'l7Floodplaint®Wetlands� i�yWatershedDistrict� >; I �o T YRO,CRIPTION OF WORK TO BE PERFORMED: Please Type or Print Address: G l v r M f CONTRACTOR Name: �J 01V IOk L,' e vs Phone:'T ? 9 � 95 3 919 O Address: d Q v 8 roo-d c�3 7,h H'A o g 4l , Supervisor's Construction License: �d �pU Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER t� �-r.� YP 9n I'1 Scr�r.Ja � 4 Phone: "O 3 . No._ 1 I 1 -) O FEE SCHED ULE: B ULDING PERMIT: $92.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED 01V$125.00 PER S.F. Total Project Cost: $ Jc� r Cho • cw FEE: $_ Check No.: ` � Receipt No.: Q40 I 0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑Swimming Pools ❑ TanningLlVlassageBodyRrt ❑- 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 ❑ ❑ COMME CONSERVATION COMMENTS HEALTH COMMENTS Reviewed on Si nature Reviewed on Si nature n Zoning board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision:' Comments Water & Sewer Connection/si nature &Date nriypwalf Permit DPW Town Engineer: Signature: Located 384 Osgood Street , FIRE DEPARTMENT - Temp Dumpster on. site yes- no Located at 124 Main Street Fixe Department signature/date COABMNTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ff.: 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.$10041000 fine Doc:.Building permit Revised 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 ❑ Ph oto 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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 ❑ Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals AL the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording ist be submitted with the building application Doc: Doc.Building permit Revised 2008mi Location_ 5-103 Tvh.,v,�,,�r� .s 7 No. Date 4o? , Check # �- f 24byo TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL Building Inspector N Im 2 ;mo } {r. »A 00\ U) z 0 \ \ :-i m > 0 0 = 00 0 (3) a. 0 J ' w\ p/\ 0 (D (D 00 Ili 0 r E 0 r� cn cn n:: � O cn w � 1 S C C ?�O _ dN Sco H y = �.' I m C7 m c! G. t7 T m � ?s tom' _I =..Orth ca T 55 CL m moray .a CO) m is mAJa o.�v o Z�.V O H OO CL =b CD m N O m CL CD3 co y CL W :m N � CDfAm gyCD. =r 0 CD 0ca �► U �3 'O O • � ?: ED C H�CD CD m m . a ,S. Cl) n = o c o o - Cn PT, d Cn C ° v y te d gi C1 ►o Pi ° d n ` CA C� O COQ! Z co) O C7 �� CL r m m o. y X 70 MC, T v 0 `° M X CD CL o Q� a m CD �. CD CD °m°P y. —C. 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The project name and location are: Blockbuster Demolition, 562 Turnpike Street, North Andover, MA 01845. The Architect is: Maclaren Associates located at 11 Main Street, Atkinson, NH 03811. The Owner and Contractor agree as follows: Interior demolition and clean up and to locate underground piping. The Owner shall pay the Contractor the Contract Sum in the current funds for the Contractor's performance of the Contract. The Contract Sum shall not exceed Fifteen Thousand Dollars ($15,000.00) subject to additions and deletions as provided in the Contract Documents. 0 her (signature) Printed name and title l` I Contractor (s gnature) Sa"t-lo-� YrcA r,(1 mf - Printed na a and title 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: v rv, S • 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 I OA. The debris will be disposed of in: Q,2 <:� 1 (Location of Facility) Signature of Pe Applicant Date t•pe Dehis lv i5sne- 4 ree.