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Home My WebLink AboutBuilding Permit #Exception - 57 OLYMPIC LANE 5/1/2018 OORTH BUILDING PERMIT of�t.a� TOWN OF NORTH ANDOVER o? APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �SSACH�1`+�� Date Issued: IMPORTANT:Applicant must complete all items on this page .LOCATION ? PROPE 1'dnt y . TW OWNER: d u�c'xY` . Ic•mac°Vie. Print MAP-N'0 . PARCEL; ZONING D15TRI,CT: Historic.District yes no m,, Machine Sfiop"Village yes 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 SheOthers: lition Other Well Flaodplain Wetlands Watershed Distnct 'Water;/Sewer DESCRIPTION OF WORK TO BE PREFORMED: N � G01 foIV IdgntificationpPlease Type or Print Clearly) OWNER: Name: ov1Ae— Phone: g1 7ff 665-60660 Address: 5-7 OVm a rC CONTRACTOR N:arna:° ." :. Phone.' Address.r . - k Surpervisor.'s Construcfio.n.Lib en e: EX, _Date:: Home Irnpraverner'11 anse:: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 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 guaranty fund Signature of Agent/Owner` = Signature of Contractor 'y` J 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 COMMENTS CONSERVATION Reviewed onIt-W Signa I ture (J' J COMMENTSA9� HEALT Reviewed on Signature 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 DPW Town Engineer: Signature: Located_ 384 Osgood Street ,FIRE;DEPARTMENT -Temp Dum Wer°on side yesno Located.at 1-24 Maii6 Street Fire Department si,griature/date CO.M:MENTS 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 I DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine I NOTES and DATA— For department use i i ❑ 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 ❑ 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) ❑ 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 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 i Revised 2.2008 %SAN 1 21 'A AMMr�.10FP R��4 R"v it". V 44, WWW"M On wwhn "tgn .......................� ........ .... . till J W* . 4- mostz"WHAN-00 Sic. P ffl.w 'D qg g P g 0q, 0 'T, 16 Jr 1.1;, "ll, TAT�z 14 MOM a IN FA Fu mwhi�..-�X; 0 0 tI, . F� "mama. I.-M W""I�.-,�l SEE` M Wag U.-P- ANATOMY,. 4'14'. _g Ell .............. q� "T a� U'iti U Pun,P.. its log A ..%F. r X A .......... 4N .......... _1'1k't1N:1,zgl M�.f to .1,W.1 T� I v;,71,4 WK t'lT"r PPI s V.:, Www MA MIMI 55MMA Wwo I "A 0-440- _v_ AW Q vtti 0 ot: �k_ f,gl eo-YiL, o- -=WAS T M�wv q yit, f. t, 17 j, wow shy- - "Toon 0 AGW M M"M ASUPS "A "MY, -0 MO 7� tt*31§,.Nv "sit -g_ Kxwn"N Q"§64 0 T "Q&K-P qt� k"M ; oa Ms.IS- �111_Ft� RMN"","q04 on Ak- tr I.--4�k -no.W, -&-Aqv --n-y-y-M-0 ................ 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'Mum, JUNE VIEW ..........1, in My, J . ..... 1 FORM U - LOT RELEASE FORM l INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ******************''`*********APPLICANT FILLS OUT THIS SECTION"""" APPLICANT �rP �e fPHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) 151�// STREET �r)vC ST. NUMBER 5-7 USE ONLY********* RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED l/ DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED � SEPTIC INSPECTOR-HEALTH DATE APPROVED / DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WA T ER CONNECTIONS DRIVEWAY PERMIT PMO FIRE DEPARTMENT �+ EN_i RECEIVED BY BUILDING iNSPECTO R DAT%�tt4G pEPAi Revised 9\971jm