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HomeMy WebLinkAboutBuilding Permit #Exception - 575 CHICKERING ROAD 5/1/2018 NORTH BUILDING PERMIT °� t LEU �4 TOWN OF NORTH ANDOVER �2 - ` ` °A APPLICATION FOR PLAN EXAMINATION yry Permit No#: Date Received C, Z.- CH 5 Date Issued: IMPORTANT: Applicant must complete all items on this page L0CAT,ION� � �S Cc Prat PFZOPERfTY OWNERvf .,: _. . _ Print 100 Year Srucure yes no MAP PARCEL:__. _ ZONING DISTRICT _ _ . . .>Histonc ®�stict :yes }. 'no" _ �- -- - Machne Shaop_Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial j ❑Alteration No. of units: gCommercial I ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ DemolitionElOther - --- ❑ Septicp Well, ❑ Floodplain ^Q Wetlands ❑ Watershed District DESCRIPTION OF WORK TO BE PERFORMED: _ 0 I Identification- Please Type or Print Clearly Y q Y75'? OWNER: Name: l�o.,,` �. Crnr�,� Phone: 978- I I— Address: Contractor Name: . Phone:_ s _ E-mail," Address_. Supervisor's Construction License s _ Homer Improvement;License ._��_ Exp. °Date: �a ------------- 4 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/Ovvner _ Signature of contractor_ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ ❑ i Tobacco Sales Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes r Planning Board Decision: Comments i x Conservation Decision: Comments Water & Sewer Connection/Si nature& Date Driveway Permit DPW Town Engineer: Signature: . ., Located 384 Osgood Street iFIRE�DEPARaTL Vern �.®`um s e �P ,roc#ated5at��24 M p - p,t r onj site; .yes �no� _ � ;ainp.Street, Fire rDepartment signature/date. 10,OMMENTSi 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 DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 VOTE: 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/Cross Section/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 DOTE: 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 COTE: 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:Building Permit Revised 2014 North Andover MIMAP October 30, 2015 !F ,49 - 569 4 10 56� # 6 070-0-0025; 3 #57 65 084 .L.06 070.0-0Q35,' O&!F: -00 7,' O7Ei.0#l0:;4; #44444444 7 a #,taYrl 550 #555 Oti4#,27 a84:._• .. �S` #i4 03!t?:O-Ot-23 ti 003l D #i6 07(1_0 6 #214 #24 _ ✓� 085.8-aQIO` i #36- � Location ' t t/- ' �� - 55 -----� Date � s�`�s:a=coos No. i/ #22- #,20; 085 000T TOWN OF NORTH ANDOVER #25 i1,4: • , 14 085\_x.=0022 �; • p r'' OaSS 0=0021 Certificate of Occupancy Building/Frame Permit Fee\711 ; Foundation Permit Fee $ 085:0-0021. n_ i Other Permit Fee $ TOTAL $ 42oss o=oo_2s' \'/4185'A--0Q32#9', �. Check# 085 0-0031' r �1r � � - �•' Building Inspector 0s50o40 =fit; ,, 7xz6i< #490 PS t13 #39' #47 _ 83 070,-0043; - #ss ass 1 �t59: 07�.o-00?s; a7i.�r=occas. us7 0022 _ 038 #75, #sob O�s�-.oQ44 giaRs-a=oa�.3a 058x4002 #52� aMVPG Bo Wetlands Zoning Bu sine s 1 District Municipal Boundary G Exempt Lands C Busine s 2 District Horizontal Datum:MA Slateplane Coordinate System,Datum NAD83, Rail Line C Busine s 3 District Meters Data Sources:The data for this map was produced by Merrimack Interstates C Busine s 4 District Valley Planning Commission(MVPC)using data provided by the Town of —I O GeneraBusiness District �1O�` North Andover.Additional data provided by the Executive Office of —SR C Planne Commercial Dev ? � �� Environmental Affairs/MassGIS.The information depicted on this map is C Comido Development Dist 3 planning purposes only.It may not be adequate for legal boundary Roads C Corrido Development Dist for tannin definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER {,Easements C Cduido Development Dist MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING ❑Parcels Industri I 1 District THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY G Industri 12 District Zoning Oveday C Industri 13 District `# OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT AdUit Entertainment C Industri I S District * ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF 13 Downtown Overlay District Reside ce 1 District '� .tom THIS INFORMATION ©Historic District C Reside ce 2 District to Water Protection C Reside ce 3 District C Hydrographic Features de ce4 District —Streams 1"=150 ft e-5 District e ce 6 District —ge Zesidential District