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Home My WebLink AboutBuilding Permit #247 - 575 OSGOOD STREET 10/2/2009 I TAORT11 BUILDING PERMIT oftt,�o TOWN OF NORTH ANDOVER .0a`by.;,. ` �'•'° o APPLICATION FOR PLAN EXAMINATION « � � � � � ^o� ear Permit NO: Date Received �9SSACHUS�� Date Issued: ; IMPORTANT:Applicant must complete all items on this page LOCATION i`' �CD"c Print PROPERTY OWNER _ I mo, • h-10 1� Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes C Machine Shop 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 Others: emolition Other eptic `Well Floodplain Wetlands Watershed:District Water/Sewer' DESCRIPTION OF WORK TO BE PREFORMED: rn Identification Please Type or Print Clearly) OWNER: Name: R2:Tt �_-71FS*�k Phone: '5-72?�, 7Z� i i1 miz- Address: c':;� 5 cf c)c-c_> i-4> '[4 fii4=xLVF.�— i`►r� C3t CONTRACTOR N ame: , `t p. �t� :Phone: Address: Supervisor's Construction License: Exp. Date;: Home ImprovementlAcense: Exp. Date: �ARCHITEC /ENGINEER "Ik 4�HPhone: �� Address:� t+A um a4"T !* 21!!�! Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ES FATED COST BAS 0 125.00 — 2ty i�,�i� �Jl 'S ItD Total Project Cost: $ e-Jc: .j : $ Check No.: Receipt No.: NOTE: Persons contractifg with unre 'stered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of.contractor CV1 1 R�►� t.tAU 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 >k� 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 o 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 J Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 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 d COMMENTS I 7AQ,U Ire-M00+-'5 me-7 - AV CONSERVATION Reviewed on /�14 X Signature t' COMMENTS1�4 110 l FSE LTH Reviewed on Signature 1 COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comment Water & Sewer Connection/Si nat & ate Drivewa P rmit ?6"� r- tkv��L 1DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dury p ter on site yes no Located at 124.Main Street Fire Department signature/date 21 COMMENTS _ 4 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. ®O 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 r MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use l f ❑ Notified for pickup - Date i Doc.Building Permit Revised 2008 Location�``� No. ! Date NORT1y TOWN OR NORTH ANDOVER F? O� AL a y Certificate of Occupancy $ CMUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ f TOTAL $ Check # / 22 4 b 5 ' '-- --� Building Inspector NORTH Town of 4Andover . �_ dover, Mass-,/0 ' 2 - v T O 4- LAKE COC MIC HE WICK V 7 ADRATED Pl? �`s E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT............ D.�l .+% a.0 ............................................................/....................................... Foundation has permission to erect........................................ buildings on.....Jr....�....:..........01�74P G[ ,...... ..................... Rough to be occupied as.......... .. i?Zv...........�!././ .....� l1�. . ............. rov. s....--.. Chimney provided that the person accepting this permit shall in every respect cofn orm o the terms of the application on file in Final 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 CONSTRUCTION TARTS Rough a.............................. Service BUILDING INSPECTOR 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. � 1 i Town of North Andover NORTH q Building Department ?O��c�LED �6460 1600 Osgood Street o North Andover MA 01845 Tel: 978-688-9545 Fax: 978-688-9542 m" 11 COC NIC Ml WICK y1 �d DEMOLITION OF BUILDING AFFIDAVIT �RArE07 SSACHUS� DATE i,l 7,':: � OWNER'S NAME & ADDRESS LOCATION OF PROPERTY TO DEMOLISH r-57c��> DESCRIPTION CONTRACTOR'S NAME &ADDRESS DEPARTMENT SIGN-OFFS DEPT. OF PUBLIC WORKS -WATER: SEWER: DEPT OF CONSERVATION HEALTH DEPT: Septic Well HISTORIC COMMISSIONAN& GAS ELECTRIC . -TELEPHONE CABLE TAXES POLICE n FIRE -z' D EXTERMINATOR DUMPSTER- ON/OFF STREET DIG SAFE NUMBER DATE REC'D BLDG. INSPECTOR Doc.form demolition of building affidavit