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Home My WebLink AboutBuilding Permit #322 - 58 GLENWOOD STREET 10/20/2006 TOWN OF NORTH ANDOVER OORTFI APPLICATION FOR PLAN EXAMINATION 04 -(-ae ,e1ti „, • °o i Permit NO: Date Received �� +► � �.^ � Date Issued: �- r)e ' '( ��s-S C14 IMPORTANT: Applicant must complete all items on this page LOCATION �I ey��,�1�t7`(J ST N• A Pri nt PROPERTY OWNER o S S �� I^Vm Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ❑ One family Addition ❑ Two or more family ❑ Industrial E. Alteration No. of units: Repair, replacement ❑ Assessory Bldg G Commercial Demolition Moving(relocation) ❑Other ❑ Others: Foundation only DESCRIPTION OF WORK TO BE PREFORMED la tx o im 6ux, Wf. buj Idle Iden ication Please Type or Pri Clearly) U 50S. OWNER: Name: H oh ✓ Phone: I`/�� DD Address:_ _ S 8 J 5+ _ r CONTRACTOR Name: k \`�, , Phone: Ck G 9 Address: Supervisor's Construction License: Exp. Date: -L- Home ZHome Improvement License: CJ OA Exp. Date: ARCHITECT/ENGINEER Name: Phone: I \ddress: Reg. No. FEE SCHEDULE:BULDING PE MIT: 12.00 PER 81000.00 OF THE TOTAL.ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ J� "000 FEE:$ Check No.: Receipt No.: �-2-D Page 1 of 4 Location No. j �f l Date' t / • TOWN OF NORTH ANDOVER , • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector` / I TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools Public Sewer Tobacco Sales Food Packaging/Sales 01 Well Permanent Dumpster on Site 17 Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fiend Signature of A ent/Owner g g Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED ATE APPROV PLANNING & DEVELOPMENT ❑ t A 6 COMMENTS See— 044{ c!wren+—M;K+ ,po,g e DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes _ Planning Board Decision: Comments I Conservation Decision: Comments Water& Sewer connection/Siznature& Date Driveway Permit I Building Department artment 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 Addition Or Decks ❑ Building PP Permit Application ❑ 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) 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) r ( PP ) ❑ Copy of Contract a Mass check Energy Compliance Report 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 1)oc:INSPE('TIONAL SERVICES DEPAR'1'IIEN'r:BPFORM105 1 \ Page 4 of 4 I Building Setback ( Front Yard Side Yard Rear Yard Required T Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) CONSERVATION ATTACHMENT TO 58 GLENWOOD STREET BUILDING PERMIT APPLICATION No ground disturbance proposed or approved. All work shall remain within the existing building footprint as proposed. The applicant shall adhere to the following Best Management Practices during construction in order to adequately protect the resource areas: No dumpsters shall be placed within 50 feet of the edge of the BVW;No construction equipment or materials shall be stored or staged overnight within 50 feet of the edge of the BVW; and a minimum of 10 hay bales and sufficient stakes for staking these bales(or an equivalent amount of silt fence) shall be stored on site prior to the start of any work for emergency purposes. Any work beyond what has been described herein which would alter(by means of ground disturbance) any resource area on site must be submitted to the North Andover Conservation Commission(NACC)in the form of a Notice of Intent or Request for Determination of Applicability(whichever is applicable)for review and approval prior to implementation. Should alterations occur on site, all work shall immediately cease and desist until the NACC has granted approval for such work. The NACC reserves the right to impose additional conditions and penalties and/or fines should impacts to any resource area occur. An official letter from the Department in this regard shall be forthcoming. Page 3 ot'4 Inc:INSPECTIONAL SERVICES DEPARTMENT13PFORM05 Created JAI' Jan 2006