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Home My WebLink AboutBuilding Permit #191 - 61 CORTLAND DRIVE 9/13/2006 TOWN OF NORTH ANDOVER NORT►i APPLICATION FOR PLAN EXAMINATION O`�tLlD gtio •6 O �O t A Permit NO: Date Received + s Date Issued: " d� &S US IMPORTANT: Applicant must complete all items on this page C LOCATION 6 (Z UJv Z M 1Gm~f Print,, PROPERTY OWNER F2 Mmj �LC Print MAP NO.: PARCEL: I ZONING DISTRICT: R TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK T B PREFORMED si& 1�2 (�, n fV -� S A �Q A"�Identification Please Type or Print Clearly) OWNER: Name: Iv\`�` S �C Phone: &J%,A,1m-4 Address: N' CONTRACTOR Name: ✓d t Phone: Address: J-0 �GrCf�+•+ !4� , J2V Supervisor's Construction License: Exp. Date: Home Improvement License: luExp. Date: ARCHITECT/ENGINEER (� Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1090 00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ Z$'8fs 6 Lh K 12g)" )(M,06 FEE:$ g33Z. + 1 a 4:>- f IST ka G 4- leo C-a Check No.: �l� Receipt No.: Ly Page I of 4 Ale- S 32 Location Inl „ �/` No. A2 Date NORTH TOWN OF NORTH ANDOVER 41 Certificate of Occupancy $ � G ��s�,•' MUBuilding/Frame Permit Fee $ �✓ ti, S Foundation Permit Fee $ Q Other Permit Fee $ TOTAL $ 41f� Check # `e /�B.ilding Inspector TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well Tobacco Sales ❑ Food Packaging/Sales [I❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with an egistere c ntractors do not have access to the guaranty fug Signature of Agent/Owner Signature of contractor t Plans Submitted lans Waived ❑ Certified Plot Plan Elamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ []Water Shed Spec 1 Permit ❑ Site Plan pecial rmit ❑ Other COMMENTS '�\ I T REJE TED DATE APPROVED CONSERVATION ❑ COMMENTS TE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Temp Dumpster on site yes—no— Fire Department signature/date Building Setback (ft.) N l A c v) qag r,u Front Yard Side Yard Rear Yard Required Provided aequired Provides Required Provided / / Dimension Number of Stories: I Z Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: 34). Z h/ NOTES and DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan.2006 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application o Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o 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 o 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) o Copy of Contract ❑ 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 have 4 of 4 NORTH Town of 4Andover 0 .�_ - . s. ) 91 LA E dover, Mass., COCMICKEWICK �,p A�RAT E D p'? �C7 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT........... ..... ... t.f .... 40%af.....cow.1.�.0..!!W..... ""&Ir .. Foundation has permission to erect........................................ on. ...e-%0&^wrAAV#V-.*1.... �� Rough to be occupied as.................... �.... �.�A�.I..�.. ......?................................................................ Chimney provided that the person acceAjo this ermit shall in every respect c form to 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 CONSTRUCTI STARTS Rough ............. Service D CTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. IF—SEE REVERSE SIDE Smoke Det.