HomeMy WebLinkAboutBuilding Permit #Exception - 614 FOREST STREET 5/1/2018 a
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION U I Q
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PROPERTY OWNER (—Pe LC At 30 C-r-fzC-JC�r C�i� Unit#
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MAP NO: 10 S PARCEL: ZONING DISTRICT: Historic District yes
Machine Shop Village yes no
100 year-old structure yes no
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:
❑ Demolition ❑ Other
®+Sep�ic �Well �`F1o�dhlam� � -_ Wafers}ied trict
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DESCRIPTION OF WORK TO BE PERFORMED:
(Identification Please Type o1rPrint Clearly)
OWNER: Name: H Phone: U1-4-953 -+2_(,LA
Address: LON FDF-e-25,,�'r- STAT
CONTRACTOR'Naine: Roes fi C �0 +77L f Pliorre: �'�� - l-I�d-��l�.
Address: I SC? t-A�OC)Le- LL)W�Z,l_.. 0yW\ U l�CSZ
Supervisor's Construction License: 06(,o Exp. Date: 22 Z�13
- Home Improvement License: Exp. Date:
�v�.v�-QodL
ARCHITECT/ENGINEER t,, xx tai-r� -�ui,'1' Phone: q--)�6 Z,S-4
Address: "63 Wez�r-k tIA-it l Sf. Reg. No.-
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 1 ° c C> FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the aranty fund
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Sw mm"lg 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
CONSERVATI0�9 Reviewed on ' �° Sclnature
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HEALTH Reviewed on Allr Si nature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
!Nater & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
/'1/1T.TT ST %T rCY
Dimension
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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.$100-$1000 fine
NOTES and DATA— For department use
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2011 June/mi
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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
u Workers Comp Affidavit
❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition or Decks d>ie— ?Q��Izs
❑ Building Permit Application
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❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract 1 �
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
a Mass check Energy Compliance Report (If Applicable)
— --a-Engineer-i-ng Affidavits- or--Engineered-product=---- --- _ _ - -- ---- - - -
MOTE: 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
o 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
MOTE: 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.. Thea applicant must then et this recorded at h c and roof of recording
p pp g the Registry of Deeds. One copy p g
must be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
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CERTIFIED PL01T PLAN
MAP 1050 BHA MYERS':
N/F LYNDON 12273
PLAN 176.09'
I.PIPE
160.00' (FND)
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17.3't i 1I WELL LOC.
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PROPOSED I
I.G. POOL 51
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17.0
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of 1 ;
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M 55: 00 Z ro
~ OARAGE Ejp5T1NG S.F.
p o „st,. ;; ;: i W.f. DWELLING I ��, v ro.
X614 c w
c h• r 30.6't
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1150.00' 211.60'
�• p,q,gp�g,pciRf_a.53.ci? Pi8�2$9B'�tE:91?*PRPA9EA�AA9F9�'�"'���a�
(140TFND) ' :r
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! ' ZONING DISTRICT: R1
� REQUIRED:
PROVIDED, EXIST (EXEMPT)
MIN. AREA: 87,120 S.F. MIN. AREA: 43,610 S.F.
CALL MIN. FRONTAGE: 175' MIN. FRONTAGE: 150'
MIN. YARDS: MIN. YARDS:
TOLL FREE FRONT: 30' FRONT: 116.4'
1-8,38—DIG—SAFE ASSESSOR MAP: 105 D
(1-888-344-7233) PARCEL: 127 SIDE: 30' SIDE: 30.6'
REAR: 30 REAR: 109.2'
72 HOURS IN ADVANCE POOLS: POOLS:
10' SIDE AND REAR 17' SIDE AND 91.5' REAR
LOCATION : 614 FOREST
1 . STREET
REVISED: 2-AUG-11 BY: WGH I
LOCATION: NORTH ANDOVER MASSACHUSETTS
CITY/TOWN STATE
DATE: 29—JULY-2011,1
ZN Of ode. SCALE: 1 INCH = 40 FEET.
DEED AND PLAN REFERNECE:
WILLIAM ESSEX NORTH
HOLT 1 REGISTRY OF DEEDS.
N 3%M DEED BOOK: ._1 1 ,2 9 7 PAGE: 313 PL. BK.: PLAN
CERTIFICATE OF TITLE NUMBER: PLAN No. � 0133.
CERTIFICATION IS HEREBY MADE TO: TOWN OF NORTH ANDOVER
OWNER: . 1 'GREGORY E. & MICHELE J. STEIN
THAT THE EXISTING STRUCTURES AS SH%WN ARE SITUATED ON THE LOT DESIGNATED, IN COMPIJANCE WITH
P.L.S. DATE THE APPLICABLE ZONING BY—LAWS, FORSSETBACK, AREA AND FRONTAGE REQUIREMENTS OF THE
MUNICIPALITY WHEN CONSTRUCTED, EXCEPT WHERE OHTERWISE NOTED, OR ARE EXEMPTED FROM
WILLIAM G. HOLT ENFORCEMENT.
CERTIFICATION IS HEREBY MADE THAT T E STRUCTURE(S) SHOWN ON THIS IS NOT LOCATED WITHIN A
LAND SURVEYOR, DESIGNER SPECIAL FLOOD HAZARD AREA (100 YE,4P) AS DELINEATED ON THE FLOOD INSURANCE RATE MAP FOR:
83 WEST MAIN STREET COMMUNITY No. 2500.98 i PANEL No. 00090 DATED: 6-24- 3
M E R R I M A C, MA 01860 THIS PLAN WAS PREPARED USING EXISTING RECORDED INFORMATION, EXISTING MONUMENTATION, '\ND
ASSESSOR'S
ISES. TIS PLAN
MAKESNO DDTE MINATIIONOAS TOTTHEPEXS ENCENOF SUBSURFACE STRUCTURES, UTILINSTRUMENT SURVEY OF THE ITIES, ORHPRESENCE
TEL: (978) 257-4576 OF HAZARDOUS MATERIALS.
E—MAIL; biligholt0g01.COt"1'1 JOB NUMBER: 11-004-CPP
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