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Home My WebLink AboutBuilding Permit #610-11 - 62 EMPIRE DRIVE 3/15/2011TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: !d ! d ' 1/ Date Issued: IMPORTANT: M Date Received must complete all items on this Print MAP NO: © PARCEL:�ONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ,kNew Building i5,One family ❑ Two or more family EI -Industrial ❑ Addition ❑ Alteration No. of units: ❑ Commercial ❑ Others: ❑ Repair, replacement ❑ Assessory Bldg ❑ Demolition ❑ Other-- `Wetlands 0 Watershed�Distrrct (kSeptc+Floodpldin -- DESCR IYTIUN UP w UK& i U Dn rr nr Ur Fc oyvLy OWNER: N or Print Clearly) LZ—(f—- CONTRACTOR Name: 0 A Address: Supervisor's Construction License77-offZQ 3 Exp. Date: SSS 3i Home Improvement License:f (G 7 �Z- / Exp. Date: ARCHITECT/ENGINEER -% Phone:? 35-2--319- c Address: E Reg. No 2-77465 FEE SCHEDULE. BULDING IT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ FEE: $ ��y Check No.:� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund CinnafitrA.nf'At/®Wn✓-,Signature:ofcontractor b2— Location No. Date 40RTs, TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ CHU Foundation Permit Fee $ ID 6) Other Permit Fee $ TOTAL $ Check # /-?, 23956 Building Inspector Plans Submitted ;4 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans le TYPE OF SEWERAGE DISPOSAL Public Sewer Well ❑ Private (septic tank, etc. ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed COMMENTS_ re „ 4..1.x.' a HEALTH Reviewed on Signature COMMENTS t Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comm Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes Locatedno384 Osgood Street Located at 124 Main Street Fire Department signature/date COMMENTS -I --- — - -- — - — - 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.$100-$1000 fine NOTES and DATA — (For department use ® Notified for pickup - Date Doc:.Building Permit Revised 2008 wy " 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) ❑ Muss 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 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 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 Chat the appeal period is over. 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