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HomeMy WebLinkAboutBuilding Permit #577 - 62 PETERS STREET 4/7/2008 BUILDING PERMITo`"°eT bgti TOWN OF NORTH ANDOVER F APPLICATION FOR PLAN EXAMINATION « b� n0 C 7. Permit NO: "� Date Received ��SSACHUS Date Issued: YL7 to M •ORTANT:Applicant must complete all items on this page m ,LOCATION , -Print, PROPERTY,OWNS Prin - e MAP NCO: PARCEL: . ZONl.NG DISTRICT; Histotic District yes, no Machine,Sl op Village eyes 'no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family 1ndustrial VA"Iteration No.,of units: ✓iCommercial Repair, replacement Assessory Bldg Others: Demolition Other Septic' Well Floodplain Wetlarids"W' tbrshed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: (29272A-M VIQSAe5, 4 D10WW=K, Amt2 (1) 51±4y, 'Identification Please Type or Print Clearly) OWNER: Name: _ 65 Phone: Address: (, �p, �. vY , 0%e qS _ CONTRACTOR Name: � Ntit2 ,�u�. yd•,� Phone: *t$ 1' ' Address: ©t� � 1 _.fAh � t8 Supervisor's ConstructionLicehse:G ��� � . . Date. q '5 `•C>Q, , Home improvernent.�.icense: ffiy8'15' - Exp, Date; ARCHITECT/ENGINEER Phone: Address: Z.Oo Svf�;J SS A,AAt aVi- A& 5Lo 66Reg. No. 25 7 FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: Qz FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access t e guaranty fund . .._" _ ., ignature of Agent/Owner ',,, 1111111 S.ignature o#�oratracto a ; 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 ti jam,-s,.•. THE FOLLOWING-SECTIONS FO.R OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U•FORM ' DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED EAL H' COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision:'! Commenter ' S, - . - Water & Sewer Connection/Signature &Date Driveway Permit Located at 384 Osgood Street - F]RE DEPARTMENT -Temp`Dura�pste"-'' it yes `` ,no .Located at 124.,NIain:Street ,Fire-Department signa"tureldate TT '' Al COMMENTS -° :, 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) I ,I N �I -i 0 Notified for pickup - Date Doc.Building Permit Revised 2007 t 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 o 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 New Construction (Single and Two Family) o 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 i' 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 s` that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording f must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 �I Location a U rl.S' No. Date M°RTN TOWN OF NORTH ANDOVER o�L � s i ; . Certificate of Occupancy $ s;KMUst<�a Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL $ Check # 2 057 uildng Inspector