HomeMy WebLinkAboutBuilding Permit #368-16 - 65 BRIGHTWOOD AVENUE 8/21/2016 BUILDING PERMIT oFtNOR%ORTIi H
TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION * 70
Permit No#: Date ReceivedA�RATED c5
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Date Issued:k/it 1;7
IMPORTANT: Applicant must complete all items on this page
LOCATION. 9/Lllr,47PVOOD, iF'✓G A1,0PL
ff iV'P�Ot/
PROPERTY OWNER AA.17Y+C)1/
Print 100 Year,$tructure' yes. C j
MAP– PARCEL: ZONING DISTRICT: Historic District yes Yom"
_ � .
Machine Shop Village yes_
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition Two or more family ❑ Industrial
Alteration No. of units: Z ❑ Commercial t
3
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands. [J'Watershed District
Water/Sewer .
_ DESCRIPTION OF WORK TO BE PERFORMED:
S7- E-oo/7 ,4'17-4, > s /3A—t! lZc7r.Lob L, ���� �Lcho�z/itic�r
fN fiv p o w S
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Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
Contractor Name: _ Phone: q 7-8 6 8 S/o?o _.
Email
Address: Sir- S A—L. 7 _.
Supervisor's Construction License: _ Exp. Date: v
Home Improvement.License: . Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $ �V
Check No.:n' Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have a `ess to th uara fun
Signature of Agent/Owner Signature of c
Location �V�� t�
No. .60K— Date 177 1�0
r
• . TOWN OF NORTH ANDOVER
Y "*' Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $ "�
Other Permit Fee Yip
TOTAL $
Check# I
2} Building Inspector '
4 ll j�
Location 1/t j" &+4—t'0eAW
No. — Date 0)/
. - TOWN OF NORTH ANDOVER
LED
j a , •
Certificate of Occupancy $
Building/Frame Permit Fee
Foundation Permit Fee $
POther Permit Fee $
TOTAL $
Check# '
3 i 4 Building Inspector
Plans
Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ I
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Sw"nuling 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
PLANNING & DEVELOPMENT Reviewed On Signature_
-' COMMENTS
t:
CONSERVATION Reviewed on Signature
COMMENTS
r'
HEALTH Reviewed on Signature
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
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE-DEPARTMENT - Tem FDum ster on-site
p p yes . . . _- ._ noa
Locatedlat 12&Win;8treet
Fire-Department signature/date
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)
+6 et- � b, el c
Crti m N
❑ Notified for pickup Call Email
jDate Time Contact Name
--y__.......-............._...___._...-------------
Doc.Building Pennit Revised 2014
Building Department
artment
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
' I
Roofing, Siding, Interior Rehabilitation Permits
o Building Permit Application
o Workers Comp Affidavit
a Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o Copy of Contract
o Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
o Building Permit Application
o Certified Surveyed Plot Plan
o Workers Comp Affidavit
a Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
o 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
o Certified Proposed Plot Plan
a Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
a Mass check Energy Compliance Report
o 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
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:Building Permit Revised 2014
Enter construction cost for fee cal - North Andover Fee Calculation
Construction Cost
$ 2 '55,000.00 m
$ - $ 300.00
Plumbing Fee $ 37.50
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 37.50
Total fees collected $ 475.00
65-67 Brightwood Ave
368-2016 on 8/21/2015
Kitchen and Bath Remodel
NORTH
own of ndover
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LA
'KI� h , ver, Mass, .%,j u6j& 4Z2 _26110
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COCNIC N&WICK
ADRATIE . q`� Wig. 12' 1
s �
BOARD OF HEALTH
Food/Kitchen
PERNT D Septic System
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,,,,,,,,,,,,,, BUILDING INSPECTOR
THIS CERTIFIES THAT ................. ........... .................�. ........ ..........................................
has permission to erect ........... buildings on !W1 .�4� .... �..,,, Foundation
............... ............ . ..... ....
n (� 11
Rough
to be occupied as � a ............ . ..... Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in 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 CONST TS Rough
Service
.... .. ......�.. .. ........ .........
Final
BUIL SPECTO
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
F NORTH
own of N. EAndover
O '� 0
No.
h ver, Mass,0 LAKE
ACOCNIC"IWICK a•
S U
BOARD OF HEALTH
Food/Kitchen
PERMIT T Septic System
41
THIS CERTIFIES THALD
T ............... 1!1 O BUILDING INSPECTOR
............ . ............ ......�.�r.k�... ................
. ..
has permission to erect .......................... buildings on ....� � Foundation.........�. .. .. . �0,,,,
ugh
to be occupied as .. ". 'r...... l .
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in 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 MONT S ELECTRICAL INSPECTOR
UNLESS CONSTRUCTI S TS Rough
I lop,
L0000,
POP 05w,"N Service
............... ................. Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildinz Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.