HomeMy WebLinkAboutBuilding Permit #542-14 - 65 RUSSELL STREET 1/13/2014TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: '? Date Received
Date Issued:
IMPORTANT:: Applicant must complete all items on this page
LOCATION (O.S� TI: y-
Print:
PROPERTY OWNERZL
- Print100 Year Old Structure yes no
MAP NO: PARCEL: ZONING DIST RICT:Historic District yes
Machine Shop Villaae ves no
TYPE OF IMPROVEMENT.
PROPOSED USE
Residential
Non- Residential
❑ New Building
One family
❑ Addition
0 Two or more family
❑ Industrial
17Alteration
No. of units:
❑ Commercial
X Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
0 Floodplain ❑ Wetlands
❑ Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
C
IdentilliPcation Please Type or Print Clearly)
OWNER: Name: '1' KZ LLC, Phone: G -(fir Z63.
Address:
CONTRACTOR Name:
Phone:%�—
Address: `i ARom, N), �r dvP_ A
Supervisor's Construction License: O 55 l Exp. Date: " 5 f l
Home Improvement License: W
Date: N
ARCHITECT/ENGINEER NIA Phone:
Address:
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: $ Ll S, ocD • FEE: $ 540 .
Check No.: 101
NOTE: Persons contracting with unregistered
Signature of Agent/Owner,
Plans Submitted .K
Waived ❑
Receipt No.: �? 712e
actors do not have access to the guaranty fr
Signature of contractor
Certified Plot Plan ❑ tamped Plans ❑
Plans Submitted lM Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
. -TYPE_OF°;SEWERAGE DiSPCSAL
Public Sewer
Tanning/Massage/Body Art ❑ ..
Swimming Pools ❑
Well ❑
-Tobacco.Sales -E]
•Food Packaging/Sales ❑
Private (septic tank, :etc.- ❑ - - ..
=permanent Dempster on Site ❑
THE. FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED: DATE.APPR_OVED
PLANNING & DEVELOPMENT ❑
COMMENTS Ala
CONSERVATION
COMMENTS
Reviewed on % 1'0 \ \
HEALTH N IA Reviewed on Signature
COMMENTS
r
Nl'AZoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
N /APlanning Board Decision: Comments
N AConservation Decision: Comments
ArWater & Sewer Co neC$ionlSi nafure � � Drivewa Permit
t�fC��
]DPW 'Food._ Engineer: Signature) A.�
Locatea 6M US ooa Street
FIRE DIEPARTMNf Temp Dempstejosite yes . no
Located- at:124,Main Street:- . _
-Fire Departme►it�signatu"re/date-
COMMENTS
:-Dim-ension
Number of Stories: 2 Total square feet of floor area, based on Exterior dimensions. 168
C� x3S)
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 2010
Building Department
The fo0owing is-arlist of the required -forms to be filled out for: the. appropriate. permit to .be obtained.
Roofirg, Siding, Interior Rehabilitation Permits
❑' Building Permit Application
0 Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
o 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)
❑ 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
that the apo.,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be subm.+.ted with the building application
Doc: Doc.Builiing Pernut Revised 2012
Location
No. �O? "� Date
Check # / e�ll
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $�—
Foundation Permit Fee - $
Other Permit Fee $
TOTAL $
Building Inspector
f
W6
w.
{� Location
f w
No. 642 —, 4 Date Z'T
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ /M
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # —A� \
1
27374 Building Inspector
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 542-14 on 1/13/2014 Date: March 25, 2014
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 65 Russell Street
MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER
REGULATIONS AS MAY APPLY.
Certificate Issued to: TKZ, LLC
78 Great Pond Road
North Andover, MA 01845
Building Inspector
Fee: $100.00
Receipt: 27374
Check : 1028
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APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
�� ,ear •
Argo ^Pa,. 5
cyu]BUILDING PIERIMT #.
9SSAs�i
ADDRESS/LOCATION OF PROPERTY: (0s R LZ -sell
IVlap_j=Parcel Lot Number l
SUBDIVISION: N
DATE REQUESTED FILED/READY FOR INSPECTION: 3/2 i I -Atli
CLOSING DATE ON PROPERTY:
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DAVE IS REQUIRED
ALL WORK AND SIGN -OFFS MUST BE COMPLETED Witt, THIS TIME FRAME. A
REINSPECTION FEE OF TWENTY DOLLARS ($20.00_; _ BE CHARGED IF THE STRUCTURE
DOES NOT MEET ALL APPLICABLE CODES.
Permit Issued to: T K _ l _, L. C _
Address: s
J:
ROUTING T—
J.
TOWN ENGINEER, SITE PLANT.— DRIVE -WAY REVIEW U�
CONSERVATION NO W6nl A Meat o R 00G 3/a Y// L(
PLANNING
DPW-WATERNIETER E�c�sT1.n coN„�zlo+vs
SEWER CONNECTION El 1" ° c � �N64-.S
DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR, TO
SUBMITTAL OF THE OCCUPANCYANSPECTION REQUEST
DPW N/
File: Application for OC form revised Jan 2007/2011
/A*--- 3-24-1
SWiNATURE
Enter construction cost for fee cal -
North Andover Fee Cakulation
Construction Cost
$ 459000.00
m
$ -
$
540.00
Plumbing Fee
$
67.50
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
67.50
Total fees collected
$
775.00
65 Russell Street
542-14 on 1/13/2014
Repair and Renovate Existing House
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Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
Construction Supcn-isor
License: CS -055417
THOMAS D Z,AHO'RUIKO '
115 CARTERFIELD R1?jWqI 6 c
N ANDOVER MA 0184
F.
Expiration ")
Commissioner 04/05/2014 i
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