HomeMy WebLinkAboutBuilding Permit #795-14 - 65 RUSSELL STREET 5/6/2014Permit NO: 6� It
Date Issued: I� t
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print.
PROPERTY OWNER T KZ �—�-
Print–. 100 Year Old Structure yes no
MAP NO: _PARCEL: ZONING DISTRICT:—Historic District yes
Machine Shop Villaqe ves
TYPE OF IMPROVEMENT.
PROPOSED USE
Residential
Non- Residential
❑ New Building
N One family
kkAddition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
0 Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
0 Demolition
❑ Other
❑ Septic 0 Well
0 Floodplain 0 Wetlands
0 Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
2-CAK Ghe,&&E ATtA(gFD FRAM�UCTURE'
Identification Please Type or Print Clearly)
OWNER: Name: `�,,Z LLC, PhoneR:X 7-Z05-
Address: 79 44 -ext 44 R0 4 N • A Y�dUe�'�i�A A � 195 L
CONTRACTOR Name:
Address:`%$•
Supervisor's Construction License: Exp. Date: I '4
Home Improvement License:
Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
S
FEE SCHEDULE.)BULDING PERMIT. • $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total Project Cost: $?,U� om . CO#I 2/loo)FEE: $__2.140.00 _
Check No.: Oily Receipt No.: 2714543
NOTE: Persons contracting with unregisteredcp�ractors do not have access to the guaranty
,Signature of Agent/Owner.Signature of contractor
Plans Submitted ' i 04ans Waived ❑ Certified Plot Plan ❑ tamped Plans ❑
-: - PlansSubmitted, Plans W. aived ❑-..C.ertified Plot Plan ❑ Stamped Plans ❑
TYPE:0F SEW-ERAGEDISP.0 AL"
Public Sewer
Tanning/Massage/Body Art ❑ ..
Swimming Pools El
Well ❑
Tobacco.Sales ❑
-Food Packaging/Sales 0
Private (septic tank, etc.. ❑ .-•- :.
=permanent I)uinpster on Site ❑
THE. FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE -APPROVED
PLANNING* & DEVELOPMEN- ' ❑
COMMENTS
CONSERVATION
COMMENTS
HEALTH
Reviewed on
Reviewed o
d1�/2�y �I
O a`
�Vi
COMMENTS Dh 0eAlk) Q--eT�„�,p,r
Zoning Board of Appeals: Variance, Petition No: tJ Zoning Decision/receipt submitted yes .
Planning Board Decision: tJ 1.A Comments
----- - -- r j _
y��
_Dimension
Number of Stories: lZ_ Total square feet of floor area, based on Exterior dimensions._
Total land -area; sq. ft.: F
-ELECTRICAL: Movement of Meter location, mast or service dran 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
A& _L � 'p— or")
® Notified for pickup - Date
Doc.Building Permit Revised 2010
Building Department
The foltswing is-a�list of the required .forms to be filled out for: the appropriate. permit to -.be obtained.
Roofh-- g, Siding, Interior Rehabilitation Permits
❑ BkAilding 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)
❑ 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
a 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 apw• 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.Bui?ding Permit Revised 2012
Location
jSSe II ��
No. �.--
� Date -5 (011k+
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $ 6L
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ �,
Check
543
f3u`ilding Inspector
N88'24'00"W
175.00'
TSR �
LOT AREA
17,500 S.F.f
36.5' 37.6'
Ex. Bulkhead
5'
17.0'
o New Conc. U� , , �-
N Foundation �f
1
Ex. 1 Story
Wood Frame
Structure
40.4'
Ex. Roofed Entry J 15.0'-J
(Unenclosed)
66RUSSELL
j 20.00 I 80.00'
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20.00' .-
175.00'
S88'24'00"E
STREET
ZONING INFORMATION:
ZONING DISTRICT : R4
ASSESSOR INFORMATION:
MAP 71 PARCEL 5
1 CERTIFY THAT THE FOUNDATION SHOWN WAS LOCATED FOUNDA TION AS-BUX T
BY AN INSTRUMENT SURVEY AND EXISTS ON THE GROUND AS SHOWN. 5 RUSSELL. STREET
NORTH ANDOVER, MA 01845
HOF s py«% Of PREPARED BY:
JOHN D. SULLIVAN III, P.E.
CML m y 22 MOUNT VERNON ROAD
No. 41,686 1 o BOXFORD, MA 01921
(978) 352-7871
4C Lot
SCALE: 1"=30' DATE: 5/13/14
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
S 20,0.00.00)
m
$ -
$
240.00
Plumbing Fee
$
30.00
Gas Fee 100 comm.
$
110.0.0:0;
Electrical Fee
$
30.00
Total fees collected
$
400.00
65 Russell Street
795-14 on 5/6/2014
2 Car attached Garage
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Massachusetts - Department of Public Safety
Board of BuildingRegulations g a#ions and Standards
Construction Supervisor
License: CS -055417
Thomas D ZahonuJco
78 Great Pond Road
North Andover NSA 01845 "'
)1 fit Expiration
Commissioner 04/05/2016
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