HomeMy WebLinkAboutBuilding Permit #699 - 65 SAVILLE STREET 5/23/2006Itc
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Permit NO: 67
Date Issued: *2A
TOV4'N OF NORTH ANDOVER
APPLICATION FOR PLAN EYAMI'NATION
IMPORTANT: Applicant must
Date Received: ^ 3
lete all items on this
LOC.xTION 6r ., j-�,rc2
PROPERTY OWNIE
N9AP NO.: dI� PARCEL:
TYPE AND USE OF BUILDING
TYPE OF IMPROVEMENT
New Building
Addition
Alteration
Repair, replacement
Demolition
Moving (relocation
Print
ZONING DISTRICT:
HISTORIC DISTRICT YES ❑
PROPOSED USE
Residential Non- Residential
"ne family
Two or more family Industrial
No. of units:
Assessory Bldg Commercial
Foundation only
DESCRIPTION OF WORK TO BE PREFORMED i3
Identification Please Type or Print Clearly)
OVb NER: Name:
.address:` �a..3\c
Others:
CONTRACTOR Name: C q Phone:
Address:
Supervisor's Construction License:
Exp. Date:
Home Improvement License: Exp. Date:
ARC'HITECT.'ENG[NEE R Name: Phcne:
kddress:
Reg. No.
7 k ;L -
FEE SCHEDULE: BULDIAG PERMIT: SI0.00 PER 53000.00 OF THE TOT IL EST1.41:I TED COST R SED OA SI'5•00 PER S.
Total Project Cost :$.__ 4/,/)do xI0.00= FEE:$
4 ----
Check NO.:
g– Receipt 'vo. / 12 14 Z—
11:v,tv 10'4
TYPE OF SEWARGE DISPOSAL S�immimT Pools
_ Tanning'1lassa'De Body Art —
Public Seer _
Tobacco Sales
Well Food PackaainvSales
-
Permanent Dumpster on Site
Private (septic tank, etc. _ Electric Meter location to
project
NOTE: Persons contracting with unr(!gjskxgd contractors do not have access to the guarrrnty fund
Signature of Agent, Owner Signature of Contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF- U FORM
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED
❑ 17—
❑Water Shed Special Permit
Site Plan Special Permit
❑ Other
DATE APPROVED
DATE REJECTED DATE APPROVED
CONSERVATIO 11-
COMMENTS
HEALTH
COMMENTS
r
DATE
DATE REJECTED DATE APPROVED
Zoning Board of Appeals: Variance, Petition No:
Zoning Decision., receipt submitted ves
Plannin'l, Board Decision: Comments
Conscruticn Dccision: Comments
'Xatcr & S nNcr connection si:,nature &. date
[cmp Dempster cn site yes_ no Fire Department signature date
Building Permit .Xpproied and ISSUcd by:
Building Setback (ft.)
Front Yard
Side Yard
Rear Yard
Required
Provided
Required
Provides
Required
Provided
DIMENSION
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
VOTES and DAT, \ —(For department use)
y
1';,c3,1 t
i; t; ',siTcrif;NAL SLR�IC(_S-)ITAI. I".IL . LPH)k,bl(;5
(.".:;n.IA ii.•."r,
Building Department
Trie 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
a Photo Copy Of H.I.C. And/Or C.S.L. Licenses
j Copy of Contract
a Floor Plan Or Proposed Interior Work
Addition Or Decks
o Building Permit Application
Surveyed Plot Plan
o Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
a Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydra
Calculations (If Applicable)
Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
Building Permit Application
j Certified Proposed Plot Plan
Photo of H.I.C. And C.S.L. Licenses
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
Mass check Energy Compliance Report
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board 1
appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy an
proof of recording must be submitted with the building application
),Ic; I\tiPh("171)\.\1.. SER\'I('ES DEP �Rl ME\ FAPFOIt11115
Location 6r �k t,�4 (��t
No. 4, qQ Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $� �-
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
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