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HomeMy WebLinkAboutBuilding Permit #022-2011 - 673 GREAT POND ROAD 7/1/2010 BUILDING PERMIT of 1,90 T"qti TOWN OF NORTH ANDOVER c? APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ZQA 01 a` �gSSACHUs���y Date Issued: f \ IMPORTANT: Applicant must complete all items on this page i:OCAT4ON " 471SL Q O Print . PROPERTY�01NNERt SUE.f -5 ( RP - •� � w"� P,.rint - � rt _',MAP 210-:'-�3 PARCEL: 2►+ ZONING DISTRICT:A ;Historic,District yes a. 'rio Machine Shop Villa e -res _ �no � TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential N uilding One family Addition --� 5PA Two or more family Industrial Altera ion No. of units: nercial Repair, replacement _ p Assessory Bldg Ot _.. Demolition Other Sepfic Well Floodplain Wetlands tersh istnct` Water/Seaver_ r . DESCRIPTION OF WORK TO BE PREFORMED: I N s O 6 U*-.) 1;?4 2iPooc. Identification Please Type or Print Clearly) OWNER: Name: RCX3FILT 14 • F7k-4W%A Phone: I Address: Flu-40 P-D&D P . "rC�R. t A4A O tcgqS. a CONTRACTOR r Name C+ tj.+ � . S`� � hone: , .. Address: 1F, G -- �.:I 1<'Tt.: i C �- ` 7 . 10 Exp �Su ervisor's Construction License Date: H , ' ' Exp. Date; ']" Home Improvement License. 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. g0 $ 9�2 Total Project Cost: $ � (PSS' -OO FEE: Check No.: -r2 Receipt 2 - Receipt No.:NOTE: Persons contract w' u egi a ed c tr ctors do not have access to the guaranty fund ignature of Agent/O nw er Sitor gnature of contractor r Plans Submitt Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body ArtSwimming Poo s I Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE-FOLLOWING-SECTIONS FOR OFFICE USE ONLY INTERbtPARTMENTAL-SIGN OFF'- U FORM `v � GrJ��e� S�t2 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT a� G —T- V I COMMENTS ti'deok�'4j �7 r CONSERVATION Reviewed on (064 1 7 Si nature HEALTH Reviewed on - Signature - COMMENTS' 1 Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board becision:• Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: *Located 384 Osgood Street F]RE��EPARTMENT -Temp Dumpster=on site :yes m +i . no. . Locatedxaf 124 MainStreet a .Fire Departmentwsignattire/date: ~ . a :.COM i 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 c ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 i Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, gSiding, Interior Rehabilitation Permits t ❑ 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 ❑ 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 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 2008 Location No. 0 .2 6 Date ?11110 "ORT" TOWN OF NORTH ANDOVER i Certificate of Occupancy $ �,SSACHUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # rZ) i 2 -3 0 6 t� /buwlhing Inspector NORTH TONMo 1Andover . ; . � 0 No. l o I/ C, _; o dover, Mass., OLAK �. COCHICHEWICK %S RATED P'P�',`�� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ............................................. .. ...................�r........................................................................................... Foundation � � qac buildings on :�'.....�. o.��.. .................. Rough has permission to erect.................:... ... g � ��jl, Chimney to be occupied as .... ..........�/......... ff`` ................. .... .... ......................... .......................................................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 5 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough ............................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det.