HomeMy WebLinkAboutBuilding Permit #Exception - 68 GLENNCREST DRIVE 12/5/2013TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Iss . ued: IMPORTANT: Applicant must complete all items on this page
LOCATION
Prirft.',
PROPERTY OWNER
PrO .100 Yedr'Old S.trkture yes no
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Villaqe ves no
.TYPE OF IMPROVEMENT.
PROPOSED USE
Residential
Non- Residential
0 New Building
0 One family
El Addition
0 Two or more family
0 Industrial
0 Alteration
No. of units:
0 Commercial
0 Repair, replacement
El Assessory Bldg
0 Others:
0 Demolition
0 Other
0 Septic 0 Well
0 Floodplain 0 Wetlands
0 Watershed District
0 Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
/-\aaress:
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCH ITECT/ENG I NEER 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: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
g' -9- -a fig- re- - o f- - A - e n- tub w- n,e- r _S -iq--
nature of contrz-stor
Plans Submitted Di Plans Waived Certified Plot Plan El Stamped Plans
Location
No.46— I
0
S�'
Date I -4,� 1,
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee
Other Permit Fee
TOTAL
Check #2-k c)
27157 "building Inspector
a
91
96 . — �,o
Plans Submittedil
1i _V
PlansWaived-F] - Certified. Plot Plan D Stamped Plans" El
TYxTE:0F-SEW-ERAGEDISP_0SAU
Public Sewer
TanningfMassage/13ody Art
Swimming Pools
Well
Tobacco.Sales -E]
Tood Packaging/Sales 0
Private (septic tank, etc.. -0
'Permanent Dumpst-er on -Site El
THE FOLLOWING SECTIONS FOR -OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
.:,-.,DATE REJECTED:
PLANNING &'DEVELOPMENt'
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
DATE.A.PPR-OVED
Reviewed on Siqnature
Reviewed on Siqnature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes-..
Planning Board Decision:
Comments
Conservation Decision: :Comments
Water & Sewer Connection/Signature & D.ate Driveway Permit
DPW Tow;! Engineer: Signature:
Located 384 Osgood Street
Dufhp�§t&r'6h`s'ite*-.Ye�§ no
,�L6c�ie8-bt-1�4 Mai'
r, Str6et
'Fire*
TS
COMMEN
--Dimension- - .
Number of Stories:
Total land area,- sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
'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 21 A �F and G min.$10041000fine
NOTES and DATA — (For department use
I
Ll Notified for pickup - Date
Doe.Building Permit Revised 2010
Building Department
-The foR : -)wing isi-a-list of the. required -forms to be filled out foe the appropriate. permit to:be obtained.
Roofivg, Siding, Interior Rehabilitation Permits
U B,uilding Permit Application
u Workers Comp Affidavit
u Photo Copy Of H.I.C. And/Or'G.S.-L. Licenses
u 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
L3 Building Permit Application
Lj Certified Surveyed Plot Plan
La Workers Comp Affidavit
• Photo Copy of H.I.C. And C.S.L. Licenses
• Copy Of Contract
Lj Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
u Mass check Energy Compliance Report (If Applicable)
Li 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)
u Building Permit Application
Ei Certified Proposed Plot Plan
u Photo of H.I.C. And C.S.L. Licenses
Li Workers Comp Affidavit
• Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (if Applicable)
• Copy of Contract
E3 Mass check Energy Compliance Report
u Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cast�s 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.tted with the building application
Doc: Doc.Building Permit Revised 2012
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office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration. 155783
Type; Pdvate Corporation
Expiration: 5/812015 Tr# Z39592
BARRY�JOHN CHIMNEY SERVICES INC
STEVEN LINCOURT
20 GROVE ST UNIT 5
FRANKLIN, MA 02038
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