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Home My WebLink AboutBuilding Permit #433-2016 - 69 OLD VILLAGE LANE 10/6/2015 BUILDING PERMIT NOR%ORTIi TOWN OF NORTH ANDOVER 02 y - - ' '° APPLICATION FOR PLAN EXAMINATION Permit No#: I Date Received R �- �gSSACHUS��ci Date Issued: 1�'J IMPORTANT: Applicant must complete all items on this page LOCATION -,/0(7 t� �L-� /moo Print PROPERTY OWNER 4�S6:�0o 0 Print 100 Year Structure yes no MAPA3-7 PARCEL:-,9e-5-,9 ,ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resi ential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial R'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ Septrc fl Well FloodplanWetlands, 1Natefshed ®istncf, !Water/Sewer � DESCRIPTION OF WORK TO BE PERFORMED: O Ident!qr-�tion- Please Type or Print Clearly OWNER: Name: Phone:97��.3"�. �' Address: Contractor Name: 4ezy orjq Phone: s�.vP Email: Address: Supervisor's Construction License: Exp. Date: A;L�Y//za, Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. To I Project Cost: $ �� FEE: $ � Check No.: " Ih Receipt No.: NOTE: Persons contracting U21th unregistered contractors do.not have a ess the gu ty fund ��zi� 6rdfw Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ - TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS - . . - .. - •. I PEALTW Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning'Decision/receipt submitted yes I Planing Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/signature& mate Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street fF,RDEPR+TrME-N T ,Tp�Dum empsfer��onsite' �yes .t �. (!L�oeated at�1f2,4�MairitStreet, _ � � � -` k.� 4 - r-......J.�,fi,a .t----- - �" —, it Fire,De artment�i "iture a e° na /dat .. 4 ice^ ; 4 *,1 � Y•�Y i p, s ♦r- } �� ` :s� a4 '�..t a� ♦ . �, i .1 : I. .»e t a Y _ h tri, t. r,. S� 1 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: Meter location mast or service drop requires ELECTRICAL: Movement of� p q 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 Call Email Date Time Contact Name f__........ i Doc.Building Permit Revised 2014 Building Department The 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 Photo Copy Of H.I.C. And/Or C.S.L. Licenses 4, Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: 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 ,4. Workers Comp Affidavit 16 Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract 4. Floor/Cross Section/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 OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 r Doc:Building Permit Revised 2014 t%O R TH Town of . ? _E ndover n *wj Ar\ No. C T h ver, Mass COC Hic"RaWK p�RATED S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT BUILDING INSPECTOR . .. .. .. . .... .. .... . . .. �n �(`� \r 1 Foundation has permission to erect .......................... buildin s on .l�J. Q. ...11.!.L. .. e-' Rough to be occupied as .............. `1.. . ....... .......... ...... .!�................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIOS ARTS Rough Service .............. �,.... . .......... ........................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired to Occupy Building 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. Smoke Det. Massachusetts -Department of Public Safety Board of Building regulations and Standards License: C5-075302 tk BENJAMIN C OSGbo 69 Old Village Laife �' North Andover NSA 0?84S�t J '` Expiration Commissioner 12/04/2016 Location No. 7 j b Date •'� TOWN OF NORTH ANDOVER • c,�C ED IGy� • j • Certificate of Occupancy $ i Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# O�� r 2 �c' 4 7 2 Buildiri96 ector,