Loading...
HomeMy WebLinkAboutBuilding Permit #321 - 7 COPLEY CIRCLE 10/20/2006 Ot NORTp 1 •,ao � .yO TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION SACHUSEt Perm it NO: t V Date Received_ --`!/i�,— Date Issued: v'a4�- IMPORTANT: Applicant must complete all items on this page LOCATION _ Print PROPERTY OWNER ko, . -e.`4\, -�. Print MAP NO.: c, PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential D New Building grOne family ;Addition E Two or more family C Industrial D Alteration No. of units: iJ Repair, replacement ❑ Assessory Bldg ❑Commercial ❑ Demolition n•Movin (relocation) ❑Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: ,.Q� ..,,..,._,..� Phone: Signature Address: CONTRACTOR Name: Phone: G b�'N—S 3 Address:. Supervisor's Construction License: 5-3 Exp. Date: \Zq Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: � '7 Address: !'mow �,c,��"� Reg. No. FEE SCHEDULE:BULDING PERMIT.$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. 00 Total Project Cost V1 UV x&SEE:$ Check No.: Iteceipt No.: _�'1 Location a &I No. Date �d -U' /* NOR71y TOWN OF NORTH ANDOVER f w a + ; ; Certificate of Occupancy $ r- �Nust< Building/Frame Permit Fee $ J+7 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ E Check # �7 S Building Inspector TYPE OF SEWARGE DISPOSAL Swimming Pools �l Tanning/Massage/Body Art Public Sewer — F7 Tobacco Sales — Food Packaging/Sales Well L Permanent Dumpster on Site Private(septic tank,etc. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty.rund Signature of Agent/Owner �„�� Signature of Contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plan ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY. INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ �/ a fl ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS �� ¢�`� � + ?a+�%► �f �✓+�. I�ar� awl—. �� -040�Lqdm 44 ATE REJECTED DATE APPROVED CONSERVATI Q COMMENTS NJ 0 ;I 'l/I IfIQS 0N.3/11q- H, - DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes V Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature&date Temp Dumpster on site yes_no-t�— Fire Department signature/date Building Permit Approved and Issued by: Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION �S►� Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA—(For department use) r Doc INsrEC rum AL sLIZVICLS nrrAr,I'MI NY.13I+0kMO5 Created AIC Jan'006 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 ❑ Debris Removal Form ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work p Addition Or Decks ❑ Building Permit Application ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Form ❑ 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) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Form U ❑ 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 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:INSPECTIONAL SERVICES DEPARTME.tiT:BPFOR1105 F NORTH o - of : Andover 4 7- o dover, Mass., I� COCHICMEwICN V ADRATED `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.............. ... 4.--A.......5. ..`I M91.. ...................................... Foundation • has permission to erect........................................ buildings on....' ..... aip..&7--jeop"twe...................... Rough tobe occupied as........ ...�.I.. ............ .. 0....�.� �............................................................................. Chimney provided that the person accepting th s 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 qr(p 0 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTITS Rough ..... ....... er�ice . .. .. S . .. . .. ... ................. ....... 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.