HomeMy WebLinkAboutBuilding Permit #Exception - 7 SOUTH CROSS ROAD 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION 7 a..,r-74 6 a' //or-a/ Anfoa,&
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PROPERTY OWNER S ,�`cac?C' /4.4c t&C,
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MAP NO: -39 PARCEL: t' � ZONING DISTRICT: Historic District yes
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
0 New Building 29 One family
®Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
0 Repair, replacement ❑Assessory Bldg 0 Others:
0 Demolition D Other
®+Sephc>
owe l-1 s ®rFloodplaiu� P(].tWetlands ®3 Waterslied District3
'�,Wate /Sewer;
DESCRIPTION OF WORK TO BE PERFORMED:
(Identification Please.Type or Print Clearly)
OWNER: Name: Alfie L ;,VJ 14e- Phone:
Address:—
�•' �' c-� ���- 3 74d ll
CONTRACTOR Name: � �`7' Phone:
Address: 5Yiu fJx - clZc1
I'I Supervisor's Construction License: 7G Exp. Date: I �+ J
Home Improvement License: qt 1 �,J I Exp. Date:
ARCHITECT/ENGINEER rf2Pi o Phone:
Address: U,u 15)L� 55 14IU4- 1114- cl46d Reg. No.
FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
`dotal project Cost: $ �a t�63 � FEE: $ C0- '
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guar n nd
Signature of AgPnt/OwnerSignature ofcontract r;
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
d Building Permit Application
a Workers Comp Affidavit
d Photo Copy Of H.I.C. And/Or C.S.L. Licenses
e� Copy of Contract
d 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 frorn Fire Depar hent prior to issuance of BILI; Pen-nit
Now 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)
o 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 Reeds. One copy and proof of recording
must be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
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176.48 7 SOUTH CROSS ROAD l
X- EP I (TAX MAP 38/ BLOCK 181) I J
LOT AREA 43,560 SF 'II 1079 /
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Plans Submitted ® Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL 0
El
T
ming Pools
Public Sewer Tanning/MassageBody Art
Well El Tobacco Sales Packaging/Sales
El
Private(septic tank,etc. V Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS GN OFFOFFICE- U FORM E ONLY
INTERDEPARTMENTAL
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑
COMMENTS
CONSERVATION Reviewed on Si nature
COMMENTS
HEALTH Reviewed on 1
�:�nature A
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: comment-
Driveway
!later & Sewer Connection/Signature&Date
Permit
DPW Town Engineer: Signature: Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes
no
Located at 124 Main Street
Fire Department signature/date
COM
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