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Home My WebLink AboutBuilding Permit #214 - 70 HUCKLEBERRY LANE 9/18/2009 TOWN OF NORTH ANDOVERAPPLICATION OR PLAN EXAMINATION f Date Received Permit NO: I/ Date Issued: licant must comp Tete all items on this page IMPORTANT: App LOCATION-JI-9-UPr Print PROPERTY OWNERS PrintHistoric Distract yes MAP NO: 2Jt�D PARCEL:& ZONING DISTRICT:_.._.-Machine Shop Village yes � TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ne ami Industrial e ui in Two or more family Commercial Addition No. of units: Others: Alteration Assessory Bldg Repair, replacement Other Demolition Wetlands Septic Watershed District Floodplain Well l Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) Phone: —6 i OWNER: Name: J INV IF Address: /Vu Phone: CONTRACTOR Name:. Address: Exp, Date: Supervisor's Construction License: d Exp. Date: i Home Improvement License: Phone: ARCHITECT/ENGINEER Reg. No. Address: TED COST B� 'mit BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIBASED ON$125.00 PER S. . FEE SCHEDULE. ieals 0 0 _FEE: $ irding S.. Total Project Cost: $ _Receipt No.: Check No.: do not have with unregistered contractors access to the guaranty fund NOTE: Persons contracting _-.. - --� Signature of contractor___-------- - Signa-�ture.of Agent/Owner, Plans Submitted Plans Waived TYPE OF SEWER e c pepartmen 1 Build►ng its it to be°btained. 'lied out for the appropriate perm list of the required forms to be f� ehab►litation Perm► The following is a Siding, Interior R Roofing lication permit ApP ❑ Building Comp Affidavit C.S.L. Licenses ❑ Workers Of H.I.C. An dlOr ❑ Photo COPY Work permit ❑ Copy of Contracr posed Interior of Bldg ;veered products riot to issuance Or P e artment p ❑ Floor Plan Affidavits fo' n off from Fire D p ❑ Engineering its reQuire 9 NOTE: All dumpster perm Addition Or pecks Permit Application ❑ Building Surveyed Plan ❑ Certified Comp Affidavit Licenses Ian And ❑ Workers of H.I.0. And C. .L. Wath Sprinkler P ❑ photo COPY lav Of Prop OSed W°rk ❑ Copy 0i Contract rossectionlElevatl A Plan Applicable) it ❑ FloorlC ort (lf PP of Bldg perm raulic Calculations anCe Rep products to issuance Hyd check Energy n sneered p ent prior ° Mass sign off from Fire Departm Engineering Affidavits for E g ❑ Engl ermits require NOTE: All dumpster p Fam►►Y) (Single and Two Cons ew truction N lication zon Permit App ❑ Building Proposed plot Plan Ian An i ❑ Certified Prop . And C.S.L. Licenses to Include Sprinkler P Plani ❑ photo of comp Affidavit One To Be Returned) rkers plans ❑ W° of Building licable) Conse ❑ 'Tw0 Sets If ApP draulic Calculations ( ort pep Wates Hy of Bldg ❑ Copy of Contract Compliance Rep Pr( Mass check Energy for Engineered P ( e artment prior to issuance AV DPW 7 ❑ Mas Affidavits Fire p the Board of rec Eng;veering vire sign off from from must stamp the decision. ne copy and proof of tea FIRE D E: All dumpster permits require the Town Clerks office n► egistry of Deeds. Located NOT t was required at the R Fire De' special Aetna ust then get this recorded or sP ►scant m variance ver. The app In all cases peal period is° building aPPl�cation COMME1 that the appeal with the b must be sublu .� -- - it Revised 2008 Doc: Doc.BuildingPerm -- -------- TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: ,J / Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION -7q J4urik'1Q �Pr r'�I 2 i )Vc)p-41 Print PROPERTY OWNERID- Jy0m, Print MAP NO: D-W PARCEI-4S-�/�ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew u6-Tdin` ctne farm Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: QL Phone: -1 Address: CONTRACTOR Name: L-as+;rya � L" o 1jd Phone: Address: 1W)IJ, arra c to rA'.S'hec z Supervisor's Construction License: Exp. Date: ` Home Improvement License: Exp. Date: 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. Total Project Cost: $ , U 1 0 0 FEE: $ Check No.: 2 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund signature of Agent/OwnerZ , Signature of contractor 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 ❑ 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: Doc.Building Permit Revised 2008 .1 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: X / 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 ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 J Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/N4assageBody Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Si nature A,X4T/4-- �J COMMENTS ��- l 16T2) HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway 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 COMMENTS Location No. .21 .,-1 Date NORTH TOWN OF NORTH ANDOVER . OL Certificate of Occupancy $ sNUs<� BuildinglFrame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # a 2L . ZU Build(Kg Inspector NORTH Town of 4Andover . . : - No. a , _ dover, Mass., a T LAKE COCMICKEWICK V ORATED OPa\ �5 E BOARD OF HEALTH PER IT T D Food/Kitchen Septic System Max BUILDING INSPECTOR THISCERTIFIES THAT.......�...............�.......................................................... .......................................... .................. Foundation has permission to erect........................................ buildings on... .� . ..t,�G.. .440.9 '� .. ••• `••••• Rough to be occupied as .k...... ............ .........f ............................ Chimney ../..o .... provided that the person accepting this permit shall in every respe 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 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTION STARTSRough .............................. ........ ........... ...................... Service B LDING TOR 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. 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