Loading...
HomeMy WebLinkAboutBuilding Permit #Exception - 70 OGUNQUIT ROAD 5/1/2018 i BUILDING PERMIT o* FORTH �.fLE0 ,bA TOWN OF NORTH ANDOVER 02 APPLICATION FOR PLAN EXAMINATION Z yM Permit No#: Date Received40 SACHUS���� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 76 �Y��/ /r�u-c )_I 7` _. - R0, -Print PROPERTY OWNER Prin LL - 100 Year Structure yes no MAP _ PARCEL: ZONING DISTRICT: , Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic El Well El Floodplain ❑Wetlands 11 Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: j A1 Identification PI ase Ty a or Print Clearly ^� c� OWNER: Name: Phone.-6 Address: �J CohtractorkName: _ Phone: r 7-S-9n Address: -. A dc)� (l citl f j Supervisor's Construction License: - Q 4 _ Exp. Date:J� t Horne. Improvement.License: r 353 �. ._ Exp. ,gate: _ ARCH ITECT/ENGINEER&O / � Phone: Address: Q PSG-- M 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 guaranty fund Signature of,Agent/Owner . Sigriatiare'of,contractor r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TypF OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Sody 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Si nature COMMENTS Uj0--ns r CA- 1 HEALTH Reviewed on Si nature 2 COMMENTS cr� S Gr �•,�.�7c �� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/s*natur & te / aDrivewaPermit DPW Town Engineer: Signatur ��� LocatedJ 384 Osgo d Street FIRE DEPARTMENT - Temp Dumpster on site ,yes Located�at 124 Main Street 'Fire Department signature/date COMMENTS. �l.r>r3-e_�, l�.s_�i_�L.a �_ BUILDING PERMIT NORTH q tt LED 16 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ' I� z e"� Permit No#: Date Received � � oRAa," �SSACHUSS��� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION O C�g�rag�l t- load Print PROPERTY OWNER Scs-ndra H c.-Fi Z _rhc Pnnt 100 Year structure yes no MAP .PARCEL:, ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential fl'New Building EfOne family ❑Addition ❑Two or more-family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑,Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain E Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: e,o CC)nS taC: i 1 Identification- Please Type or Print Clearly OWNER: Name: C3, r , N 6 =nom Phone- (�11 `7/ 7- GS qD Address: Coil b6f, ?�d e.'�--ogS -Noon A-ra ,/cr" C)l v4 S Contractor,Name:\c idiom L•.M4ciVPhone: 977-3UI-Co403 -- Address:l} a�dc_r N►;11 re, 16 101 An.6c>JgC, Hn 01810 Supervisor's Construction License: CS _b4Lo_1'i�9Exp. Date: �aG �a015 Home Improvement License: _ _ ,Exp. Date: 1,I �Ga�01 ARCH ITECT/ENGINEER CS�� hone: C11�— C9C9y — I(a c5►�y IJ Address: �.�. C� 1�ec �� Reg. No. a T I C6 FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ci/ '7, '700 •°`) FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ESignature ofAgent/Own _f Signature of contFractor ' + ac f Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE"OF SEWERAGE DISPOSAL ❑ Swimming Pools ❑ Public Sewer Tanning/MassageBody Art ❑ Well ❑ Tobacco Sales ❑ FoodPackaging/ ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS Reviewed Si nature CONSERVATION on J PA pp (� COMMENTS a". �" ' h� HEALTH Reviewed on Si nature ( i \ COMMENTSr . t _ 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 -no. i FIRE.DEPARTMENT - Temp Dumpster on site yes - Located at 124 Main Street j Fire Department signatureldate - _.. Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. ~4 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 o Engineering Affidavits for Engineered products 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 o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ffi ❑ Engineering Affidavits for Engineered products All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit ew Construction (Single and Two Family) o Building Permit Application g Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses © Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkle Plan And.. Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products II dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit s if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals eal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording initted` the building application evised 2014 ti