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Home My WebLink AboutBuilding Permit #285 - 762 DALE STREET 10/11/2006 TOWN OF NORTH ANDOVER pORTh APPLICATION FOR PLAN EXAMINATION 0* ,',So k ,°q'u'o �� '• ° OL F- 'A Permit NO: Date Received *i► i �-y o ' Date Issue�C/ Ar 1J Reno►° 5 SACH�1S IMPORTANT: Applicant must complete all items on this page i LOCATION not PROPERTY OWNER Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building ❑ One family Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: Repair, replacement ❑Assessory Bldg ❑Commercial =i Demolition ❑ Moving(relocation) ❑ Other ❑ Others: I El Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or riot Clearly) OWNER: Name: 4P 17 Phone: 6 4 � Address: 7 f7- CONTRACTOR Name: 5-4�- Phone: Address: Supervisor's Construction License: d�'S�,j 7 4Exp. Date:---,2—,/ Q' Home Improvement License: 10716 Exp. Date: / ARCHITECT'ENGINEER �--"— Name: Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ IQ0 Check No.: ��d — Receipt No.: -- Page Iol'4 Location No. .` Date J, NORTIy TOWN OF NORTH ANDOVER r f 9 Certificate of Occupancy $ Building/Frame Permit Fee $ /1Tr fACMUSt Foundation Permit Fee $ Other Permit Fee $ TOTAL $ I 4 Check # �0 k 19677 Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools C F1Tanning/Massage/Body Art E]Public Sewer Well 1-1Tobacco Sales ElFood Packaging/Sales 11 Permanent Dumpster on Site ❑ Private(septic tank,etc. El Permanent Meter location to project NOTE: Persons contracting f4th unreLylnot have access to the guarantyfund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED It,EALTH ❑ ❑ 'f,�,gMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes a `no Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer connection/Siynature&Date Driveway Permit i I Building Setback ( Front Yard Side Yard Rear Yard RequiredProvided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use) e, Page 3 of 4 Doc:INSPEC"IIONAL SERVICES DEPARTMENT:BPEORM05 O.aled JMC..i;m.'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 M ❑ 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 Addition Or Decks I ❑ Building Permit Application ❑ 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) 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 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 DEPARTMENT:BPFOR-N105 Page 4 of NORT Town of And No. �,- dover, Mass., • O LAKE 'JC ADRATED C2 H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... ..c.. .............5 a.� . ......... A..0....... .... . . .................. Foundation A.has permission to erect........................................ buildings on ....?.( ........ ....w..... !C.10.00.1.0.07............. Rough ej to be occupied as....... / ...........$9......... Chir•. chimney provided that the er cce thispermit shall in every respec form to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating the ILnspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough S�'� PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUC�TIO ST S Rough ::. .................... ................. .................... Service 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. x , x �T p A. -amnzonujealllc a�✓��aaoac�zuaeG�b BOARD OF BUILDING REGULATIONS' License: CONSTRUCTION SUPERVISOR Number: CS 053176 Birthdate: 02/15!1958 Expires: 02/15/2007 Tr.no: 7346.0 Restricted: 00. STEPHEN M SMOLAK 762 DALE ST NO ANDOVER, MA 01845 Commissioner _ . s� ✓f2e 'l.om7/�a'r2cueaGCR a�.i�Za4laclZuvP,�6 Board of Building Regulations and Standards,. _ HOME IMPROVEMENT CONTRACTOR •_- : Registration: 10.7161 Expiration: 7/29/2008 , , Type: Individual STEPHEN M.SMOLAK Stephen Smolak