HomeMy WebLinkAboutBuilding Permit #523-15 - 79 HEWITT AVENUE 12/4/2014BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: 0 —i6 Date Received
Date Issued: 14 I
IMPORTANT: Applicant must complete all items on this page
LOCATION 0.V.
Print
PROPERTY OWNE
%ILIC-
Print 100 Year Structure yes o
(Z
MAP PARCEL: `�_ _ ZONING DISTRICT: 3 Historic District yes no
Machine Shop Villaqe ves (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
0 Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
a &!5L
Identification - Please Type gr Print Clearly
OWNER: Name:
Address:
Contractor Name: eskrt5 1 _
Address:
M
Supervisor's Construction License: 45-e,-130377 Exp. Date: 4,-7- to (5
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER
Address:
Phone:
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: $s./C�'�% FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fu
Signature of Agent/Owner Signature of contractor0 - L -,- V,
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE'OF SEWERAGE DISPOSAL
Public Sewer ❑
Tanning/Massage/Body Art ❑
Swiimning Pools ❑
Well ❑
Tobacco Sales ❑,
f
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
COMMENTS 0
Reviewed On �" Signature.
n �
At E.
CONSERVATION Reviewed on
COMMENTS
HEALTH
COMMENTS
re
pir
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Comm
Conservation Decision: Comments
`Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site yes
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Located 384
no
Street
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
Nu i is ana uA I A ( l -or department use
❑ Notified for pickup Call Emai
Date
Doc.Building Pen -nit Revised 2014
Time
Contact Name
No
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/Cross Section/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: Building Permit Revised 2014
Location 7 / / k G-- I w4,4—
No. 6'o? 3. -/5 -
Check #��
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $�0
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Building Inspector
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Town of North Andover
Building Department
1600 Osgood Street Bldg 20, Suite 2035
North Andover MA 01845
Tel: 978-688-9545 Fax: 978-688-9542
DEMOLITION OF BUILDING AFFIDAVIT
DATE
OWNER'S NAME & ADDRESS
LOCATION OF PROPERTY TO DEMOLISH `ZR ,Aj jt�
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CONTRACTOR'S NAME & ADDRESS (';65 A"yn cr- Iq (--k-(tV,r esff_&Q1 lVCQ d�lA
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DEPARTMEN SIGN -OFFS n
DEPT. OF PUBLIC WORKS - WATER: ', ri;V1�,�' � ��V,11 W SEWEI t� 7
HISTOR SIGN Vk) t 14—
PLANNING
GAS 5yG
ELECTRIC lebL-GV-
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EXTERMINATE���"
DUMPSTER - ON/OFF STREET DIG SAFE NUMBER # z0l y9-1111 Y9 S
BLDG. INSPECTOR
Building Demolition Affidavit
nationalgrid
40 Sylvan Rd
Waltham MA 02451
November 14, 2014
Chris Herrick
chris herrick@msn.com
RE: Service Removal for Building Demolition.
Dear Mr. Herrick,
This letter is to confirm that, per your request, National Grid has removed the electrical
service and meter 12852927 from 79 Hewitt Avenue North Andover, MA as of 11/13/14.
If you have any questions or need further assistance, please feel free to contact me at
(508) 357-4753.
Sincerely,
Moira Ghent
Customer Fulfillment
Ph # 508-357-4753
Fax # 1-888-266-8094
moira.ghent@nationalgrid.com
"
ColumUia Gas -
of Massachusetts
A NiSource Company
995 Belmont Street
Brockton, MA 02301
Date: December 4, 2014
To Whom It May Concern:
The address listed below has had the gas service(s)
disconnected and is now ready for demolition.
ADDRESS: 79 Hewitt Street
TOWN: North Andover
STATE: Massachusetts
Sincerely,
C �o&V
Maintenance Administrator
Integration Center
Columbia Gas Of Massachusetts
508-580-0100 Ext 1304