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HomeMy WebLinkAboutBuilding Permit #043 - 790-800 WAVERLY ROAD 5/1/2018 f NORTH p TOWN OF NORTH ANDOVER COM APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received: " N'0%T,1 AINDOVERIV Date Issued: IMPORTANT: Applicant must complete all items on this e LOCATION &0 r?� PROPERTY OWNE ►.) Print MAP NO.: PARCEL: N tv+ -,-� Lr1,4 ZONING DISTRICT: ow MA-1! 1-7-s I TYPE AND USE OF BUILDINd"q-'' Lt:' 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 XCommercial ❑ Demolition ❑ Moving(relocation) 90ther ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED 0q,W 7£X-A-t( Qcs d J( N 1� cit✓AAy 7 9\00A�� \qlAtU,,q�4-A t Identification Please Type or Print Clearly) �l OWNER: Name: (a-`2 V qsl�M Phone: G kT7-33 LINO r� �-=•-- Signature ��/� Address: CONR)F_7� S� kc�J7DaJ Y/I�� �(, / CONTRACTOR Name - ` - rL1, `U Phone:�56 Address: 2-'!> -ST S!2 Od-9 �7 t Supervisor's Construction License: C!rO- QA7 Exp. Date: Home Improvement License: V Exp. Date: ., ARCHITECT/ENGINEER LnW4S ��,tl� Name: Phone: Address: 43 Ct70 ®stG) Ql Reg. No. —I S FEE SCHEDULE:BULDING PERrY1I9:$0. APER$110 OF T S.F. E TOTAL ESTIMATED COST BASED ON$125.0 /-,o � Total Project Cost :$` Check No.: 9=a0 Receipt No.: 7<6 •1 �y - Page l ott4 �f7 / 0 a,-7 2�r)�cVd t t+tail,tA9 M-66 lIEWARGE DISPOSAL Swimming Pools Tanning/Massa e/Body Art ❑ � Public Sewer Tobacco Sales ❑ Food Packaging%Sales u Well ❑ Permanent Dumpster on Site Private(septic tank,etc. ❑ Electric Meter location o project NOTE: Persons contracting with u i. contractors do not have access to the guaranty id Signature of Agent/Owner Signature of Contracto Plans Submitted ❑ /ans aived ❑ Certified Plot Plan 11S ped PlansE FOLLOWING SECTIONS FOR OFFICE USE NLY INTERDEPARTMENTAL SIGN OFF-U FORM i DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ A/ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS J1S, --� TE REJECTED DATE APPROVED CONSERVATIOQ:("— COMMENTS GL� DATE REJECTED DATE APPROVED ._ r HEALTH ❑ /j���� 19 K- �or SCIS `/ COMMENTS vr✓ t - �- ^ y. u--l+-.tea! (_._z ss a% Zoning Board of Appeals: Variance, Petition No: —7 5' 3 Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature&date ©(14 Temp Dumpster on site yes_no Fire Department signature/date I Building Permit Approved and Issued by: 11a.-e 2 of 4 Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided 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 1 I i I I t 'f h Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 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 ❑ 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 ❑ 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) i ❑ 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:B11FORM05 Page 4 of 4 7) , �T `-'OF43EWARGE DISPOSAL Tanning Massa e/Bod Art ❑ Swimming Pools Public Sewer Tanning/Massa y Well ❑ Tobacco Sales ❑ Food Packaging/Sales 11 Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location o project NOTE: Persons contracting witl: u i, contractors do not have access to the guaranty d Signature of Agent/Owner Signature of Contracto Plans Submitted ❑ ans aived ❑ Certified Plot Plan ❑ S ped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE NLY INTERDEPARTMENTAL SIGN OFF-U FORM I ; DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ A ❑Water Shed Special Permit 1 ❑ Site Plan Special Permit t ❑ Other COMMENTS TE REJECTED DATE APPROVED CONSERVATIO ; �—�10 iv 206-6 l� t COMMENTS 7 i DATE REJECTED DATE APPROVED I HEALTH ❑ X 711,D 0r , COMMENTS w G —ICA Zoning Board of Appeals. Variance, Petition No: -7 S t 3 Z— Zoning Decision/receipt submitted yes . Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature&date / �_ Ze� Temp Dempster on site yes no Fire Department signature/date ' �•liZ �$2��Z� -� S/ �� I - i i Building Permit Approved and Issued by: I Page 2 of 4 I : Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided 4 I i 1 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) Pale 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created RMC.Jan2006 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 F o 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 I4 o Building Permit Application ❑ Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o 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) s New Construction (Single and Two Family) 1.` o Building Permit Application ❑ Certified Proposed Plot Plan 4 ❑ 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 Sprinkler Plan And : Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report 2 I 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 Dor.INSPECTIONAL SERVICES DEPARTNIEN'r:1311FORS105 i I : Page 4 of 4 `' 4Location W/evedf V -� � � No. - Dates NOD TOWN.OF NORTH ANDOVER _ ' O � s }�o Certificate of Occupancy $ .��:.. Building/Frame/Frame Permit Fee $ �� s k1U 9 r a Foundation Permit Fee $ Other Permit Fee $ TOTAL $ C� Check j�; W, /010 cV� Building Inspector