HomeMy WebLinkAboutBuilding Permit #387 - 8 SAMUEL WAY 12/9/2008 BUILDING PERMIT NORTH q
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TOWN OF NORTH ANDOVER or 4•�' °�
APPLICATION FOR PLAN EXAMINATION '"
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Permit NO: "y'
7 Date Received
9 '
4
` ��SSACHUS
Date Issued: 1 A 1 ®y
IMPORTANT: Applicant must complete all items on this page
LOPATION
PRPERTY�OWNER print � �
E Print
MAF''NO, PARCEL: ZONING DISTRI( T Historic District yes
,2
211
IVlactine Shop Village yes C `Y-
TYPE OF IMPROVEMENT PROPOSED USE
Res'dential Non- Residential
/New BuildingOne famil
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
•:Septic 'Well Floodplain Wetlands Watershed District
.W ater/Sewer
DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Mease Type or Print Clearly)
OWNER: Name. 'L�1 �"� 4Phone`:` ! �Z.�'7�` =
Address:���� ��. 1� �=ny I
F Wig.
CONTRACTOR Name: ` hone:10)7
res - !5111
Supervisor's-Construction License: GS 77 '7 Exp. Date: 712A 1201,1-' :
, --Wit•--,1 � t /ta-.��
-Hb ne Improvement License: Exp. Date:
ARCHITECT ENGINEER TDEI'd 1A 69 Phone:`::)�� 3.71
Address: c>l L-1" 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: $5CD 1 ,1:31 x 6=+200 FEE: $
Check No.: ����� Receipt No.: a/7416
NOTE: Persons contracting with un i ered contractors do not have access to the guaranty fund
1H7
. .
LSignatureyr6f Agent/ Signatureof contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body 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
Signature I*//
'-7-
COMMENTS o �c:_ �
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Commen
Water& Sewer Connection/Si nature&_ ate Z6rife.y Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE=DEPARTMENT - Temp Durr er on site yes no
Located iat 9244 llairi Street r ��
£ Fire Depart nertt,sianature/date
ti
OMMENTS
C . . e
Dimension
Number of Stories: ,
Totals square feet of floor area based on Exterior dimensions.2�� t
q
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 No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— For department use
i
❑ Notified for pickup - Date
Doc.Building Permit Revised 2008
JI f
1
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
i Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
I o Copy of Contract
o Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
i
Addition Or Decks
i
o Building Permit Application
❑ Certified Surveyed Plot Plan
o Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
a Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
o 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)
o Building Permit Application
❑ Certified Proposed Plotr Plan
Li Photo of H.I.C. And C.S.L. Licenses
r
E Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
r Hydraulic Calculations (If Applicable)
i` o Copy of Contract
o 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 Application
Revised 2.2008
Location
No. 3Y 7 Date lahl
TOWN OF NORTH ANDOVER .
• , yo
Certificate of Occupancy $
Building/Frame Permit Fee $ 43. �o
r.
Foundation Permit Fee $ 00
Other Permit Fee $
r X533. P
TOTAL $ 6 i
>r Check # -7
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21 .746 4h
Building Inspector
NORT#q
c
0" of ? Andover
No. 3 9 7 _
R 4
Y o , Ldover, Mass.,
T O - LAKE 1, T
COCHICHEWICK V
�oRATED
NN BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT............. ?� .�. .
.. .........................:... Foundation
permission to erect............:.......... ',, c
p buildings on ........... A ' ......:........................... ... Rough
has
9 .
t0 be OCCUpled aSr / '�" c! /�/ �� v `� SC: Chimney
............. .. :. .......... ' . '. .. .. .. . . .. . . . . . .. , 2V. y
provided that the person accepting this per it shall in every�ipect conform to the terms of the application�bn 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. W Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR.
UNLESS CONSTRUCTIO STARTS t
Rough
-s^ Service
GG BUILDING INSPECTOW �.
Finale
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Removop ,,,: Final.
No Lathing or Dry Wall To Be Done FIRE7 DEPARTMENT
Until Inspected and Approved by the Building .Inspector. X
; Bu er-
Street No.
SEE REVERSE SIDE Smoke Det:
i
L_ Nlassachusctts - Department of Puhlic Safetc
Board of Building Rer
gulations and Standads
Construction Supervisor License
License: CS 99769
Restricted to: 00
AARON SASSEVILLE
24 BUFFUM STREET
SALEM, MA 01970
Expiration: 7/24/2011
('uumi .i,nci Tr#: 99769