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HomeMy WebLinkAboutBuilding Permit #387 - 8 SAMUEL WAY 12/9/2008 BUILDING PERMIT NORTH q 6. do TOWN OF NORTH ANDOVER or 4•�' °� APPLICATION FOR PLAN EXAMINATION '" �o ua 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: r 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 f 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