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HomeMy WebLinkAboutBuilding Permit #70-11 - 81 EMPIRE DRIVE 7/19/2010BUILDING PERIT. TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �`' / Date Received Date Issued: IMPORTANT: Applicant must complete all items on this pate - f r4llw�:"' LOCATION Print PROPERTY OWNER (9J2 -C6 j#AP Print MAP 210 1a' PARCEL: d fP ZONING DISTRICT:IHistoric District yesPno Machine Shop Villaae ves ) TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Others: Repair, replacement Assessory Bldg Demolition Other / S ell Floodplain Wetlands/.. j Watershed District , C 1111'ater/Sewer qe.5 UhbUKIF HUN OF WORK TO BE PREFORMECI -L� alp r-�r ... f /__ At Identification Please OWNER: Name: Address: CONTRACTOR Name: Address: C Supervisoi Home Improvement L or Print Clearly) ARCHITECT/ENGINEER Phone: Address: Reg. No -(9k2-3/dZ • 61, Zt FEE SCHEDULE. BOLDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: --L �L' % (D Receipt No.:1� NOTE: Persons contracting with unregistered contractors do not have agcehq guaranty fund Signature of Agent/Owner Signature of contract Location !7 ,v No. _��� Date 1 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #,/0/- 23 1"; 6 /231"+6 Building Inspector 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 INTERDEPARTMENdAL SIGN OFF = U'FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Vj o. Si nature COMMENTS 'tea; -;,�, ra GZ,�.�I ,P�y�►-s°; `- u .HEALTH Reviewed on Signature _ COMMENTS ' t. • �, ; � _ .. _ �� � ... � t , >, _ - � '- ;��: � �'.�e . . Zoning Boar&of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street EIRE DEPARTMENT Temp Dumpster on site yes no Located,at 124 Main Street Fire Department signatureldate COMMENTS 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 NOTES and DATA — (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 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/Crossection/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 2008 M M t", �i P U O, O w° Cl)w° o w a ga_ .z m a°' U w o a�' w � U a°' US w CD a�' w . + rQ o cn v Ci �i P U O, O C C c o Q y O ■O 0 c m m CD 0 CD c � CD co 0 o � O d a. Q L c � O N c4- C Ccc i.+ C CD �O w ts C C CL '.a c y R C c. C cc ev cc CO2 0 c Q Cc Ea 0 c O ,.. CL N c IuL 0 �0 c `�. o 0 Vs cms 0 c � M L a � CDM m 0 L ca .� � 3 s Q! O E 0 .3 �• C �` N •_ `• m O a Cc 0 O C O 0 CLU m O Q! c N Q = 0 O m v H Z O s O O.r. o CL c) c Q m : a 0 c c = 0 .0=3: N y0+ CL o N 0 ~ D CO2 W O yO■ Cc —'oZ .y a. c •. W .m O. O0•N Z O V 0 CDcm H _ca o O. U3 CD O � m 0 CO2 C2 =4 a : — 4-C13 ::Ip �i P U O, O LLI W N 19 W W 0 C C C Q y O ■O ■E m m CD 0 CD CD co 0 cc O d a. Q c4- C Ccc CD ca C ts C C CL C.3 y R C ■ C C cc CL CO2 LLI W N 19 W W 0