HomeMy WebLinkAboutBuilding Permit #518 - 85 MAIN STREET 1/23/2007Permit NO: V /�
Date Issued:
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received /—,7,3
L
FO A
IMPORTANT: Applicant must complete all items on this page J
LOCATION r)n L 1� S
Print
PROPERTY OWNER \ (--Iv--\
Print
MAP NO.: PARCEL:
TVPF AND iTCF. OF RITTT,DING
ZONING DISTRICT:
HISTORIC DISTRICT YES ❑
y
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
❑ One family
Two or more family
No. of units:7
❑ Industrial
❑ Repair, replacement
k Demolition
❑ Assessory Bldg
❑ Commercial
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTOR Name:
Supervisor's Construction
�o--m-,/e Improvement Licen
�a3) t
Date:
p. Date: S I --, ii . �2
e
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED C ST BASED ON $125.00 PER S.F.
Total Project Cost :$ 2-.dJUoaC.0 FEES
lei
Check No.: �/ Receipt No.: g 1,9S'
Page I of 4
TYPE OF SEWERAGE DISPOSAL
Art ❑
Swimming Pools Ll
Public Sewer F1Tanning/MaTanning/Massage/Body
Well ❑
Tobacco Sales ❑
Food Packaging/Sales ❑
(septic tank, etc. ❑
Permanent Dumpster on Site ElPrivate
Electric Meter location to
project
rersuns contracting wttn unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor's
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ St ed Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED
PLANNING & DEVELOPMENT ❑
COMMENTS
CONSERVATION
COMMENTS
HEALTH
4 COMMENTS
c
DATE APPROVED
a
DATE REJECTED DATE APPROVED
❑ ❑
n
DATE REJECTED
a
DATE APPROVED
FIRE DEPARTMENT - Temp Dumpster on si - yes no
Fire Department signature/date
r COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Comments
Water & Sewer Connection/Signature & Date Drivewav Permit
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)
Page 3 of 4
Doe: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created JMC. Jan.2006
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)
❑ 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:BPFORM05
Page 4 of 4
Location
No. Date
MORTIy
TOWN OF NORTH ANDOVER
� R
D
;
Certificate
^a ;
of Occupancy $
MUs t�'
Building/Frame Permit Fee $ 3O
Foundation Permit Fee $ +
Other Permit Fee $
TOTAL $
Check #
�
q
t 9949
/f�
/Building Inspector
The Commonwealth of Massachusetts
Department of Fire Services
Office of the State Fire Marshal
P.O. Box 1025 State Road, Stow, Nti A 01775
PERMIT Date:
North Andover Permit No Dig Safe Num er
( City of Town) (Lf Applicable )
rn accordance with the provisions of M G.L.l 4 8 Chap.ter_J,_Q_ as provided in section 5 7 7 CMR 34 Start Date
This Permit is granted to: i�7(l 621-4—r / of 1
Full natiie of person, Firm or Corporation
Permissionto locate dumpster for construction/renovation/demolition of building.
Comments: dumpster must be. 25' from structure if unable to place with required
Restrictions: clearance dumpster must be covered with plywood or tarp end of work -day
at
( Give location by street and no., or describe in such manner as to provied adequate identification of location )
Fee Paid$ 50.00 /..,, Fire Chief
This Permit will expire / %—O ( Signature of offical granting permit) Off ical granting permit ( Title )
d
Board of Building Regulations and Standards
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Registration: 152688
Type: DBA
Expiration: 9/20/2008
EAST COAST HANDYMAN
ALFRED VERDONE
91 BROADWAY
METHUEN, MA 01844
0PS-CA1 0 50M-05/06-PC8490
71. �om�mza uuea a�./G%aaaac/urarlta
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 152688
Expiration: 9/20/2008
Type: DBA
EAST COAST HANDYMAN
ALFRED VERDONE
91 BROADWAY
METHUEN, MA 01844 Deputy Administrator
Update Address and return card. Mark reason for change.
Address [] Renewal ❑ Employment [:] Lost Card
License or registration valid for individul use only
before the expiration date. If found return to:
Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Boston, Ma. 02108
No without signs ure
i ✓he Panvrio�uueal� .�✓G%aaoac�cwelia �,
k BOARD OF BUILDING REGULATIONS �.
License: CONSTRUCTION SUPERVISOR i
i
Number: CS 028073 }
Birthdate: 03/20/1942
I
Expires: 03/20/2008 Tr. no: 15228 '
Restricted:. 00
EDWARD J PHELAN
931 TURNPIKE ST
N ANDOVER, MA 01845��%j /
Commissioner --------�