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HomeMy WebLinkAboutBuilding Permit #742-2011 - 86 OLD VILLAGE LANE 5/4/2011TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO• 7� 2a1i Date Issued: --s Date Received r ' . IWORTA.NT: Applicant must complete all items on this nage ---1 LOCATION 96 dib 11"I"arle ' / Print PROPERTY OWNER /Y 1�h o 1So Print MAP NO: D PARCEL: �b 61Z Print DISTRICT. Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑One family ❑ Addition ❑ Two or more family ❑Industrial [I Alteration No. of units: ❑ Commercial J.Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other r❑Septic "=l7We11;�'Bloodplaiu©Wetlands-�_ 12, i',�WyatershedrDistrtct"yj } DESCRW 110-N V1' WORK. 10 BES PER OR ED: Identification Please Type or Print Clearly) OWNER: Name: (1 "L.el at so t.,/ Phone: Address: e�o D(z OC44•e kpe-, CONTRACTOR Name: Az Ai^ ;5 5 cum :r, -i Phone: 66 cf- Z3 Address: C�/D /Z/ A(Aol S� Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERM/T: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cosi:: $ Check No.: Z Receipt No.: NOTE: Persons contracting with unregistered contractors of h Ve ccess to the guaranty fund Plans Submitted ❑ - Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Well ❑ Private (septic tank, etc. ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMEN CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes nn Located at 124 Main Street Fire Department signature/date 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 No, MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine Doc:.Building Permit Revised 2008 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 Neter 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals AL the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording ist be submitted with the building application Doc: Doe.Building Permit Revised 2008mi 0 F=4 0 H O u J 0 z \ _a r C J v :.. c. y O C_ $ E.5 z y Qz ( �Emm O c� _c c o � CD = C G o1 C J • Cc•= co Cn z ci v o - a \ N eca c o .� Q. � E co cc W 0 � ca o.cj O O A C �c L:m VJ m �/� VJ ev 10 r=.+ cmco ' .y Z w �cx� m � � V CL h A•�Z o C v oo. o a� c O O Q o :cmc co C. = F - o c a=••' 03 m N C Ng LU .� �Np = "�'' .. = r.+ _c 0. �••' .y o.= c N_ Z C* = �• A O � o N ao�m: mCF CO J :tea yon EN z Cl) H a� nm m c U COD o O •O O 0o Q O V� m c E �O p m co N = C M. 3 � 0 - 'O c CCD 0 o O. Cc �= C N O. N A o Q vs «: W y C 'O L v H ' p� ev lCO v 1\ =CD' o a W W Z v ,�-1. c CD . :mom mO a vrnoo C.) ti ev � Z os O C CL c O —_ = m:a�3: H cc o r W mss ,r •N d «. =_ r+ c Z h W E v .0 cc.), .N O V m O ® C CO) CL m _ EMO) O s 2o.wm 5 W W 19 LU //WU/� Y/ 0 LU U) LU U) W W W W N North Andover Building Dept 1600 Osgood Street Bldg 20 Ste 2-36 North Andover MA 01845 HVAC PERMIT FOR THE INSTALLATION OF AIR CONDITIONERS, BOILERS, EMERGENCY GENERATORS, FURNACES OR ROOF TOP UNITS. The undersigned applies for a .permit to install the following at: LOCATION 9,s Of > V c f f.dej g 4,&A -C_ DATE K" _1 '7^t � OWNER OF PREMISES JAI, N ADDRESS We D!D Ac Ay-_ AAry CONTRACTOR NAME ( �Y�, �i� s�.��iras :rA!ne, ADDRESS .0/0 A10&r,&57' NO, PREMISES NAME MATERIAL OF BUILDING k Sacla,t- TYPE OF FUEL CH VINEY NO. OF FLUES CHIMNEY THICKNESS UTiNIZI7 L24ING HEIGHT SIZE IF STEEL STACK LOCATION DESCRIPTION OF HEATING APPARATUS TYPE OF HEATER/FUEL HOW MANY MAKE 10l►i 1►1• y PROTECTION AGAINST FIRE AS REQUIRED HOW PROTECTED LOCATION IN BUILDING ROOF TOP UNITS OR EMERGENCY GENERATORS (See the State Code pertaining to chimneys, smokestacks and heating apparatus.) DIMENSIONS: LENGTH LOCATION ON BUILDING SIZE OF ROOF RAFTERS SPAN OF ROOF TIMBERS PROTECTION AGAINST FIRE AS REQUIRED HOW PROTECTED BTU INPUT / OUTPUT WEIGHT WIDTH HIEGHT HOW SUPPORTED MATERIAL DISTANCE ON CENTER _ FUEL TYPE APPLICANTS SIGNATURE �� DATE 3 Location No. %�/2 — 2 • Date �1 i "ORT" TOWN OF NORTH ANDOVER ` 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee�,,aL $ 72— 2`"TOTAL TOTAL $ Check # :� orw 24��4 Building inspector