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Home My WebLink AboutBuilding Permit #608-16 - 9 SARGENT STREET 11/17/2015BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * �? f � Permit No#: Date Received W 4 r � �SSACHUS�� Date Issued: NO V r � IMO TANT: Applicant must complete all items on this page LQCATI;ONi, 1011/X PFZOPE_ R�TY0.INNER' p� tPnnt100 Year StructurE M'AP' _ f0 !PARCEL--- Z NIN'G 018TRf'CT Historic i istricf TYPE OF IMPROVEMENT' PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition bvwo or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other D'Sepfic: DWI- eIII�IFloodplainr giWefl`ands. u rshed strict: �Wa et�F h ,,UVater/Sewor ---- ION OF WORK TO BE PEKFUKMEU: - Please Typf or Print Clearly OWNER: Name: Orlrlracc- Phone: pSupervis_or1. _ _ _ ARCHITECT/ENGINEER Phone: Address: _ 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: $ FEE: $ Check No.: q Receipt No.: NOTE: Persons contracting with unregistered contactors do not have ac��th�e guarantyfund 'Sgnature,ofSAgent/Qwnery _ � r��i _��iSignatureof�confractor: �/�._ Plans Submitted ❑ Plans Waived.[] Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swiumning 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 PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Reviewed On Signature Reviewed on Signature Reviewed on Siqnature Zoning Board 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: r�iR�11t1Y1C_IYAIj = t124��Main�St�eet�� -- - - - - - -- Located 384 Osgood Street ,ye n�site: s -_ - � 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 Doe.Building Permit Revised 2014 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 MOTE: 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/Cross Section/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 40TE: 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 VOTE: 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 Clerics 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 2014 i�h. �--�� 'I71�i5 � �e �-. Location NoApQ�-- 2o�� Date TOWN OF NORTH ANDOVER Certificate of Occupancy $- - 26— Building/Frame Permit Fee s -7 - Foundation Permit Fee $ Other Permit Fee TOTAL $ Check # 2000684 Building Inspector