HomeMy WebLinkAboutBuilding Permit #504 - Dogwood Circle-Bldg 17 Units 1701,1702,1703 2/5/2010t
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
Two or more famil
Industrial
Alteration
o.
Commercial
Others:
Repair, replacement
Assessory Bldg
Demolition
Other
Septic . Well
Floodplain Wetlands,
Waters District .
Water/Sewer
.
ur-ak,rar I FUN Ur VVUKfK I U tit l'tKFUPtMED:
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Identification Please Type or Print Clearly)
OWNER: Name: Phone: "-)'b -(,b_7-55o0
Address: IoN �� l� .
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CONTRACTOR Name. T Phone 7 $ -� °(��l7 �-CY
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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: $ '�1"
Check No.: / `Zr
Receipt No„�,2
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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Sig .' nature of Ag a Suture of contra_.--
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Location /x r., acne/> r%l1 �45
No. S� �/ Date
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TOWN OF NORTH ANDOVER
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Certificate of Occupancy
$ -�
Mus
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
TOTAL
$
Check # 211v
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22 4
Building Inspector
Q
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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
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
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COMMQ4T.�$
HEALTH
COMMENTS
DATE REJECTED DATE APPROVED
Reviewed on
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6 �
Reviewed on Signature C
,i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decisions- Comments. ,
S a; •.J � a r. t U
Water & Sewer Connection/Signature & Date Driveway Permit
-DPW Town Engineer: Signature:
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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 servicedroprequires approval of
Electrical Inspector Yes
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
Doc:.Building Permit Revised 2008
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"I 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
o 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 ...
o 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
Doe: Doc.Building Permit Revised 2008