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HomeMy WebLinkAboutBuilding Permit #730-2011 - Juniper Circle-Bldg 22 5/1/2018TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: 0 -,;�d/1 Date Received PROPERTY OWNER V0 Aq ut 41 +r b)''5 AC Print MAP NO: _PARCEL: ZONING DISTRICT: Historic District yes (cZD Machine Shop Village yes gp TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building ❑ One family ❑ Addition ii'wo or more family 11 Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic .Well ❑Floodplain, 0 Wetlands; El Watershed District ❑ Water/Sewer DESCRIPTION OF W0 IImm OWNER: Name:_KR " Address: /'00 r0 BE PERFORMEll: f mop Please Type or Pfint Clearly) 4"/oafe , . 9 78-a7-53oo , 7Li 4v17©tJ_4. *g aiOK CONTRACTOR Name: t/ip Phone: �78-(o87-S3C�J Address: /06 4,,77Vlit N PP''_i' Sw+ie M Supervisor's Construction License: IW51 Exp. Date: � t %z /4/ C5 S7571 116,112.1 Home Improvement License: Exp. Date: 4606+ VabsC461 ARCHITECT/ENGINEER kjolz_ jAe 6 Phone: a—r,7R= Address:�#�T - 7 g FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ FEE: $ �, �U O '— Check No.: Receipt No.:l NOTE: ie—rs-onsTcontractini 4itfilvAlegistered contractors do not have access o he ggpranty fund �Sigriature of Agent/Owner Signature_o contractor _r 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 COMMENTS J� ' HEALTH COMMENTS Reviewed DATE REJECTED DATE APPROVED Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Water & Sewer Connecti Comments Co '4 -z7— l � ' al DPW Town Engineer: Signature: iaL Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpst on site yes -no- Located oLocated 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 NOTES and DATA — For department use ® Notified for pickup - Date Doc:.Building Permit Revised 2008mi 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 o 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 o 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 a Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 10T€: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit 1 all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording gust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi 1 Location ©/ ��� f� r�r` o Z:7;19 as f� ,ao-� No. Date 1 NOR111 TOWN OF NORTH ANDOVER 9 ;e Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check #� $ 6,A00- 24 lD. 24 1, US X�? / Building Inspector