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HomeMy WebLinkAboutMiscellaneous - 164 HILLSIDE ROAD 4/30/2018 (2) BUILDING PERMIT of fg0RoT" .1 TOWN OF NORTH ANDOVER c? '`ti?- , b.e o°„, APPLICATION FOR PLAN EXAMINATION At Permit NO: �* Date Received �4q�ggTEO•�"'`,C`�* �SSACHU`�f� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION R PERT P O Y OWNER; t�"\ ���xX.�C'Al Print "MAP NO:PARCEL: ZONING DISTRICT: . =Historic Distract- yes -no Machine Shoop Village" yes, o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Buildingne family ition Two or more family Industrial teration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic, Well Floodplain Wetlands . Watershed District :Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: E$t c�_P-Y t 6 Al ajE /0 2 Identification Please Type or Print Clearly) OWNER: Name: \�, �,��`\c�C Phone:178 _�ea -rhe'), Address: b`� LX Z A CO_NTRACT0R Name:. e\ rn Phone: Address Supervisor's Construction License : t, *?6),:z , Exp. Date: bmA- Homo lmprovement License, Exp. Date; ARCHITECT/ENGINEER Phone: �j78-69 %-/l(_S_ 3. Address: ReezV�ev Q5-: A)Ay� cam,,sent . Reg. No. FEE SCHEDULE:BULDING PERMIT:$1M0(PER0��OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ �� Check No.: Receipt.No.: 4// NOTE: Persons contracting wit unregistered contractors do not have access to the guarantyfund 5i 'nature of A -ent/Owner ` F __g � _ ..... . g . _ __. -'°'"C.: ture"of;contractor� 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 E3 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 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) o Copy of Contract ❑ Mass check Energy Compliance Report ❑ 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 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 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 i Doc.Building Permit Revised 2007 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH COMMENTS 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 Located at 384 Osgood Street FIRE DEPARTMENT Temp Durrpster on site yes no `Located at 124 Main Street .Fire Department signatureldate -COMMENTS Location �r/ �� /7// /111 'e /1?1/ NoDate 1215-1-0 7 NORTH TOWN OF NORTH ANDOVER Of �so . ,ti0 3? _ OL F 9 s , Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2084- 1 Building Inspector ,A T#j c Tovm of _: Andover No. Q LAKE o dover, Mass., COCMICKEWICK 7�AQRATED pP�\ �C S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT 6/1 I/��............ .................................... ................................ ...................................... ..................... Foundation has permission to erect........................................ buil Ings on...,/6..z/.. 1 ..... .. ................ Rough .... � .......... . � L to be occupied as....................� .�2.�4!. .. ......- 4�©ry...... ..f..°V 1.D .......I6<.. .� . �c ... .�....... Chimney provided that the person accepting t is permit shall in every rdspect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTION STARTS Rough ....� ........ Service BUILDING PECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or D■ ) Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i E� , E Y All t ReA P2 CLCU, (AN �y r. I 1 -,A-J l4 — �I 74�9� -SG n1�i�b x,.?� _711pto -,AMY i ra (\ rr ra�2�5 ,I NO3 U u Ud r� AWE) c 0\ YI I CER7IFY THAT THE STRUCTURES I.P. waf SHOWN WERE LOCATED BY AN FND INSTRUMENT SURVEY AND EXIST ON THE GROUND AS SHOWN. ZONING INFORMATION: ZONING DISTRICT . R3 MIN. BLDG. SETBACKS: , FRONT 30 FEET SIDE 20 FEET REAR 30 FEET . f ASSESSOR INFORMATION: MAP 98C PARCEL 22 '�Sft?IdALE�G� �cc�v DEED REFERENCE: 1 BOOK: 3857 PAGE: 180 ��,iti Of OWNER INFORMATION: oma' s G WILLIAM & SARA WELLOCK ' rn s. -� 164 HILLSIDE ROAD -i o LOT AREA o o,0 •13972 33,476 S.F. rn� NORTH ANDOVER, MA 01845 FCI �p �-- Lt Ln � w 0 0 O f SEXISTING SEWER LINE CONTINUES j ��OF TO #81 WESLEY STREET. OWNER PROP. ADDITION #81 WESLEY STREET HAS EASEMENT Q cn RIGHTS TO MAINTAIN SEWER LINE THROUGH #164 HILLSIDE ROAD (DEED: 3857/180) �- PROP. PRECAST I BULKHEAD ( ' S I 47.5' 1—� I.P. 210 M o S'I' FND i 2� J 35.3' / , � � � . � � � � � � � � � EX. 2 ST. 1 ST. / WD. FR. i EXISTING SEWER LINE /STRUCTURE/ ! GAR. /1 LL/ 37.1' I � 1.35' SECOND n co FLOOR OVERHANG I j o o PLOT PLAN OF LAND 73.1' 75.2' I Z " #164 HILLSIDE ROAD NORTH ANDOVER, MASS. _ I PREPARED BY: N2470708"E I JOHN D. SULLIVAN III, P.E. 1 p 149.74' (MEASURED) 77P. 22 MOUNT VERNON ROAD FND 150' (DEED) I FND BOXFORD, MA 01921 HILLSIDE ROAD (978) 352-7871 SCALE: 1"=40' DATE: 11 /5/07