The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 32 BRIDGES LANE 4/30/2018 (2) / 32 BRIDGES LANE J 210/104.D-0072-0000.0 h Location 3D2(2,d>'rS No. Date -c —02 NORTH TOWN OF NORTH ANDOVER . s + ; ; , Certificate of Occupancy $ CMust`� Building/Frame Permit Fee $ S. Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 157 ,) 3 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEM3O.LISH A ONE OR TWO FAMILY DWELLING dw rn BUILDING PERMIT NUMBER. c:;) ! DATE ISSUED. ,� lrf CdI ® SIGNATURE: Building Commissioner/InEeEtor of Buildings Date if. Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: chic Lai /•Uri/ ,/1�A Map Number Parcel Number 1.3 Zoning Information: /�/t 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information. 1.8 Sewerage Disposal System: D Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT F m 2.1 Owner of Record -/ T Y � �� _ r %USI Name(Print) Address for Service YSigialffire Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: o 5t7�,n ,n� License Number Ad ess � f� Expirlition date � S na Telephone r 3.2 Registered Home Improvement Contractor �r Not Applicable ❑ Te W Company Name j rn Registration Number r Address ! n Exp on Date ^ S Telephone Y i SECTION 4-WORKERS COMPENSATION(AG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes...... No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) Alterations(s), ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Pe 7444- Brief Description'of-Proposed'Work:+u o tew" �"� V' I" Z l•'/ a�� ,� r Ili SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE:ONLY Completed by permit applicant . 1. Building �y p (a) Building Permit Fee �j Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC , 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES s�,FOR BUILDING PERMIT ct I> Sa "t/ r G as Owner/Authorized Agent of subject property Hereby authorize to act on M behal- i al natte�relative rkauthorized by this building permit applicati�i.—5 �A i n i of wner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, I Z �` as Owner/Authorized Agent of subject pro/erty-74/- Herebv declare that the statement and information on the foregoing application are true and accurate,to the best of my knowledge and belief (TC V t o ,ZZ P int Na ` -/�v f5 of caner/A ent Date ., tr NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS0 I 2 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS IIEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE mP7 2 e P CN + FORM U - LOT RELEASE FORM 9 -I S-°�- INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLIICANT FILLS OUT THIS SECTION*********************** APPLICANT /V 1 r° e A7 r 4 lgd-O -S OI? PHONE 2 Py -4i?� 4C" )1 LOCATION: Assessor's Map Number ` PARCEL rl a SUBDIVISION LOT(S) STREET G _.. a n ST. NUMBER =3 a ************************************OFFICIAL USE ONLY*********************************** REC MMENDATIONS 9-f TOWN AGENTS: CONSERVATION ADMINISIRATOR DATE APPROVED D DATE REJECTED COMMENTS (IJGh � 6� Ru1ati m uJ�r 4 flor� a��2P�. / TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED 1 DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS f�a IVtk,,) elCraya. b.tAA,JS-f- PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT I FIRE DEPARTMENT i RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 I'm i No ....;_ENA _O , L!<Y .... .. �3_•;16:G... �` r [ y 00 t i 1 } ! r I i ,fid 5n S•f• _�3�'.I� s � i f t i °` •° Rew,ou- P(A,c t s N_ G-T C s I j __ .. .. __ _. _.__. _. I I` 1 1 I North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) t Signature o ermit Applicant 7 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i •1 R The Commonwealth of Massachusetts Department of Industrial Accidents ,. Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please forint Name: t/ C t' E S q E Z W i c i Location: 1�6 W V City [M A G1 /yl /T Phone �1 —49 d •��d�/ am a homeowner performing all work myself. l I am a.sole proprietor and have no one,working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name; Address Cityz-- Phone# Insumnce Ca. _ Policy# Ad-dress City: Phone#- lnsurancg:-Co. Policy# F:wh#re to secure 25A or A40L 1,52 can lead to the andtor one ars'c��e as required under section e �d crirninat . penaities,of a fine up:to$1.500.00 ye imf5risonrnent as'welt as penalties in the form of a STOP WORK ORS and a Me of($100:00)a day against me. understand that a copy of this statement may be forwarded to the Office of lnvfstigaffora of the f31A for caverage verification, t do herby certify under he pains 8 pen ies of perp"that the irrfonnahon provided above fs true anil cwft-t F Signature nate ��- Print namee l t �i� Phone Official use only do not write in this area to be completed by city or town official' E] Building Do t' P pr-heck if immedFate response is required Building Dept 0 Uconsing Board El Selectrr an's office? Contact person Phone# D Health Department C7 Other M4 WORKMAN'S COMPENSATION NORTH Town of over 0 fn No. 77 di oe)e? 0 LA 0 dover, Mass., COC HICHEWICK 00;?ATED P' H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System C..I.4) K :Z BUILDING INSPECTOR THIS CERTIFIES THAT........ ....................... . ... ........................... ................................................. Foundation has permission to erect.. buildings on...... ......... ..... 2)644.....41POW.416 Rough 44 M q veto Chimney to be occupied as......0 toe M.......A ..............................................eR 41 ............................................ provided that the person accepting this permit shall in every respect 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. i o 40/47Q PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR r'TI1 I UNLESS CONSTRU%__� JLO STAR C Rough • SerAce ............. A* ... ......L ............................ ..........Z5 BUILDING INSPECTOR 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 Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.