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HomeMy WebLinkAboutMiscellaneous - 40.N Main Street 0 3 a �' ( %40RTFf 41 1y ON + �� BUILDING PERMIT o SLED ,-� TOWN OF NORTH ANDOVER o2 h�'� °•'6 APPLICATION FOR,PLAN EXAMINATION ` y M Permit No#: Date Received DAITED I.4R1 9SSACHUS�� Date Issued: ORTANT:Applicant must complete all items on this page Ci -T ,PROPERTSY,®WNER'___ _ V 1 t`zf Pnntr 1 CDwYeM ru�cfpre, (MAP f � )A @E ZONING DISTRICT �:Historic:bistrict, ` ��� -� t -�' - • ` Machine�Shop Village'_ _ye TYPE OF IMPROVEMENT PROPOSED USE _ Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family EKndustrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain o Wetlands Watershed Disfrid, 0 Water/Sewer: L :- DESCRIPTION F WORK TO BE PERFORMED: P6 01aj 50 k6 by't Iden[�' c tion (91- 1� �Z(`se Tg�pe or Print Clearly' OWNER: Name: �i�V ' Phone: Address: �4 �(11 r LL Cdntractor Namea u cd GJIe7�d�+Phone :.. Q� (5.�? S Address: J ,.Supervisor's Constr;uctonLicense: _ _ _ _ __' Exp. Date _ • � ; _ " Horne Irriprov Ment Licen"se _ Exp pate ARCHITECT/ENGINEER Phone: Address: Reg. too. FEE SCHEDULE:BULDING PERMIT.-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. E Total Project Cost: $ �6�' �� FEE: $ � Check No.: Receipt No.: NOTE: Persons contracting t unregistered cont actors do not have:access to the guaranty fund °S`ignatu�e__of_Agent%Oe.r - Signature of contractor Plans Submitted ❑ Plans Waived El. Certified Plot Plan ❑ Stamped Plans ❑ 'Tw :-';&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 Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on 1`{ (a S ig nature La�' Tr COMMENTS . HEALTH Reviewed on Signature r 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124.Main Street Fire Department signature/date COMMENT,S i limension 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 droprequires approval of Electrical Inspector Yes No ®ANGER ZONE LITERATURE: Yes No MGL Chapter 166 section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email ate Time Contact Name Doc.Building Pen-nit 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 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/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 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 Vf Contract act ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 40TE: 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:Building Permit Revised 2014 Location t ` V` 1 No. 'd of -7 Date ��. /v. g 0! 6 . • TOWN OF NORTH ANDOVER • ` � ' Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ ' TOTAL $ Check# j� / ,Z (Building Inspector NORTh1 own of ndover 0 - rh ver, Mass, o ��_ o b COCKIC„ewKK It. RAreo ►•PP,`,�5 U BOARD OF HEALTH PERMIT .T LD Food/Kitchen Septic System IIl THIS CERTIFIES THAT ....... ... 1.k..... .. .�.. �.. ................................................. BUILDING INSPECTOR .•. Foundation has permission to erect .......................... buildings on .�0. .�.....MA. k ••••• Rough to be occupied as .... ....... ... ...... *•� .. � ...... ... .. � . Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. OVAL Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU1 .0 AR Rough ................... Service . .. .. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. 1 T f � fl28.0-00x3 .. 20 R"IYER.UIEW ST Lawrence 0.72.0-001 z 028.0-0004' ` lU•RIUER1 MEW ,,� 4O NORTH MA`It� S7; �_• �-. 11 RIYERI/I•EW ST RINERW:EW S 028 0 0029 NORTH MSN ST P3` i '� �*7 NORTH NIAINST 4 NORTH MAIN ST „ c 075:Or0003 ' , u IQ-2 Oa01 t of►7.o—oodz ;°Ferry Streets ,; A _ � ,,.'`0.17.0-000116 FERRY ST 12 FERRY ST, � `" 017.0-000360 ASHLAND Sf 028.0-002 ). 60 ASHLAND ST r, Y � • i i ` x,028.0-0019 017.0-002' ' '.4 '` 170 SUTTON ST 017.0-ofl22 017.0-0004 ,. � i 48 ASHLAND ST � e •'\V�,`. I 01►7.0-0005 :,��`.: ,; � �f ` 44 ASHLAND ST ! 028m'0=0007 Horizontal Datum:MA StalepWne Coordinate System,Datum NAD 83, Meters Data Sources:The data for this map was produced by Merrimack _ f NQf47'k q Valley Planning Commission(MVPC)using data provided by the Town of North Andover.Additional data provided by the Executive Office of �OO` Environmental AffairslMassGIS.The information depicted on this map is itsfor planning purposes only.it may not be adequate for legal boundary _ {n definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER f A MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY • i +F OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT c ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION 'A1{D 4Ss�cHus�t 1"=115 ft . I I