HomeMy WebLinkAboutMiscellaneous - 58 BEVERLY STREET 4/30/2018 58 BEVERLY STREET
2101009.0-0032-0000.0
L
NORTy
BUILDING PERMIT quo
�a
TOWN OF NORTH ANDOVER o A
APPLICATION FOR PLAN EXAMINATION
Permit No#: �� Date Received AMD
gSSACHUs��
Date Issued:
I PORTANT:Applicant must complete all items on this page
LOCATION
Print
J
PROPERTY OWNER ig D U
Print 100 Year Structure yes
MAPPARCEL: ZONING DISTRICT: Historic District yes Ono
Machine Shop Village ye
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ne family
❑ Addition ❑Two or more family ❑ Industrial
❑AI eration No. of units: ❑ Commercial
epair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other —
❑ Septic ❑Well ❑ Floodplain ff Wetlands ❑ Watershed District
❑Water/Sewer _
DESCRIPTION OF /WORK TO BE PERFORMED:
AAlf u � �u l fit ?�� ��2 �T 77/n�-C 4
Identifi tion- Please Type or Print Clearly
OWNER: Name: Phone: 2-6I�
Address: 5F T6:y(ytW �r
rma
tor Name: t' ck *Dkko l Phone
ssor's Construction License: �f 6 y1 Exp. Date:
Home Improvement License: �h C� f Exp. Date: 3 ,/? ,(2—
ARCH ITECT/ENGINEER
.f? '(7ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 21�1� 6 — FEE: $ 32—
Check No.:
"qcl Receipt NO.: �
NOTE: Persons contracting with unregistered contractors do not have acc s to t e ua anty fund
-----�_
t
r r� F �L
Location �1� vt �L1 � ' -
No. "1 '" Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ _
Building/Frame Permit Fee $ --
Foundation Permit Fee $
o
Other Permit Fee $
TOTAL $
IL
Check# I
I A. �' M
fi Building Inspector
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales 11 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 Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Gunservation Decision: Comments
Water& Sewer Connection/Signature� Date Driveway Permit
DPW Town Engineer: Signature:
---.
ire+ Located 384 Osgood Street
FIREaDEPARTMENT -Temp�,Dumpster.onsite ,yes _ not
tediat
FQepartmentsignature/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.$1o0-$1000 fine
NOTES and DATA— (For department use)
❑ Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014
J -
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
OTE: 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/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
OTE: 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
2012 IECC Energy code
Engineering Affidavits for Engineered products
OTE: 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
t
Doe:Building Permit Revised 2014
1