HomeMy WebLinkAboutBuilding Permit # 5/13/2015 ... .................................. ............
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BUILDING PERMIT I., F D
0 6
TOWN OF NORTH ANDOVER 41-
APPLICATION FOR PLAN EXAMINATION iL 0
PermitNo#: Date Received ZL�IhArED 5
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Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER '�71 o C, ,
Print 100 Year Structure yes no
MAP Q?)"7,) PARCEL ZONING DISTRICT: Historic District yes q9
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
El New Building one family
El Addition El Two or more family El Industrial
[I Alteration No. of units: El Commercial
El Repair, replacement El Assessory Bldg D Others:
[I Demolition [I Other
nary P'r w A,
t SnitemJ-01 F-Jin IN 111
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DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: Phone: ,,,-7
Address: :13_
Contractor Name: t,,,J'1,) Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.,$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 30 () 0 FEE: $ .0
Check No.: � k; Receipt No.: -ellzs I WA
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
607'
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plate6 Stamped Plans ❑ ��
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swilming Pools ❑
Well ❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE NESE ONLY
INTERDEPARTMENTAL SIGN OFF m H FORM
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
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SERVATION Reviewed on � Si nature
l I
COMMENTS } _
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water els Sewer Connection/Signature & Date Driveway Permit
]DPW Town Engineer: Signature:
Located 384 Osgood Street
/
FIREI"DEPARdTI�IENT Ternp, Dumpster
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Located'at 124J MainyStreet /
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C0MMENd S'S
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Town of -1
miludover
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h1. ver, Mass, (AL 11)a
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COC MICc.2 MI MACK V
A0R',7ED A .(5 %J
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BOARD OF HEALTH
Food/Kitchen
PERI T1k% IF D Septic System
THIS CERTIFIES THAT ............. .... . . .....Cr . kaoBUILDING INSPECTOR
.. ...... . .. .. ..
Foundation
has permission to erect .......................... build' �
...................n
Rough
tobe occupied as .........%......1716. ........................... .... . .t................................................. 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
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 ONELECTRICAL INSPECTOR
LESS CONSTRUC ST S Rough
Service
............. . .............. Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Kermit Required t® 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 Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
TOWN OF NORM AND OVEP,
GFIBICE OF
BUM)DING,DE.0.f3.C .J[.I.Y.Li_rN r
1600 I)sgoodtxeeBuilding20, uzEe 36
7$�,,�n F4 � • •Noith Andovexy Massadhusett.-4x 845
�Atf1U5�. '
Gerald A.Brovrn '1`elepllox�e(978)688 95 5
lnspectorofl3ad3ngs Fax (978)689-9542
B t�1
-PPPMT")?LIC.A.TfON
` 1'leasepaiuE - .
DATE: L
BOE EtaC.A.TfON,' '!
Numb or Street A ddzess Map) ,ot
t ° "
Name. WorUham
w
—01-Y Tmm
%p coilJ
fihe euzxent eempfzan dor"holneowl?ers"was extended toeJuc�e ownex ae�tipied dwellings to t�vo units or;ess and
fa allow u�1,haallPa„vers to enga¢e an?bdi�Vidual•t'orhire,- ho does notpossess a Jic(=,nse,provided mat the oyez
acts as snpoxvisor). Statel3ulzding (Code Seotlon,x08.3.5.7)
DEMIT ON OFROMEOWNER ,
Persons) vvho awns aparcel of land on which helshe resides nr zntends to reside,on which there Vis,or zs intended to
b�,aorteortwo amilystzuctuzes. Apersmwhoconstzuctsmorethatonehomein•atwayearpezzodshallnntlle
co>zsidered ahameowz�ex
The mderszgned"llomeownce,assumeszespmszbxlityzoxcomplianc;es wifh the State Building Code azul other
.Applicable codes,lly laws,znles and-regulations.
The nndersigned"homeowm?rmrt�ues that WAD the Town ofgol fiAndo•verD-aildiug De�atEtt�emt
MiRimumi spectlonproceduresandrequkomentsandthath.e/shewillcomplywith;saidproceduresanl
reguireznents, .. � `
110AMOWN�9RSS1GXA-TD1W UA
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APPROVAL OP J3WD)NG OFFICIAL
3.2evised-7-2009
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1~orznSlozneoWners$xeznp�ion • ,
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8O.ARD OFAPP.EATS 698-9541 CONTSEMTAHON 685-9530
REAMW-9540P�.ATTNINCr 6S�9�3;