HomeMy WebLinkAboutBuilding Permit # 11/12/2015 BUILDING PERMIT T, o
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TOWN OF NORTH ANDOVER ® _"-.•
APPLICATION FOR PLAN EXAMINATION P
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Permit No#:,S,�x'.�I3/,� Date Received m�
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Date Issued: >l �iJ cNu
E%IYORTANT:Applicant must complete all items on this page
LOCATION i i -j- ,3 I. y:� (LST L.{)
Print
PROPERTY OWNER
S' Print 100 Year Structure yes
MAP PARCEL: <` ZONING DISTRICT:-jE,,S Historic District yes_=j
Machine Shop Village yes
TYPE OF IMPRO71F
OSED USE
ntial Non-Residential
New BuildingefamilyAdditiono or more family ❑Industrial
❑Alterationof units: ❑Commercial
❑Repair,replasessory Bldg ❑Others:
❑Demolitioner�''ep�ic�7tVad �WaWWerGSeww __ \
DESCRIPTION OF WORK TO BE PERFORMED:
Pk terr 4k - . i - i --, t Y
ddentifiration-Please 1lype or Print Clearly
OWNER: Name:-
Address
V
ame:Address .d
Contractor Name: Phone: —�F +5Z-Y�V-
Email:
Address:Z :<. S ,1,� 1-1r Z n ea k
t r
Supervisor's Construction License: Exp. Date: 5
I Home Improvement License: Exp. Date:
ARCHITECTIENGINEER Phone:
Address: Reg.Nom'
FEESCHEDULE:BULDING PERMIT'$12.00 PER$1000,o0"THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F.
Total Project Cost:$ FEE:$
Check No.: /216 Receipt No.: T
NOTE: Persons contracting with unregisteredtractors do not have acces to the guarantyyurt
Plans Submitted Plans Waived❑ Certified Plot Plan❑ Stamped Plans❑
TYPE OF SEWERAGE D: Tb-.
I,
Pobiic Sewer Tanning/MassageBody.Art ❑ Swcacuc pools ❑
Well ocSales ❑
Food Packaging/Sales ❑
Private(septic tank,etc. Permaneta r ampstar on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
PLANNING a DEVELOPMENT Reviewed On Signature_
COMMENT S cso t 1`� h®`i=,• al' tI1,Si`:
CONSERVATION Reviewed on /-!5- signature `� s llr-
i
COMM_FNTSas�e�rd`fa
HEALTH Reviewed on Signature 'v k
COMMENTS j&&1 ,1 ,-S
Zoning Board of Appeals:Variance,Petition No: L;FAzoning Decision/receipt submitted yes_
Planning Board Decision:ji;ss 't1;8�'II Comments
Conservation Decision:- P ZgZ-,42-' Comments 71
Water&Sewer Connection/Si nature e t l y d e I Z
Driveway ermit
------999999------������.� y
DPW Town Engineer:Signature l
Located 384 Osgood Street
FIRE DEP ENT Temp Du ps on site ,es �' t , no,:
Located at 124
FireDepar#mentsignature/date
COMMENTS
Dimension
Number of Stories: Total square feet of floor area,based on Exterior dimensions. t >r
Total land area,sq.
ELECTRICAL:Movement oi:Meter location,mast or service drop requires approval of
Electrical Inspector Yes Ido
I
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA-(For department arse)
E q �i 1 �-u
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® Notified for pickup Call Email
Date Time Contact Name -
D—Bading Permit Revised 2014
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Town of a NORr� Andover
No. S�g'�i�
*�mph ver,Mass,
PERMITT® 3 U IOWL
BOARD OF HEALTH
Food/Kitchen
Septic System
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THIS CERTIFIES THAT........ i\ Z......`.. ................................................................................ BUILDING INSPECTOR
...........
has permission to erect..........................buildings on
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to be occupied as.............-�� .....:-.. ° ilk. lon>..0-W. ............................................. coney
provided that the person accepting this permit shall in every respect corm to the terms of the application F;nai
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
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PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIOARTS Roogh
_.,
Service
/ .............. mai
BUILDING INSPECTOROR
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildin; Rough
Display in a Conspicuous Place on the Premises—Do Not Remove Fi-I
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
ILLED
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FENCE 1
(SEE NOTE 2)
CENTERUNE
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LOT 11, 15 GRI1=I Lk),F,
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