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HomeMy WebLinkAboutBuilding Permit #Exception - 0 Ogunquit Road 1/20/2010 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page i_OG 'T ON h i , P,a�nt • PRtJP.ERTYfl�71/ lERf'.t�l''" Y�./ Print I111Ai?NO: ROEL : _ZONIIGSTR1,TlNistoa is 3?asta�ct yes, b • ' . _, f lachine Zhbp Vallag p -yes i10 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Buildin One family) dition wo or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other t" le11 F�lr odDlam, etla ids etershert Dash ct DESCRIPTION OF WORK TO BE PERFOED. stru� on. YL R � ► �'1011�4� 3 o sq -F CD) OP-) ICA I C-.-CLC�e-, Lind -e .Identification Please Type or Print Clearly) I , OWNER: Name: 1 Phone:�1� Address: �7�7C7 PSC- jv21 "St �J - Y)6OYtK 77777 Cr�1TRAC7OFt Namey e 5'12 ?honea``� `� Address `7 b Super�asor'sonstructio� l:lceas � 1`xp Date �,Cl.l.O "Honesrn:pa-ovaYaaent I.aeense : .,� 3 Etp Date_ 10 ARCH ITECT/ENGINEERIa I(i� _ ill t n s Phone:���( Address: JPR )n ma Reg. No. 7(D5 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund R,= Si nature of A ent/Owner - 9 a - 9 Signature of contractor .. Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site II THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on U Si nature 3 WV 1�1 COMMENTS i' � HEALTH Reviewed on Signature f COMMENTS y ,�fl�-z - ,-z.S -3//9// Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes PlanningBoard Decision: Comments Conservation Decision: Comme Water & Sewer Connection/sic naturW� f��eZV Drivewa Permit DPW Town Engineer: Signature: Located 384 Osgood Street BRE'DEP.ART.MEKT -'Tern a ster Dn Usite. P des �,no, Lcated-,at 12 llain.Street' Fire Departrhen#signature/bate 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.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 i Building Department i 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 I o 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 ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 i New Construction (Single and Two Family) Building Permit Application 0 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 ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: 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: Doc.Building Permit Revised 2008