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HomeMy WebLinkAboutBuilding Permit #056-2017 - 10 Longwood Avenue 7/19/2016 F NO BUILDING PERMIT o� OE0q '1' t � ti 6 TOWN OF NORTH ANDOVER 4` ! APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received ATE0 �9 �SSgGHU5- Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION I d L dkg A l lVb AV6 Print PROPERTY OWNER 11 Vh A - Print 100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes` TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 2 One family ❑Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic El 1/11e11 ❑ Floodplain Wetlantls, ❑ Watershed Distract C7 Water/Sewer _ DESCRIPTION OF WORK TO BE PERFORMED: I l� lL " tr © <`G� Identification- Please Type or Print Clearly I yp Y OWNER: Name: -Tlr Lo fh.�J RV-e eZP1 Phone: Address:--L6UC Contractor Name: Phone: Email: Address: I. Supervisor's Construction License` Home . Improvement License: Exp. Date: ' ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PE MIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON 125.00 PER S.F. Total Project Cost: $ 860. Od FEE: $ <3,0 Check No.: Zoo 1 Receipt No.: W 6 lV NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund . contractor 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 6 Building Permit Application 4, 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 1 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 Doe:Building Permit Revised 2014 J Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Sody.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 m'U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature I COMMENTS ' I i J ?oning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes l =Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature Date Drivewav Permit DPW Town Engineer: Signature: Located 84 Osgood Street t4G �.r _ FIRE DEPARTyernpp mp„ster onsite �yesa "F oca s ' I Fire De�art�°r`•t-fes _.�-:.�..-ter u � . - • �., . ,� p z�ment,�signature%date ' -� <�. 'C®M' IVI E fV y . 1 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 f Location /z2 Z-A of A,t- No. ©� 7�j.� Date 07 /I' 26j,6 IIS • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ I Building/Frame Permit Fee $ rte j i Foundation Permit Fee $ '_ Other Permit Fee $ _ TOTAL $ r Check# r 9' 30630 4 Building Inspector � !