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HomeMy WebLinkAboutMiscellaneous - 42 North Cross Road 42 NORTH CROSS RD MAP 106 PARCEL 97 Location �� l Nc�SS lJpw 1/V 0 No Date n`3 —O() NORT►, TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ' Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ e�S Check # Ing. 14. - 377 A/ft rc(I- - Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED. X SIGNATURE: Building Commissioner/I for of Buildin"gs Date Z SECTION I-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: c.,�4 Z Ce-©&S -Rc3 w L YJ /O(o FY Map Number Parcel umber O 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Rajuired Provide R red Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record n (� �la,rZC– VC �a 1 �f�y7 Name(Print) Address for/Service: p Signature Telephone --l- 2.2 Owner of Record: 6 --' Name Print Address for Service: kAg6ture Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ - sk-kAtLS,tA,AL,.D p�Z7.� `Tstruction Supervisor: License Number Expiration Date i Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 i 1�C ��aE� �� Co s, V-V C\ Company Name , 1 (p 3 m Registration Number r Address r S97-39 a Expiration Date Signature Telephone Y� SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes........11 No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify cicse in d.*r-k Brief Description of Proposed Work: Q, 12�n�C� S106 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(8)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, P_A-,,Z� ,as Owner/Authorized Agent of subject property Hereby authorize Mtto act on My behalf,in al -natters r tiv to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I,V__ as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Own er/A ent Date mr Elm NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMMERS 191, 2 ND 3 SPAN DMIENSIONS OF SILLS DM ENSIONS OF POSTS DINIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE `y� u Commonwealth Engineering Associates, Inc. MORTGAGE SURVEY This certification on this plan Is made for mortgage purposes only. The undersigned will not be responsible if this plan Is used for boundaries, fences, plantings, special permits or variances. IY/F WILCox NSF RAGS ' 85.51, - -,60.75 LOT 20 A = 431566 s•f• M LOT 21 � ' if = LOT 19 LU k ) .( N w 0ca o 1 N r 0-OO' I i Dec I NO. 42 0 2 srrw000; FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. ..............:..(...(.'.....i.. .....(.�.�. .i APPLICANT .......PHONE ■�•��`... ��R I C ffLL(?ca Io.� V C ASSESSORS MAP NUMBER LOT NUMBER / SUBDIVISION LOT NUMBER STREET - STREET NUMBER`` ............. OFFICIAL USE.ONLY........R;e GAOe_ .............. RECON RAENDATIONS OF TOWN AGENTS a ( z 4-mo lis . ... . . ................................... ......pp.. .............. L DATE APPROVED P a� ON RATION ADMINISTRATOR DATE REJECTED COMMENTS I DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS { DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEAL DATE REJECTED a COMMENTS PUBLIC WORKS-SEWER/WATER NNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED J COMMENTS RECEIVED BY BUILDING INSPECT R DATE t �Zi � X21 Q�xz �a r x ' F g y-2 �� 15md►cG �t - ` i E.k r 5T i e-�C1 Po2C N '" 0 �1a9 I O� S�T�PS SC 2 EE►.� pptZ C� F-;- 14) OSS?S �'d1STS I d i BUILDING DEPARTMENT DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: Location of Facility Signature of Permit Applicant i Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 3 - 1. r - BOARD OF BUILDING REGULATIONS ; License: CONSTRUCTION SUPERVISOR Number: CS 062751 Birthdate: 06/16/1963 Expires:06/16/2002 Tr.no: 27020 Restricted TO: 00 ' MICHAEL P SHAW 98 ANDREW FARMS RD BOXFORD, MA 01921 Administrator --T HOME IMPROVEMENT CONTRACTOR Registration 118637 Type - DBA Expiration 04/09/01 MICHAEL P. SHAW CONST p�AEL P. SHAW ADMINISTRATOR 98 ANDREWS FARM RD BOXFORD MA 01921 _ t .+� e. t h �� �. v t�:t✓Y��yp,''�f�a'C*�iw� `�t�� R�"1 ..3 � '';Ij i y� t NORTfl Town of Andover 0 511 �. o dover Mass. 0� COCMICMEWICK ' ' ORATED `S BOARD OF HEALTH PERMIT D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .r.... t.. ...s ..........................................Z* . ................................ .. . Foundation has permission to erect.... O.O....................... buildings on .....'T.O�' .... 5►, ON�;......4�.1 ..• Rough to be occupied as �� r � ...�"...........................�. CE..........3014 IM Chimney r`.......�Z.:.................Z�. �' IL S provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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. yy� n 6 P Cc r* tg PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 4 .nc* Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI Rough Service ;rCqLjD6ING ........ .........A.. INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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 Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.