HomeMy WebLinkAboutMiscellaneous - Sweet Heart Cup-Phase III 256 (2)TOWN OF NORTH ANDOVER BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
ROOM
Section for Official Use Onl
BUILDING PERNIlT NUMBJA-L: Comm `� ►�' DATE ISSUED: 3 ,
SIGNATURE:Id
,Commissioner
Buildin
or of Buildin Date
e
4' 1.1 Property Address:
1.2 Assessors Map and Parcel Number:
3�1 �o�T Rax1t�
��
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�j
/l %- /9Y`�o G ✓`�'\ � l 8ys
fvhip rfrmber Parcel Number
5Ce PI 'FIS{ F% 'D�Aw#�►
OS
1.3 Zoning lnformaticn:
1.4 Property Dimensions:
/, 208,3.3'5` S.F, 3 83%z�
Zonis District Proposed Use
Lot Area Frontage 8
1.6 BUILDING SETBACKS (ft)
Front Yard
Side Yard Rear Yard
R Provide Required
Provided Required Provided
1.7 Water Supply M GI C.40. 54) 1.5.
Zone
Flood Zone lofo=tion: 1.8 Sewerage Dkposd System:
Outside Flood Zona 0 MI..& ' On Sita Disposal System 0
Public ❑ Private ❑
2.1 Owner of Record
.1014 fiNl% lll&v LLL'
//3- Sym IlZrl a ,9 VE; Y��yif1l1i9, Ny
Name (Print)
Address for Service
JON 1, jfhA O
91 6 63"06
Signature
Telephone
2.2 Authorized est
7199 �NN67?d3t2T ,[3LtS>�f Gam' Dis'
14,1
617466
✓S7XyC274,1 CO. -ST, Gay/S� /10• G3�/y
Name ' t
Address for Service:
L41
y�a9-S'joo
Signature
Telephone
.1 Licensed Construction Supervisor
t
Not Applicable ❑
Address
License Number
. z
Licensed Construction Supervisor.
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name._
Registration Number
Address
Expiration Date
Signature Telephone
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0
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0
X
z
0
z
M
90
0
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r
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0
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k,
New Constriction 0
Existing Building [7r Repair(s) 0
?Alterations(s)
Addition 0
Accessory Bldg. 0
Demolition- ' Other 0 Specify
A Assembly
Brief Description of Proposed Work:
W(IN07-
A-2
A-5
0 . A-3
0
1A
1B
0
7'
11#0'
jw-, AWAI-17-
M.0-11IN4
Number of Floors or Stories Include
Basement levels
Floor Area per Floor (sf) CAA_P-d-LA<
Total Area (sf)
'Total Heiaht (ft)
Independent Structural Engineering Structural Peer Review Required Yes D No D
SECTION 10a Owner Authorization - TO BE COMPLETED WHEN.
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Z JOAI 2 as Owner of the subject property
Hereby authorize_44,fY40 6,4ehz 6 hWl—'- 5V to act on
My behalf; in all matters rel ed by this building permit application
Signature 00wol,
USE GROUP (Check as applicable)
CONSTRUCTION
TYPE
A Assembly
0 A-1 0
A-4 0
A-2
A-5
0 . A-3
0
1A
1B
0
B Business
11#0'
2A
2B�
2C
.0
0
0
C Educational .0
F Factory 0 F-1 0 F2 0
H High Hazard
0
3A
3B
0
0
1 Institutional 0 1-1 .,0 1-2 0 1-3
0
M Mercantile
0,
4
D
R residential
0
R-1 0
R-2
0 R-3
0
5A.
5B
0
0
S Storage 0 S-1 0 S-2 0
U utility
M Mixed Use
S Special Use
0
0
0)
Specify:
Specify:
Tcify-
Specify:
COMPLETE TEOIS SECTION IF EXISTING BUILDING UNDERGOING RE
R6VATIONS, ADDITIONS AND OR CHANGE IN U__
USE
Existing Use Group:
Existing Hazard Index 780 CMR 34: CA1o(�
Proposed Use Group: �%)`-7 WVh ,A
Proposed Hazard Index 780 CUR 34: L10 C*A*Z,
jw-, AWAI-17-
M.0-11IN4
Number of Floors or Stories Include
Basement levels
Floor Area per Floor (sf) CAA_P-d-LA<
Total Area (sf)
'Total Heiaht (ft)
Independent Structural Engineering Structural Peer Review Required Yes D No D
SECTION 10a Owner Authorization - TO BE COMPLETED WHEN.
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Z JOAI 2 as Owner of the subject property
Hereby authorize_44,fY40 6,4ehz 6 hWl—'- 5V to act on
My behalf; in all matters rel ed by this building permit application
Signature 00wol,
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 Yea .......0 No ....... O
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y
5.1 Registered Architect
l ,
V `1 r (� - � � '
C --), op ED 't''C
E
C�� �PL
M No. 10868 N
o 5T. LOUIS,,
PG
Name:- .: ` / GJ 1, O j//;/40 7,/121
P/0 64
Address
�ol a
Signature Telephone
meg 110
Area of Responsibility
_
Registration Number
Expiration Date
Name:
Address:
Signature Total
Not applicable ❑
Registration Number
Expiration Date
Name:
Address
Signature Telephone
Area of Responsibility
Registration Number
Expiration Date
Name
Address
Signature Telephone
Area of Responsibility
Registration Number
Expiration Date
Name
Address
Signature Telephone
Y, AM ;
Not Applicable 0
Company Name:
Responsible in Charge of Construction
Location
No. " �'f-� LLL Date
NORTN 1TOWN OF NORTH ANDOVER
yO
6 OC
9
Y
Certificate of Occupancy $
cMustBuilding/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $`—"
Check # SS644.
Building Inspector
I
V II P. v/001l JILOIUUCCI LI/lU`�/(/CQi1JlLl.'�(IdB�
BOARD OF BUILDING REGULATIONS
Aconac CONSTRUCTION SUPERVISOR
Number: CS 063158
Birthdate: 0=511972
13901res: 00512002 Tr, n6, 3916
To: 00
ARFRiD MEORMAN
1 i 1N rg VC11TPORT STA OR
MARYLYN MOTS, MO 63043 Administrator
! f�L ts:i i8 S.80t�
JA - M4 eRtit
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f*M 14 MUM 4 MMnt edition of the j
M RNWAN11% 8141@ building Code
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NM W MvMft of thin licenae,
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@1@ LAK CALL CENTER: (888) 344.7233
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TOWN OF NORTH ANDOVER
OFFICE OF THE BUILDING DEPARTMENT
COMMUNITY DEVELOPMENT AND SERVICES
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 01845
D. R. Nicetta,
Building Commissioner
Telephone (978) 688-9545
FAX (978) 688-9542
FAX TRANSNIISSION
TIME: �,J DATE _ NO. OF PAGES
FROM:
SUBJECT:
BUILDING DEPT FAX NUMBER 978-688-9542
Fax To:
REMARKS:
BOARD OF APPEALS 688-9541 BUILDINGS 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535