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HomeMy WebLinkAboutMiscellaneous - 35 STANTON WAY 8/10/2015 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit `10: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page _LOCATION r r Pnnt y PROPERTY OWNER 1 Prmf 100 Year Old Structure yes no MAP X10 PARCEL ZONWG DISTRICT HistoricDistnct yes no }. _ - Machine Shop Village yes .. _ . : no TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ew Building >ipne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other '.❑ Well q Floodplain ❑Vl/etlarids ,Watershed Di`stnct ate Sewer. DESCRIPTION OF WORK TO DE PERFORMED: Identification Please Type r Print Clearly) OWNER: Name: `�Z� d � �g�o Phone: P"� 5 ® ���2 c c , �� Address: ':.CONTRACTOR ;Name Plone. a�,�'�r1`� :5� Address iG = �, r�{rt� % r� - Supervisor s Construction License t� � °,� ' Exp Date s1. :Home Improvement Ucense` Exp Date ARCHITECT/ENGINEER f/k&y ��Z/'� Phone: : 3V21 � Address: S_e(.) � v � e � �, ���2®� �r�r ILW. Reg. No. 901 7 FEE SCHEDULE:BULD/NG PERMIT.$12.00 PER$1000.00,OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total P� ,9, ,_ ®jest Cost: $ ,_ y FEE: > �`F; Plans Submitted Flans Waived ❑ Certified Plot Elan Stamped Plans Q' TYPE OF=SEWERAGE DISPOSAL Public Sew?r E1 Tanning/Massage/BodyAil E . Swimming Pools ❑ Well El _Tobacco.Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc.. _ :permanent Dumpster on Site ❑ THE.FOLLOWING SECTIONS FOR OFFICE.USE ONLY INTERDEPARTMENTAL SIGN OFF - U.FORM .. DATE REJECTED DATEAPPftOVE-D PLAN-NINE & DEVELOPMENt COMMENTS_ :CONSERVATION Reviewed on Si nature COMMENTS .- C:7-� , -- �1 L—i �L HEALTH Reviewed on .ILI S iq natJe �� L COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes _ Planning Board Decision: Comments Conservation Decision: :Comments 1 Water & Sewer C onnecti on/Si c ]naturej& Date Driveway Permit. d DPW Tow;! Engineer: Signature: Located 384 Osgood Street SIRE-DtPAPTM.E.NT .-_Temp DumAter on site yes no Located'at 124 Main Street . Fire`®epaftmerit signature/date COWENTS