HomeMy WebLinkAboutApplication - 846 CHESTNUT STREET 2/27/2006 NORTH A
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TONNN OF NORTH ANDOVER
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;APPLIC,A TION FOR PLAN EX<, MINATION
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Permit O: _----- Date Received:
Dote lssucd: ----___--
IMPORTANT: Applicant trust complete all items oil this pa��e
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LOC':ATION
PROPERTI' OWNER— �(Ki "cam —__�1�-L `r• —
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MAP NO.: jb PARCEL: '` ZONING DISTRIC"f__
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ i
r FY PE OF II IPRO\'EMENT PROPOSED USE —_ �
----- - -- Rential —- ---- Non- Residential
New Building - One family--
\ddition - Two or more family ( Industrial
Alteration No. of units:-_7 __ — � mm -i
F-Rcpair, replacement Assessory Bldg — - Coercial
Deillolition - --- -- Other --Others:
ti1oving(relocation) — ---_-----Foundation
DESCRIPTION OF \`ORK TO BE PREFORiVIED ---
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F,,,�IgAm, -c4 13c�<�Sr> M
WntiCcation Pleas�Type or Print Clearly)
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OWN
ER: Name: ���` �� Phone. >E `-
Sipn4ture
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_Address: �_ (� W ,'Z r tR.. Z 4__
� lj ;, c�s� rv�., Phone: t�`l'
CONTRACTOR islame: -
Address:
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Supervisor's Construction License:_ Date:�) t -- p
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I-l_ tte Inlhr"ncntcnt Liccnse:, e ck c, ° ---
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Address: y t . .
f-'EE SC'HEDC,LE:,3L LDI,\G PERMIT. i/0.00 PER 51000.00 OF TIIE TOT IL ESTIMATED COST 3.1,)ED 0A
S 1?S.00 PER S.F.
Carta Project Cr>st :`1�-----------------------xl(?.!)0 FLF:
Check
TYPE OF SE\b ARGE DISPOSAL i r Pools
Tanning;Ylassa, c Body ,art S��imm i
Public SONCI'
_ Tobacco Sales Food Packaging.Sales
well
Permanent Dumpstcr on Site
Private(septic teulk, etc. ✓
NOTE: Percuns cuntroctina with unre istere(I contructors du not hove uc•ce-vs to the guorithf),%nnd
Signature oC:\ ent,Owner r �r�c e t Signature of Contractor, /4
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Plans Submitted Plans Waived ! Certified Plot Plan Stamped Mans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
I'NTERDEPARTME'NTAL SIGN OFF- U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
—Mater Shed Special Permit
Lj Site Plan Special Permit
Other
COMMENTS
kTE REJECTED DATE APPROVED
�I
CONS ERVATION-�
C0N11 IENTS ` % 4c ( G --
DA FE REJECTED DATE APPROVED
�HE.kLTH
CONINIENTS
IV
-X AV
.'oninl Board of Appeals: �ariunce. Petition No:_-__-- —
/oil in- Decision.receipt submitted yes
=Lmnin� Board Decision: Cunments---
--__----
`,eater S,-v.er connection ;iunatrne �� ,latc
1',:mp Dump:�ter on site e =_ no-- Fire Department si`nature d itc
Buildin$2 PF�rmit approved 'Lwd lssu(:d I) --- ---- --
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Building Setback (ft,)
Front Yard j Side Yard Rear Yard
Reytnrcd Provided Rcqutrcd ProN ides Required ProN ided
DENIENSION —
Number of Stories: —Total square feet of floor area, based on Fxterior dimensions.
Total land area, sq. ft.:
No YI Es,Ind DATA —(For department use)
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