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HomeMy WebLinkAboutApplication - 35 HOLLOW TREE LANE 2/28/2007 NORT1{ p TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION ,SSACNUSe� Permit NO: Date Received: �� 0 � Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION -� rint r' PROPERTY OWNER �Z� ��Tf Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Resid tial Non- Residential New Building ne family "ddition ❑ Two or more family C Industrial C! Alteration No. of units: E Repair, replacement ❑ Assessory Bldg ❑ Commercial C Demolition C Moving(relocation) [I Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) '07� Phone: V1 — 7 OWNER: Name: Address: CONTRACTOR Name: 1�. i ' !' Phone: Address: ���' Supervisor's Construction License: Jf-6u Exp. Date: Home Improvement License: ! Exp. Date:' ARCHITECT'ENGI )0,n ,r�Ct',� Name: Phonef�g 7- Address: Reg. No. FEE SCHEDULE:BULDING PERM/ :$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost x10.00=FEE:$ Check No.: Receipt No.: il.,.:e I of 4 TYPE OF SEWARGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public Sewer ❑ ❑ Tobacco Sales Food Packaging/Sales Well Permanent Dumpster on Site Private(septic tank, etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of Contractor ertifi Plans Submitted ©� Plans Waived ❑ Ced Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS ^ El REJECTED DATE APPROVED '� �1 � CONSERVATIO COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ f' COMMENTS /'I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Continents Water& Sewer connection signature&date Temp Dempster on site yes—no— Fire Department signature/date Building Permit Approved and Issued by: Page 2 0 r4 J IZS - s x �3 _ -A7 dam• �! �°�+�^ I ° vas 7 � ............. ....................... ............. ........ , . _ .................w. Zoo e � •y,w ` r � ry m m , r e v m s, + nib a.:.,,.,,, .�.�,,,� w,,. ,,,,.nui,✓.. °,mow. ...... .. �., A „r ,, , ,,, ,,,,,, .. 9 C.. , r w � G W & wr113 " w w w" w ww.. �,...._, .�_ ..__._._.,, ....._._a, .n.....e...... ...,. �....wwww..www.....w„ ,....... ................ww«. aw ww �w h �VwW°b Y � u. h. h ¢!,n° �ulY xr.+w,n�w.mw...r..w..w«....w.w.wmm. :.i..,.. a w