HomeMy WebLinkAboutApplication - 27 BRADFORD STREET 5/16/2016 BUILDING PERMIT OF"°RT b�ti
TOWN OF NORTH ANDOVER + 4` °o
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
��SSACHUS����
Date Issued:
IMPORTANT: Applicant must complete all items on this page
- r rit
ilrylAPNO _PARCELONING'D1STR"IOTIsforic �s#r�cfi yes n�
` „__ Iachiriei�op.Village _ yes . no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building � One family
Addition — 3 Sson�SJN ton Two or more family Industrial
�
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
olition Other
pfi�c Weld t floodplam _ V1/etlands 1Natershed District
e�inraw� XlJ7`l�v�j DESCRIPTION OF WORK TO BE PREFORMED:
/® ex./y Svlu�c-le 7-0 7746 -r S:; ®/'-',
SU,v�e)� /�S �ca2 /�LA�()
Identif cation P ase Type or Print Clearly)
OWNER: Name: LA) V=z6 /60"—c Phone: 97� -790
Address: c9 7
f 1
ARCHIT CT/ENGINEER C : JOSS Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 3 g�C'� '- FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
r
Signature of AgentlOwner- ' . Signature of contractor
_ _ _
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well 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 DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Si nature--/"
COMMENTS /G�C� C'
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Me
Conservation Decision: Comments
Driveway Permit- F�
Water & Sewer Connection/signature& date �
DPW Town Engineer: Signature:
Located 384 Os ood Street
FARE DE�ARTMENT Terrap}Dulr�psfer=on site des no � ,� �'� ,,���
atetl4�1llarn Street � ,