HomeMy WebLinkAboutBuilding Permit # 4/25/2016 BUILDING PERMIT of NORTH
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TOWN OF NORTH ANDOVER o
�" APPLICATION FOR PLAN EXAMINATION '' ' 7D
Date Received
Permit NU �4p�Rnreo Peas•(`�
�SS, CHUS
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION as l" 7`_ WAY
Print
PROPERTY OWNER S'VAI /06
Print 100 Year Structure yes
MAP PARCEL: ZONING DISTRICT4
UMAPHistoric District yes
Machine Shop Village , yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
pSNew Building AOne family
❑Addition ❑Two or more family ❑ Industrial
❑ Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
DESCRIPTION OF WORK TO BE PERFORMED:
meg,' 6 9 _
Identification- Please Type' r Print Clearly
OWNER: Name: /A 555W �4 eon "fd ria A Phone: � �r�'��� P 16
Address CVI t\J 6T6 w �jp MA 0' e •
Contractor Name: rS r:� _ fiCl Phone:"" _
Address: Iv :5 cad aD MA
Supervisor's Construction License:�'S A �°�� 31 ' Exp. Date:
Home Improvement License: ' Exp. Date:
ARCHITECT/ENGINEER�, QPef0�� hone - �' 1
Addressz iZ2 z-) /1I Reg. No.
FEE SCHEDULE.BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $ ��� C90
Check No.: I ® Receipt No.: 02
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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Plans Submitted)g,,, Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans
TYP
E
OF SEWERAGE DISPOSAL,
Public Sower ❑E
Tanning/Mass
age/Body Ar ❑TSw
ilrning Pools ❑
Well rTobacco Sales ❑
Food Packaging/Saks 0Private(septic tan1c, etc.
Permanent Dumpster on Site F1
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING DEVELOPMENT Reviewed On
I t .-, �-) Signature'----,-,.
C
COMMENTS
i
CONSERVATION Reviewed on
Si nature
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IS
TS
COMMEN
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HEALTH Reviewed on Signature
COMMENTS
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Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes_
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/Signature & Date Driveway Per
DPW Town Engineer: Signature:
Located Osgood Street
..........
........................
45/1/GW,
dOMME
t% R TH
Town ofE � Andover
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C% h , ver, Mass,
COCMICHEWICK y1.
x,45 RA-neo ok"
U BOARD OF HEALTH
PERM-IT T L �D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT ....... ..��.: � ��.. ... . ����� ••• ••
............ .... ... .�'.. ..... .... ...................
O'er Foundation
has permission to erect ... buildings on . . ®/ �
Rough
to be occupied as ....... . .. ..fit. .....! ..
p ® I� ...... Chimney
............. .......... . ..... . . ............ .
provided that the person accepting this permit shall in every respect nform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.'
Final
IT EXPIRESI 6 ®NTS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIONSTARTS Rough
Service
.... . .: ..................... Final
BUILDING INSPECTOR
GAS INSPECTOR
ccupancy Permit Required t® ®ccum Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.