HomeMy WebLinkAboutBuilding Permit # 5/24/2016 OORTH
BUILDING PERMIT ,,FD
TOWN OF NORTH ANDOVER 0 .........
APPLICATION FOR PLAN EXAMINATION
Permit No#: 22 tot Date ReceivedATED
S C US
Date Issued: 2
2 1i�PORTANT�.: App�licant�must complete all items on this page
LOCATION
Print
2--" F—
10 Year SuPR0PERTY OWNER &� 7� /e
Printcture yes no
MAP 16"5 PARCEL�3+ ZONING DISTRICT:_`__ Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
Li New Building El One family
El Addition EI Two or more family Li Industrial
L1 Alteration No. of units: E] Commercial
Li Repair, replacement El Assessory Bldg El Others:
11 Demolition 0 Other
.0/5011
DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
Contractor Name: Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date:
Home improvement License: Exp. Date:
ARCHITECT/ENGINEER 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: $ , FEE: $ t ?> 0 z
34
Check No.: 1b Receipt No.: �30+01
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty.fund
ntr, 4�z
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Town of
ndover
No.
LAK. h ver, Mass,
COCMICHRWICK
U BOARD OF HEALTH
PErx Food/Kitchen
M IT 1�1� LD Septic System
THIS CERTIFIES THAT .........
/��f��•�....•• •.��°. .��'..: G"`': ;,Z-/� BUILDING INSPECTOR
has permission to erect .......................... buildings on ., .�....( . :;f; a ...va Foundation
Rough
to be occupied as ...........................� ,�.lb.... �.: /
...................................................................
provided that the person accepting this permit shall in every respect conform to the terms of the application Chimney
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Final
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
EXPIRESPERMIT T S ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS Rough
Service
............ ....... .......... ... ....................
.....G INSPECTOR Final
GAS INSPECTOR
ccupancj7 Permit Required to Occupy Building
Rough
Displayin a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.