HomeMy WebLinkAboutBuilding Permit # 5/13/2016 %AORTH
BUILDING PERMIT '11"Fo6"6
TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION
90
Permit No#: Date Received
US
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION (4c, <-)Q'S
Print
PROPERTYOWNER -7k-Z,
Print100 Year Structure yes
MAP PARCEL: ZONING DISTRICT: Historic District es �`hb,--)
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Machine Shop Village yes o
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
"New Building One family
El Addition El Two or more family id Industrial
0 Alteration No. of units: 11 Commercial
11 Repair, replacement El Assessory Bldg El Others:
11 Demolition 0 Other
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DESCRIPTION OF WORK TO Bn PERFOR_ MED"
Nve,
Identification- Please Type or Print Clearly
OWNER: Name: P h o n e:
Address:
Contractor NaMEP' Phone:
Email:
Address: L. Su o 8,4
Supervisor's Construction License: Em. Date:
Home Improvement License: ......°°°°......... Exp. Date: ..............
ARCH ITECT/ENGI NEER 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: $ ��- ��-e,,
FEE: $16e),66
Check No.: Receipt No.: -,;30-5 7
NOTE: Persons contracting with unregistered coq, ctors do not have access to the guaranty fiat
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Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPEOFSEWER-AGE DISPOSAL
E
Public
S,
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ublic Sevver Tanuffig/Massage/BodyAit ❑ Swiron"n9pools 0
Well ❑ Tobacco Sales ❑ Food Packaging/Sales 11
Private(septic tank, etc. 0 permanent Dwripster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On ,gym signature_2'
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS z��'
HEALTH Reviewed on SignatUia
COMMENTS— I,,,ry
Zoning Board of Appeals:Variance, Petition No: 2d()",oe)j Zoning Decision/receipt submitted yes
Planning Board Decision: —Comments
Conservation Decision: 'q 2" —Comments
Water& Sewer Con nectio n/slignature & Date Driveway Permit
DPW Town Engineer: Signat-tire: z
Located 384 Osgood Street
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Located6at 124'Main Street O!"_4
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RATED PP��,�S
U BOARD OF HEALTH
Food/Kitchen
rERMI L D
Septic System
�� BUILDING INSPECTOR
THISCERTIFIES THAT ...................................,........................................................................................
Foundation
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has permission to erect .......................... buildings on ................... ... ......
Rough
tobe occupied as ................................ .. ..... .... ............................................... ........ Chimney
provided that the person accepting this permit shall inemery respect conform 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.
Funal
PERMIT-EXP.IRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS I ITS Rough
..... Service
.............: ..... . ........ .. ..................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
LathingNo r all oBe Done FIRE DEPARTMENT
Until Inspected and Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
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