HomeMy WebLinkAboutBuilding Permit # 6/15/2016 %AORTH
BUILDING PERMIT O�ggL@D
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO#: t ®�' Date Received �,� �•grDWPpa��y
Ssacmaus�
Date Issued:Q 'J>
IMPOR A' NT: Applicant must complete all items on this page
LOCATION 73 �e7lrll �1
Print
PROPERTYOWNER
Print 100 Year Structure yes no
MAP PARCEL: ZONING DISTRICT:_ Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑'Septic; 01Nell ❑ Floodplaim. Wetlands ❑ Watershed District,
01/l/ater/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please'Type or Print Clearly
OWNER: Name: Zr,'c- Phone:
Address: L,'�J �✓ ,�9��
Contractor Name: P e:
Email:
Address:
Supervisor's Construction cense: ® Exp. Date:
Home Improve ent License: Exp. te:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$ 2.0 ,PER$100 0 OF THE TOTAL ESTIMATED COST BASED TQN 5.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
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' town ot Andover
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INF-
U BOARD OF HEALTH
Food/Kitchen
PERMI I TU LD Septic System
TRIS CERTIFIES THAT 5
BUILDING INSPECTOR
has permission to erect .......................... buildings on ......:......... . Z . . .
A ..... .... ................. Foundation
Rough
to be occupied as . .. ...... . . .... .. ..� ....... .e..... ........................................ Chimney
provided that the person accepting this permit shall in every 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.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONS 0 Rough
Service
.. . .. &BUILINSPtECTOR
.. Final
GAS INSPECTOR
ccupancy Permit Required t® Oeeupy 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.
10
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