HomeMy WebLinkAboutBuilding Permit # 7/14/2016 ----------
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BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
4
Permit No#: Date Received
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Date Issued: CH
Rip ': Applicant must complete all items on this page
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LOCATION "ac� Z� A U'1"w q� 4 - � (
Print
PROPERTY OWNER
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
0 New Building One family
0 Addition El Two or more family [I Industrial
I. Iteration No. of units: Li Commercial
Repair, replacement [I Assessory Bldg 0 Others:
0 Demolition El Other
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DESCRIPTION 0 ORK TO BEP R Ea:
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Identifleation - Please Typ r Print Ole rly
OWNER: Name. Phone;
Address: L t�,
Contractor Name: - GLAY7"l-'A'11 hone. -18el
Email' "a mC'cw�
nko Y,
Address;�:__
Supervisor's Construction I Exp. Date: 6:21 ?,cl,
Home Improvement License: Exp. Date: -----------
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ARCH ITECT/ENGI NEER � Phone:
Address: Req, No. 0'2, :�
FEE SCHEDULE. BULDING PERMIT.$12.00 PER$1000.0 THE TOTAL EST!QTED N'T BASED ON$125.00 PER S.F.
Total ProFEE:Cost: $ $
Check No.: Receipt No.: (P zo
NOTE: Persons contracting with unregistered contractor v do not have ecce Is the guaran, 4nd
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} Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/B ody Art ❑ Swiiumiug Pools ❑
Well Tobacco Sales Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Durnpster on.Site ❑
THE FOLLOWING SECTIONES FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OPE - U FORM
PLANNING & DEVELOPMENT Reviewed On j?iA l(�) Signatures
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed ori Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/si nature &Dade Drivewa Permit
DPW Town Engineer: Signat:u€re:
Located 384 Osgood Street
FIRE IEIVT Terrtp D�t,mpster on sEte yes
Located at 124 Marri Street
Fire=Department signatureldate' _ �r
COMMENTS
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BOARD OF HEALTH
Food/Kitchen
PERMIT LD Septic System
THIS CERTIFIES THAT .. . .A �� BUILDING INSPECTOR
.... ... .... .................�����.... ...... ���.. ........ Foundation
has permission to erect.......................... buildings on
. Rough
to be occupied as Chimney
provided that the person ac in this permit shall in eve respect conform to the terms of the lica I n
p A g p p pp Final
on file in this office, and to the provisions of the Codes and By-Laws rel ting to the lnsRpction, Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
%PAOVIOLATION of the Zoning or Building Regulations Voids tht. p� �� Rough
Final
PERMIT EXPIRES 16 MONTHS ELECTRICAL INSPECTOR
UNLESS CONST TI® TS Rough
Service
.. .:. .,. ....... .....
"""" Final
BUILDING SPE TOR
GAS INSPECTOR
Occupancy Permit.required to ®ccm Puildinje 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.
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