HomeMy WebLinkAboutBuilding Permit # 9/19/2016 -� y�ORTty
BUILDING PERMIT
TOWN OF NORTH ANDOVER °
_ APPLICATION FOR PLAN EXAMINATION
Permit NO: I V Date Received' -
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Date Issued: - �SS
I PORTANT:Applicant must complete all items on this page
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PFROPERTY+O OWNER Q
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Machine Shope Village y4k i nol
TYPE OF IMPROVEMENT 1 PROPOSED USE
Residential i Non-Residential
New Building tOne family
Addition Two or more family Industrial
Alteration No.of units: Commercial
Repair,replacementAssessory Bldg Others:
Demolition I Other
Septic Yte1I �trrdplair, Wetlands, } 0 Watershed District
18terlweE
Identification Please Type or Print Clearly)
OWNER: Name: Phone
Address: �om� E3. A 01 �
Ct) TRAR Ne: .; � mom° = ,,
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ARCHITECT/ENGINEER wasmn hone:$ �'7
Address: Reg.No.
FEE SCHEDULE:BULDtNG PERM7L$1200 PER$1000.00 OF TME TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F.
Total Project Cost:$ FEE:$
Check No.: i'- 1 Receipt No.: b t;
NOTE: Persons eontractzng w egis red contractors do not have access to the gf my fund
Signature of tlOwner r Signature of contractor