HomeMy WebLinkAboutBuilding Permit # 12/5/2016 0O RT11
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION �
�a 1.
Permit IV4 Date Received xrq o+areo F`+`
Date ISSlked:
()RdT: Applicant must complete aI1 items on this page
(Dry%
LOI ATI�� N
PROPERTY OWNER I e
Print 1( a Yearnl
ructur6 Yes no
MAP PARCEL: ZONING DISTRICT; _.._,_Historic District yes no
Machine Shop Village. _Ye5 no.---.
TYPE OF IMPROVEMENT PROPOSED USE _-
ResidentialNon- Residential
1.1 New Building- F1One family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement 0 Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑ Well ❑ Floodplain r-.1 Wetlands ❑ Watershed District
U Water/Sewer
�-1�3ESC RIP TIO FW R TO E EIR ORMED,
in
Identikation- rkf
ase Type or P 'nt Clea7rly _..
OWNER: Dame. ,, r . Lilj Phone.
Address:
: Phone:
Address:
Supervisor's Construction License: _ Exp. Date:
Home Improvement License: Exp Date:
ARCHITECT/ENGINEER Phone:
Re No._` (e �6
4
Address: _ g
PEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED $125.00 PER S.F.
1 FEE: $
Project Cost: $ J _--_ $
Check No.: _ Receipt No.: _
. OY Iyer a con cit ing with unregistered contractors (Io not have.-access to the guaranty
Sidnature of coritractor
1
-imension
Number of Stories: Total square feet of floor area, based 6-n Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop)-eq€aires approval of
Electrical Inspector Yes No
DANCER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$[000 fine
NOTES and DATA For department use)
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❑ Notified for pickup Call Email
ate Time Contact Name
Doe.Building Permit Revised 2014
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Town o ndover,
ver, Mass
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BOARD OF HEALTH
Food/Kitchen
PE I Septic System
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'��� .. BUILDING INSPECTOR
RMTHIS CERTIFIES THAT .. . ..
.,........, .............. .. ., • Foundation
.. ....
has permission to erect............... ...... buildings on ...... ............. ........
.......... Rough
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Chimney
to be occupied as � " N � ••• ” """ '
provided that the person accept g 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 PLUMBING INSPECTOR
Construction of Buildings in the Town of North Andover.
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit. Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CON TI Rough
Service
••• ... Final
BUILD SPEC R
GAS INSPECTOR
Occu ancV .Permit Required to Occuey Buildin 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.
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