HomeMy WebLinkAboutBuilding Permit #Exception - 0 Martin Avenue 5/1/2018 J
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BUILDING PERMITNoRTti
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TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received 7 A�R^TEo Pp`y(
�SSACHUS��
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION
PROPERTYOWE R.. - nt , ..'�,� .. Vice�1 _ Aloc
Print
MAP.24e_ PARCEL:36 . . . ZONING DISTRICTi� J*ric District. yes.•Cno
Machine Shop Village yes eno
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
ew Building ane family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
�0'S ptic p Well. Floodplain :b Wetlands ❑ Watershed District.
ater/Sewer.
D CRIP •ION O�WORK .O BE PERFORMED:
cli �-
Identification Please Type or]Print Clearly)
10 ��;�t «-� �. i((r. � Phone:
OWNER: Name:Ut��- k 'P11 ---
Address:--R� aziK 3 7 F 0(9 s�J
CONTRACTOR Name: h
Address.' D '3y .3z
Supervisor's.Construction License: �l� Z. -Exp.'Date:. . ' '
Home jmprovemeni License: Exp. Date:
ARCHITECT/ENGINEER Phone: 7 E'
Address: Reg. No. 6L 1-P
FEE SCHEDULE;BULDING PERMIT;$92.00 PER$1000.00 OF THE TOTAL,ESTIMATED COSI'BASED ON
$925.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/OwnerSignature of contractor
Dimension
If �
Number of Stories: Total square feet of floor area, based on Exterior dimension �AQ�L
Total land area, sq. ft.: 0<:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA For department use
El Notified for pickup - Date
Doc.Building Permit Revised 2010I0ctober