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Home My WebLink AboutBuilding Permit #Exception - 1 POND STREET 5/1/2018 Of �10RTH 1 BUILDING PERMIT 32 '`S LID "6�OG TOWN OF NORTH ANDOVER _ APPLICATION FOR PLAN EXAMINA Permit NO: Date Received Date Issued: �9SS�1CHUs EMPORTANT:Apphcant must complete all items on this page LOCATION e'�� 1v• M'� Pri PROPERTY OWNERS ZnL-A� Sav� Print MAP NO: 10 G. PARCEL: VT ZONING DISTRICT: Z Historic District yes Machine Shop Village yes Pno TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ew Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ emolition 4 ❑Other Septic ell ❑ Floodplain Aetlands ❑ Watershed District ❑Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: 21 ce. ZC- 'e Phone: Address: CONTRACTOR Name: Phone: Co t} _S IZ_6a CS Address: Supervisor's Construction License: l� 2- Exp. Date: 2 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER �a��, —� � 1p Phone: 201- ` 7 L1�Z2. Address: y2q +aoe bAa-hof Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ � -, Check No.: Receipt No.: NOTE: Persons contracting with u registered a retractors do not have access to the guaranty fu d Signature of Agent/Ownerfj nature,of contractor r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ i� TYPE F SEWERAGE DISPOSAL Swimming pools ❑ Public Sewer ❑ Tanning/Massage/B Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM CANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS ,� �t HEALTH Reviewed on Si nature COMMENTS f�x� Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water &Sewer Connection/Signature& Date Drivewa Permit T)PW Town Engineer: Signature: Located 384 Osgood Street n 6P nFPaRTMENT -Temp ®umpste� on site ye_s y r = -�_