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HomeMy WebLinkAboutBuilding Permit #Exception - 100 FOSTER STREET 5/1/2018 BUILDING PERMIT a� NORry A TOWN OF NORTH ANDOVER �� y�tsLE�..6*a�G �. APPLICATION FOR PLAN EXAMINATION iL 1i Permit No#: Date Received ��SSgcHus�t�� Date Issued: IMPORTANT:Applicant must complete allitems on this page �° LOC n O n t , P OPER O,WN,0„R � cl �u ;, � . . Pnnt ., 10© earstruc Ye `�a o � M P P 'RCEL � °�"4 Z®NING�® STF2�ICT Histo is ®"istnct. �.` _'. yes # . _..92— t - ., 41 IVlachi a Shop Vilia, TYPE OF IMPROVEMENT PROPOSED USE_f' Residential Non- Residential ❑ New Building ❑ One family )A Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement AAssessory Bldg ❑ Others: ❑-Demolition ❑ Other Se fic M Well {a " ® _100 p dplai ®U1/et nd �y ® V1/ater= ed ®istr ct _ DESCRIPTION OF WORK TO BE PERFORMED: T-a CXo 5-rcre C ar T"re,iicr. Sti6,^Pti oy, 4--TeGktA- 7',<;a0 Identification- Please Type or Print Clearly OWNER: Name:"T,rler 1M v n ro z Phone: 7S -51S - 313 o Address: d 00 o.STcr 5T- 9^�,r C n ra or Names#' p-- � y '� 4 •}h r x z *ff Y�L x �} '.'F,t ��,E � iF Supe,_ r Const ' opt o 'Lice`nse a ' ' '' E&7n&_ ®ate.f ti Homme Jmproveen Li ese, ARCHITECT/ENGINEER S'Tc Lt< r Phone: - 3o5-- T8 6-o Address: 1b U eajyw LcA r o_ /U. V� d�c1' 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: $ 3 o oy. do FEE: $ i Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have.-access-Jo the guaranty fund -ir -w v. a�. v x. u .i a.. -e'it�- s� fi ._...- - - w Signature of Agent/®wner� ; , ,5.; . �. ,.:,,,_Signature of cortractar� ... .>.,,. � ^ l�� Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ W_j'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature �C 1 COMMENTS Of— O HEALTH Reviewed on Signa u 'S� (� r COMMENTS C�vl-P O�� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp ®urnpster on -ItEll es a9 :.x4 . no L►o abed at.1�24 Main Streets r Fire Department signatu a date ? .