HomeMy WebLinkAboutBuilding Permit #Exception - 100 SUTTON HILL ROAD 5/1/2018 OORTti
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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Permit No#: Date Received Rq"Arco
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION Bob V GC-Prot t ll lqd A) r o I?4�F
PROPERTY OWNER Courrr,� I-G�,,.,c,41 Ttrkto V S lG lC
Print 100 Yehr Structure yes no
MAPPARCEL: 13 ZONING DISTRICT:` 3 Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building X One family
XAddition ❑Two or more family ❑ Industrial
X Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
Demolition ❑ Other
71,.Septic 0""'Well ❑ Floodplain ❑Wetland X Watershed District
UVater%Sealer
DESCRIPTION OF WORK TO BE PERFORMED:
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Identification- Please Type or Print Clearly
OWNER: Name: Co. _ 164 tkt )vn us)ck Phone: 7g1 -- 30�-!I g�
Address: 100 5U ! F vK gill M A) , Arkof6 o- V 4 I 9�J`�
Contractor Name:lN1//,1.4 4.t f�cy,'a �w+ S Phone: ar gs'_4 I
Email: 1Z8 6 >
Address: LZW W #4 . 9 6
Supervisor's Construction License: D7.S�'7 B Exp. Date: el - /z
Home Improvement License: -7 71 `oL 9 Exp. Date:
ARCHITECT/ENGINEER&IIA-t' 6161Y1(,41 Phone.- 3L17- 664? - `175
Address: "T��i ��Q� 6Ytf_ -P, Reg. No. 32132—
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FEE SCHEDULE;BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 130 , 00 Q �S� FEE: $
Check No.: Receipt No.:
MOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
a ire ofLaQPtJOwner Sinnature
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Plans Submitted Q Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ,
'OF SEWERAGE DISPOSAL = !
Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools D
Well ❑ Tobacco Sales ❑ Food Packaging/Sales 11
Private(septic flank,etc. ❑ Permanent Dempster on.Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF A U FORM
PLANNING & DEVELOPMENT Reviewed On—5 &)� Signature_
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COMMENTS ?eC
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature .
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Conneetion/S.ignature &Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - TempQumpster on site yes no..
Located»at 124 Mbin Street
Fiire'Deportment signature/date
COMMENTS
1 Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions,
Total land area, sq. ft.:
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.$1oo-si000 fine
NOTES and DATA-- (For department use)
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Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014