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HomeMy WebLinkAboutBuilding Permit #Exception - 1010 JOHNSON STREET 5/1/2018 (3) NORTy BUILDING PERMIT of LEo - qti TOWN OF NORTH ANDOVER - APPLICATION FOR PLAN EXAMINATION Date Received R " Permit No#: �s,4SSgCHLjSE�•``' Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �� ���n 9 �! \A%l z.-,- t�O� 0 I b��j ri t PROPERTY OWNER , \n v Uk ririt 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no. Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resid tial Non- Residential ❑ New Building FrOne family Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement- ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other eptic ®SII' ® FI©odplai n 'We lands �,'�, k❑ UUate�rs�h�ed Distric ®'Water/67 �r . . « a :t 'Y "�'y x„N •'- -r Fw 2' ` i Aw a DESCRIPTION OF WORK TO BE PERFORMED: UA do C x; Lv',C Identification- Please Type or Print Clearly C OWNER: Name: Phone: Address: l Q S�) v" 1) YJ I IMC6� - 0 f Contractor Name: Phone: ���� / �v Email: ,�Gti"i fj t Js o Address: Supervisor's Construction License: C.f'—� 2 Exp. Date:_ S 0/-17a/�7 �,g2-9� Home Improvement License: / Exp. Date: ©�.'.� 2,6)/ ARCHITECT/ENGINEER �GL'V'~ °�~ Phone: Address:-�� WdI41 4P. 'Z 1 Reg. No. FEE SCHEDULE:BULD G 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 unregistered contractors do not have access to the guaranty fund „ !op, �.. dans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools ❑ Tanning/MassageBody Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. permanent Dwnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM 9 PLANNING a DEVELOPMENT Reviewed On �` I l Signature_ r� COMMENTS / �� rL,�L1VV'jM(, deci�- CONSERVATION Reviewed on Signature COMMENTS r .HEALTH Reviewed on 0 Si nature COMMENTS i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConnectioniSignature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPAR�T'MENT �; TeOp Dumpster onsite ; � ' a -rte '� ,..b, yes _... ,� �LMocated at 12..4 Main Streei � _ 'n � "'• i Y tom , i° t Fire Department signature/date .4 C '°'M MnV