Loading...
HomeMy WebLinkAboutBuilding Permit #Exception - 1025 OSGOOD STREET 5/1/2018 ey BUILDING PERMIT of No 0T 06 " TOWN OF NORTH ANDOVER 3? " � . ::a° °w APPLICATION FOR PLAN EXAMINATION G� � � y } S �t ®(� � To Mw � 1 Permit NO: Date Received a �9 q< �wX0 1. SS�CHUS� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCAX ION Pnnt,; 4 l'IOPEF2Tlf OWNER, U - b int MAP. t : PARCEL.., Z41V1NG QISTRIC : HIST }RIC D1SRf� yes- ttp TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential if New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: 6 Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other -i Stt I :well I ' plain I Wetlands=« I Wrlttl`tr✓ 1 . y` � DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) OWNER: Name: �� Q c) R LA o Phone: Z 5%0 3 Address 10 Zy DSRo o ® , A U no J C fZ- H, A p R eiche�sea,Revereeoston , .. hroP E COIF 1 aCT0 N t 1 '° int &&Restoratyon�" Fire& Water -C�eanuP Cent Greco u ter re" -Cod k cti i Ll nse8 7 617)567377 arr� rrlrcrr + ics ,5 b 5724 Phone ((617)567-4777 PO Box 50 Fax — Chelsea,MA 02150 edandOperated Q ARCHITECT/ENGINEER IT n V f. L Independenty0""v©� PAddress: ov �64�lkeg. No. \I X FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 7i A Q o FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor A, i •�°► Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF -U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS I DATE REJECTED DATE APPROVED HEALTH ❑ COMMENTmijY d A/74 WILIIL�z� TYPE 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 ❑ Z fling 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 Located at 384 Osgood Street FIRE QEPAFMEN `' Term Dumpstet-`on site yes ne_,. Located�t 124 It�aih Street ,Fire.department stgnature/date:. r' a COMMENT