HomeMy WebLinkAboutBuilding Permit #698-15 - 104 MILK STREET 3/4/2015 �. O
ti BUILDING PERMIT ' �? s°`,f•_ r °�
TOWN OF NORTH ANDOVER ��~ "' I-
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(„1 APPLICATION FOR PLAN EXAMINATION it
Permit NO: Date Received you
Date Issued: �SSAC14US�
IMPORTANT:Applicant must complete all items on this page
LOCATION 164 fr�I ) k "�-A r RQA N AtAyv.,
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PROPERTY OWNER NCrlN$ nlar,c P)a CI�Gt r
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MAP NO: 4PARCEL: U`� ZONING DISTRICT: Historic District yesno
Machine Shop Village yes 9
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
n New Building n One family
n Addition ri Two or more family ❑ Industrial
n Alteration No. of units: ❑Commercial
ARepair, replacement ❑Assessory Bldg ❑ Others:
—2-Demolition ❑Other
❑Septic ❑Well ❑Floodplain ❑Wetlands ❑ Watershed District
Water/Sewer
&Alrorir, Ae J Ocr"ny� Cvr,S:!�t
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Identification Please Type or Print Clearly)
OWNER: Name: J)-Cr.S k 'N ahs c Phone: G1_7 S P -SSSS
Address: '14r ee'l ry AKJov-er
CONTRACTOR Name- Phone: Sat;-543-- 6 3 r
j OSCeh mGna�ch%e+�F "S�n��l,c-
Address:
QtS Allo-4, c Ayt �cglSSt,r� I 0155 1
Supervisor's Construction License: Exp. Date:
CS � 070,943Q,��G��cl 6
Home Improvement License: y Exp. Datg ,, -,G 16
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 15 t^I L - 6 0 FEE: $ r C� � 6_0
Check No.: M C5,0A Receipt No.: -2 -±o
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
ignature of Agent/Own /►i"1-- ignature of contractor
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