HomeMy WebLinkAboutBuilding Permit #641-15 - 104 MILK STREET 5/1/2018 NosrH
BUILDING PERMIT a= s� . • h•'� °�
TOWN OF NORTH ANDOVER o '
/ APPLICATION FOR PLAN EXAMINATION
Permit NO: 5 Date Received
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Date Issued: c"�sEt
EVIPORTANT:Applicant must com Tete all items on this page
LOCATION I Q 3Vr C
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PROPERTY OWNER C-)eo,y'y
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MAP NO PARCEL ZONING DISTRICT: Historic Districtyes pho
Q l o Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
n New Building n One family
n Addition n Two or more family ❑ Industrial
n Alteration No. of units: ❑ Commercial
)i Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑Other
❑Septic ❑Well ❑Floodplain ❑Wetlands ❑ Watershed District
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Identification Please Type or Print Clearly)
OWNER: Name: berms Mr, C�ect.ri Phone: 9-7�-
Address: l Q Vl S� �e Q�f Gr p �rc�cv� MA G) MY.
CONTRACTOR Name:--S0Scxt\ (�cl�a gt t h-I- � Phone: ,soe-s,-I CAS
Address: -7X Pvr-v,Jerlee \-4,11 2J /4+HR�,s« , Nq Uig I 1
Supervisor's Construction License: Exp. Date:
S-07�u X13 Iaht61---1°i 6
Home Improvement License: 9 4 y Exp. Date: y /3Cl/,°,
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ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BOLDING PERMIT.-MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 444-7960'0 U FEE: $ 52? ,OD
Check No.: 144-c- Receipt No.: a e 4,7-r
NOTE: Personstracting with unregistered contractors do not have access to the guaranty fund
ignature of Ag_ _ ignature of contractor 7