HomeMy WebLinkAboutBuilding Permit #920-14 - 129 COTUIT STREET 6/16/2014 I&OWT11 q
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: � Date Received '4 :
Date Issued: 1.
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IMPORTANT:Applicant must com Tete-all items on this pme
LOCATION ��� �����S�"` 1y „�►y1N1�� ?M'✓�` o"���JS
PROPERTY OWNER C"bV 1
Pat
MAP NO;,--- PARCEM� ZONING'DISTRICT:-Historic District yesno
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
)AAlteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg [Others:
❑ Demolition ❑ Other F s
0 Septic ❑Well ❑Floodplain ❑Wetlands 0 Watershed District
0 Water/Sewer
:FnSW( RooF Yo(J Sol-4r cArroy LtLa
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Identification Please Type or Print Clearly) 7
OWNER: Name: ✓%d(o .Z`a<--0 is to Phone: 979-[89-;000-9 ,
Address: Co 4 54 j� . /IA do i 8 S
CONTRACTOR Name: Phone:
Address:
l S/ILAtrlac E /-/O.OA*L ly.4 40 017g8
Supervisor's Construction License: Ex Date:
05209p $-15 - ;?oIS
Home Improvement License: GS 2 8 Exp. Date-
ARCHITECT/ENGINEER eZ6i2e
ate:ARCHITECT/ENGINEERELane 1�v!jj Phone: 9/8-g66-844 1 ►
Address:l S A✓`e4vc �.k,�o/tro►}d1 � pt?Lf Reg. No. L 29
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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: $ 36.000.oa FEE: $ 3�O.00
Check No.: I�P qje Receipt No.: 21(a r10
NOTE: Persons contracting with unregistere o actors do not have access to th gu ranty fund
Signature of Agen.Vown. Signature of contractor