HomeMy WebLinkAboutBuilding Permit #91-15 - 14 HIGHLAND TERRACE 7/28/2014 4.. 1
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BUILDING PERMIT
TOWN OF NORTH ANDOVER ° p
APPLICATION FOR PLAN EXAMINATION * h
Permit NO: Date Received
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Date Issued:
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I PORTANT:Applicant must complete all items on this page
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LOCATION �~�t' G
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PROPERTY OWNERcuAQ_ � +
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MAP NO:(PARCEL:_ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed District
Water/Sewer
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Identification Please Type or Print Clearly)
OWNER: Name�a&2� � �rs /� Phone:9 —790"
Address:
CONTRACTOR Name: U J Phone: —7f
Address: G) - �
Supervisor's Construction License: Exp. Date:
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Home Improvement License: / 7 33 Exp. Date: Z/Y
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ A U � FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have accesso the uaranty fund y
Signature of Agen W Signature of contracto