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HomeMy WebLinkAboutBuilding Permit #Exception - 140 MARIAN DRIVE 5/1/2018 a r ;:1 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued; IMPORTANT:Applicant must complete all items on this page Prmt E fPRO.PRERTY QWNER Ar> •PE.r�_ �ldr ✓ _- ^ - _ YPrint`, �100hYear QlSd Structure yesr P `MAP'NO:° PARCEL... ZONING�pISTRICT: �HistoriciDistnct'. yes +.n -� i ..�MachineEShoptVillage. eyes, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building �' ne family ❑Addition ❑Two or more family ❑ Industrial aeration ..No. of units: ❑ Commercial l2l�—epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other peptic ❑tWell; Y (]Floodplain , etlands 4 © WatershedrDistricty ❑►INateW ewer, . DESCRIPTION OF WORK TO BE PERFORMED: `,cmeloQifPW4 Peer- aA) 44-h df Z-V AK xe.eot5o a( e"e gew 1411 if .4 .✓moi peeje- 1,4 ,?oai Identification Please Type or Print Clearly) OWNER: Name: Aor Phone: � •333-��/2 Address: Aeme CONTRAC'y�Q:R Name: /TL'E./TOiKE I�'�FGYCf-,LLC ;Phone: 9 • Zoe-°3210 LAQ100AOlm rovement+Licensee _ � _ Ezp ®ate: p ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$9200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contractin with unregistered contractors do not have access to he ua my unci e Signature of Age't/Owner _ a Signature of contractor Pipps S 66itteA� Plans Waived ❑ Certified Plot Plan V Stamped Plans ❑ FWell PE OF SEWERAGE DISPOSAL lic Sewer ❑ Swimmin Pools ❑ Tanning/MassageBody Art ❑ g ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED. DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS OBSERVATION Reviewed on Signature COMMENTS A HEALTH Reviewed on o?� Signature ' COMMENTS' D r Zoning 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 DPW Towr- Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Deipa -itment,signatiere/date .COMMENTS