HomeMy WebLinkAboutBuilding Permit #Exception - 1402 BASSWOOD CIRCLE 8/24/2006 NORTy
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BUILDING PERMIT
TOWN OF NORTH ANDOVER ° ;
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received /O
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Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION (001 dir War
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PROPERTY OWNER J�,�-Iv► Jc• �✓1
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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: -)cd-in .)a,✓I Phone:
Address:
CONTRACTOR Name: ) I W-13ci-2-9/3.2 Phone:
Address:
6 6Qr yS�Taswicb (Yl' 0/43
Supervisor's Construction License: Exp. Date:
CS -109003/ hct
Home Improvement License: Exp. Date:
/
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: $ 50(9p, 00 _ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor