HomeMy WebLinkAboutBuilding Permit #Exception - 143 SANDRA LANE 12/11/2011 Location � � ���✓��� �f1/
No. Date 0
NORTFTOWN OF NORTH ANDOVER
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41
Certificate of Occupancy $
CH < Building/Frame Permit Fee $
Foundation Permit Fee $ C�
°r Other Permit Fee $
eiQ�i`" TOTAL $
J-P) Check # ✓
2491 5"
B inglnspector
APPLICATION FOR PLAN EXAMINATION
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EMORTANT:Applicant must complete all items on this page
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Print
ZTY OWNER FAP- k COS-e -r Unit#
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,CPARCEL:(O ZONING DISTRICT: Historic District yesn�a�
Machine Shop Village yes
100 year-old structure yes c I I
IMPROVEMENT PROPOSED USE
Residential Non- Residential I
Building R66 family
tion ❑Two or more family ❑ Industrial
ation No. of units: ❑ Commercial
air, replacement ❑Assessory Bldg ❑ Others:
option ❑ Other
i ',�'®well `' �< ,�� 1_ood � i3OW,��eflands��` '�®Wastes ed ►`strict.- � �,` ',
DESCRIPTION OF WORK TO BE PERFORMED:
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(Id tificatio Please a or Print Clearly)
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Name: r.t�e Ceea` Phone
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ACTOR Name:
en/�
sor's Construction License: S . ODate: I
mprovement License..: Exp. Date:
TECT/ENGINEER ��� e,,"; Phone:
S22 e wa i� � Reg. No.
SCHEDULE.B DING PERMIT.$92.00 PER$9000.00THE TOTAL ESTIMATED COST B ED ON$125.00 PER S.F.
'roject Cost: $ � ® FEE: $
0
Ct?�/No.: Receipt No.:
Persons contractin ith unreg' a contractors do not have access to the guaran� ;
V601-60K,of , nt%Own r�* � .,, ��; . . :<; Signature