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HomeMy WebLinkAboutBuilding Permit #Exception - 1447 SALEM STREET 5/1/2018 tt NORTH BUILDING PERMIT O`�4. ,6 6 TOWN OF NORTH ANDOVER a APPLICATION FOR PLAN EXAMINATION Permit No#• Date Received �qA°RgrED SSACHUS I Date Issued: IMPORTANT: Applicant must complete all items on this page l �ya � � LOCATION lly7 S� Print PROPERTY OWNER �F C r Print 100 Year Structure yes no MAP PARCEL: O ZONING DISTRICT: Historic District ye no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building Xone family ❑ Addition El Two or more family El Industrial .Alteration No. of units: ❑ Commercial ❑ Repair, replacement ElAssessory Bldg El Others: ❑ Demolition ❑ Other - ` — ® Flood 1aA- GROE tls : W strict eptic, ❑` 11e11- - y p atershedl®i Water/Sewe -- DESCRIPTION OF WORK TO BE PERFORMED: tion - Please Type or Print Clearly , Identifica yp _ y Phone: OWNER: Name: /�� A ���°i� Address: oe S � //tea i Contract Name: e[[ ��`� Phone: � 2 c 1h1,3 Email: &3 rA) i C Address. Supervisor's Construction License: �)2 fl 3 79 Exp. Date: . ` 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. G� Total Project Cost: $ 01,5-06© FEE: $ Check No.: Receipt No.: NOTE: Persons contracting ' z un egister d contractors do not have acce to he guara fund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ESewer SPOSAL ❑ Swimmin PTanuixtg/MassageBody Art ❑ g ools ❑❑ Tobacco Sales ❑ Food Packaging/Sales ❑Permanent Dwnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF e U FORM V ANNING & DEVELOPMENT Reviewed On - Signature COMMENTS CONSERVATION Reviewed on Si nature COMMENTS �� S / A c, ALTHn I. Reviewed on SignatureJu COMMENTS �� /)ol 10 &k A A Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments !Nater & Sewer Connection/si nature & Date q Driveway Permit DPW Town Engineer: Signature: ARTMENLocated 384 Osgood Street FIRE DEPT � - - Te�rnp �. Locatetl at 124 IVlaw Street s ?•� ,� ��;- , �� �r `� �� Fire -All7 Departmentsign atusre/d4ate . t., ,�.,.3i.kt1�.t ,s°..�'�'��'�}..i�