HomeMy WebLinkAboutBuilding Permit #23025 - 1503 OSGOOD STREET 6/24/2010 1'
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BUILDING PERMIT oFt�%0R0RTH
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TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
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,rmit NO: Date Received _�5_ 1 t- �ap�AA7EG��p��y
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Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION ' I S.
�PRO,PERTYOWNER
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MAP 21-0 ' P-ARCEL - 4 �ONI?�IG�DISTRICT Hrstonc�Distnct _ yes, no-
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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
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DESCRIPTION OF WORK TO B PREFORMED: ,�
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Identification Pl as ,Type or Print Clearly)
OWNER: Name: a Phone: (V
Address:
QNTRACT
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'Adtlress
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Superyisors Construction License EXp Dade � '
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'Home rlmprouerraent�License .� � xp Dade
ARCHITECT/ENGINEER Phone:
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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: $ FEE: $
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Check No.: Receipt No.:
NOTE: Persons contracting with un r gistered contractors do not have access to the guaranty fund
Si nature of A ent/Owner Si nature of contractor
Location
No. ` f Bate 6 y
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NORTH TOWN OF NORTH ANDOVER
Of� . o y,ti0
• � ; . Certificate of Occupancy $
s^�N�s t� Building/Frame Permit Fee $
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Foundation Permit Fee $
Other Permit Fee $
TOTAL C,6 $ 00'
Check # 56 VAC
230 ;
Building Inspector