HomeMy WebLinkAboutBuilding Permit #326-14 - 16 DANA STREET 5/1/2018 A. Cf NO RTFf
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINA ON 9 = a
Permit NO: °2� y Date Received ��
A ♦�
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Date Issued: ss,.c""s�
IMPORTANT:Applicant must complete all items on this pMe
LOCATION I b4li-1+ 57-'
PROPERTY OWNER
Print
MAP NO: PARCEL:ZONING DISTRICT: Historic District yes nno -
TYPE
Machine Shop Village yes OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building w0ne family
M-Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District 10
gWater/Sewer I I /��,
U1/1L.)i�fb h 32- `f GLu-til �l �` t/ Gprf7rl�(
Identification Please Type or Print Clearly)
OWNER: Name: .bDA A)A ` UbCt1JA-,l Phone: �7,9-3 97-- 7'161
Address: 16 A4,J,4 cST / A10.. "Do rOLt "1+ 1 o/RVS'
CONTRACTOR Name: Phone: q7Fr - 36°
bAVid A-- aA i2Xc C�
Address:
Supervisor's Construction License: b � l Exp. Date:
Home Improvement License: t
Exp. Dae:
/736Y7g-
ARCHITECT/ENGINEER MA-7- 6uHHiU65 Phone: 475�-3556
Address: 87 Cei0-172Ac- /- Zp5,J1 *,--fk Reg. No. /o
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cot: $ / Lra.� FEE: $ ?60 `—
Check No.: Receipt No.: 46 51 2(D9(01
NOTE: Persons contra;r7
in with unregistered contractors do not have access t"heguaranty
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Signature of Agent/OwnSignature of contractorV