HomeMy WebLinkAboutBuilding Permit #Exception - 1725 GREAT POND ROAD 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO:
Date Received 2�
Date Issued:
IMPORTANT: Applicant must complete all items on this page
IL CATI DN; � i3 5 y T �
= ._ re,P intim
e -
�PROPERT�Y OWNER.'
' r
-win
100 Year-old Structure yes; no,
VAPINO .. IPARCEL ZONING DISTRICT
_ H stone Distract ye_ no
- - .�� {Machine Shop�Uillage� ye.4 Ino. i
.TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
❑ New Building 51,,One family
❑Addition ❑Two or more family ❑ Industrials
❑Alteration No. of units: ❑ Commercial �p
'Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition El Other
-� -. 3 Flo — _ Phds - ❑ 'Watershed:Distract
�j
❑ Septic ❑Well , odplarn ❑Wetlands
e �❑UVater/Sewer_ �.� — - - - - -_ -
DESCRIPTION OF WORK TO BE PERFORMED: �I��'
�!yS Ti�-�L j►/�'7J •��� d�C' N �- C� L— {� 1—1/1�C� -
Identification Please Type or Print Clearly)
OWNER: Name: ,¢ H?V 0- Jba'/✓ "��N^SPIV Phone: `���
Address: 1-b-5
' z(g
'CONTRA`C1®R Name _- _ _ --_ RPh _ - (�3
C6�'YS7" one:
r
lN'G
Add,(esg
4 7�-
�., - ;
r
-.s
Supervisor's�Cofinstructlon Li-be-h- ! ? Exp D_a
fHorneImprovementL+icense _1071.(0Date
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: $ ��� S~� FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
PS1 natu e of A ent/Owner ':S�gatureof3contractory ` .�
Plans Submitted 'Lji Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
-= Plans §ub'mitted ❑
Plans Ul/aived ❑.:. _Certified Plot Plan El Stamped Plans-=.:TYPE-OFEWERAGEDiSPOAL
Public Sewer
Well Ej
Tanning/Massage/BodyArt Swimming pools ❑
El
Tobacco.Sales
Pri�ate•:(septic tank- t _
==- ,etc- � ;Food PackaginglSaIes ElPermanent Diimpster.on-site ❑
THE..FOLLOWING SECTIONS FOR'OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-- U FORM
�,•�
:. . _. . .._
-------DATE REJECTED
DATE:APPROVED .
PLANNING �
DEVELOPMENT- � ❑ .. _ C j
j Ser
COMMENTS
T �nu ' G Des 1� c
4L
` tr'c 7
T �>2i
,CONSERVATION Reviewed on '�j ' .
Si"nature
COMMENTS k)) u_� 1AJ) GE) 6 ced
HEALTH Reviewed on Si nature
COMMENTS
�v s
::Vo ebb
Zoning Board of Appeals: Variance, Petition No:
l �
Zoning Decision/receipt submitted yes
Planning Board Decision:
Comments
Conservation Decision:
=Comments
Water& Sewer Con nection-si nature& Date
DPS'Toiv2 Engineer: Signature: Drive vay Permit
FIRE QEPARTIt ENT. _'
Te— m sf�r on site Located 384 Os ood Street
Located"at.124 Mair,.Street:- p yes no
Fire Departmeit.§ignature/date.;_
9 . - .
C011f►M.ENTS - _
i
xnaension
dumber of Stories:__Total square feet of floor area, based on Exterior dimensions._
rdtal land-area, sq. ft..'
CAL: Nlovernent:®f.I�leter.locafton*5 ►�iast-®r service drop requires approval of
ELECTRICAL: Yds No
Electrical Inspector
No
DAN�I�R ZONE LI 2ER URGEmin.$10 _-$1 000-:fine
MGLXIap
NOTES and DATA— (For de artrnent use
_AZA�q �p
\ Al
e
��
eA
® Notified for pickup - Date
i
i
Doc.Building Permit Revised 2010