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HomeMy WebLinkAboutBuilding Permit #771-2017 - 180 AMBERVILLE ROAD 2/17/2017Permit NO: 73— 9-0/ BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received �tORTh Of tt�eu ,s bad 0 1 h Date Issued: I I RTANT: Applicant must complete all items on this page LOCATION Awa Print PROPERTY OWNERly�j�i l'f1A Print MAP NO: _LqLPARCEL:,3_,a� ZONING DISTRICT:_Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ,'One family ❑ Addition ❑ Two or more family ❑ Industrial WAlterationG �� c{-- No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑ Wetlands ❑ Watershed District 'gWater/Sewer 0 OWNER: Name: M6r OC7(- Identification Please Type or Print Clearly) r7 -(,37 -SVS f Address: / �i /Uc�f( CONTRACTOR Name:Phone: / /1cy� r5949 Address: 40 /I f��Co Supervisor's Construction License: Exp. Date: tv- 7 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. Total Project Cost: $ ok Z-0 FEE: $ 3 (� Check No.: 10 w Receipt No.: 3 NOTE: Persons contraetitjiwit unregistered contractors do not have access to the guaranty fund 0 Location 1 7,b A f y K 1�l u L (�) No. -1 -i 1 - gU �] Check #�� T I 527 Date g . I S- - ), a 1-7 TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL .0 /�L - // Building Inspector