HomeMy WebLinkAboutBuilding Permit #Exception - 181 JOHNNY CAKE STREET 5/1/2018 BUILDING PERMIT O e NORTIy
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TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION ~ A
Permit N0: Date ReceivedArlo
Date Issued:
IMPORTANT Applicant must complete all items on this page
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PROPER` 4t �R
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MAO NO 1AttZIING �f1T' !-lt^�ORFC "II: II' `ys ":
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building X One family
❑ Addition ❑ Two or more family ❑ Industrial
9 Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: `PaoN o :I-rj C A=0 o Phone: c1'n-
Address: r"4 C e, L �e
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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: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund f
Signature of Agent/Owner Signature of contractor
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
TE REJECTED DATE APPROVED
CONSERVATI
COMMENTS 1� i_��(A EQI--� OR
1
DATE REJECTED DATE AP ROVED
,.HEALTH
X ❑ �, .�
COMMENTS
5
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
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Conservation Decision: Comments
Water& Sewer Connection/Signature& Date Driveway Permit
Located at 384 Osgood Street
FIRS QEI'ART�VIENT Temp Du r on sits yes nay.
Located at 124 Mafrhiti eet
Fire i epartmgnate-reldilte
COJVtMENTS
82.09'
- o0
ASSESSORS MAP 107 A
PARCEL 190 ASSESSORS MAF
AREA= 43, 575. 8 S.F. PARCEL 22
146.2'
POOL
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PROPOSED FOUNDATION
UNDER SUNROOM
.19' ASSESSORS MA
DECK30.6' PARCEL 1
well,
d UNR00 p
sq oa�se
EXISTING , '"A V;
2 STY. '
W.F.D. EXISTING
' 1 STY
W.F.D.
40.0'
(x �` 0
'f DRIVEWAY