HomeMy WebLinkAboutBuilding Permit #590-16 - 20 MABLIN AVENUE 11/13/2015 of 14ORT`1,y
BUILDING PERMIT 3: e• �••� °o
TOWN OF NORTH ANDOVER y ;�
APPLICATION FOR PLAN EXAMINATION
Permit NO:. ® Date Received '" °4 .
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Date Issued:
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IMPORTANT:Applicant must complete all items on this p page.
LOCATION- 5 ED ' 1{lvLUQ.
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PROPERTY OWNER
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MAP NO: PARCEL: ZONING�DISTRICT-Historic District yes n
Yes a no
Machine Shop_Villa
9
TYPE OF IMPROVEMENT PROPOSED USE
Resi ntial Non- Residential
❑ New Building One family
❑Addition ❑Two or more family ❑ Industrial
Iteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑Septic ❑Well b Floodplain l--Wetlands 13 Watershed,District
❑Water/Sewer.,
RoAaawl Ray /A ow
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Identification Please Type or Print Clearly)
OWNER: Name: ,�( Phone:
Address: 20 M49CIA4 A
CONTRACTOR Name: Phone: ~�QIS 6
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Address
Sup'ervisor's Construction.License: ���� Exp. Date: �t��j�► �
Home Improvement License: / Exp. Date;
ARCHITECT/ENGINEER Phone:
Address m ;:. Reg.,No
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FEE SCHEDULE.BUL'D►N PERMIT:$12:00 PER$1000.00;OF THE TOTAL,ESTIMATED COST BASED ON$125.00 PER S.F. �4 W a
'. :Total-.Project Cost
Check No 3 Rec I ZA iR
)VOTE: Persons cont�ac n w h n eglstes"ed contractor do no.t have,accesON
s, e; u anty fund
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