HomeMy WebLinkAboutBuilding Permit #121-14 - 20 MILL ROAD 8/4/2014 �iORt►�
BUILDING PERMIT
TOWN OF NORTH ANDOVER °
Z ` APPLICATION FOR PLAN EXAMINATION -
Permit NO: Date Received
Date Issued:
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MPOR ANT: Applic nt must complete all items on this page
LOCATION �.
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PROPERTY OWNER. %IG�ht� ,i�v► v✓`
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MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Vill-age yes o
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building -1 One family
-1 Addition -1 Two or more family - Industrial
Alteration No. of units: Commercial
Repair, replacement -i Assessory Bldg Others:
Demolition 7 Other
0 Septic ii Well 0 Floodplain- .CiWetlands U Watershed District
Wate0Sewer
itlezz',7 4i.0 17 S--4911 sN
Identification Please Type or Print Clearly) Q
OWNER: Name: a rIPhone: / 7ff` 79 - / ��v
Address:
CONTRACTOR Name: I / Phone: ► , f9f 3 y /
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Address:
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Supervisor's Construction Lice se:, Exp. Date:
Home Improvement License` Exp. Elate:
J01,14/
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: $ D `� FEE: $
Check No.: Receipt No.:
NOTE: Person nt acti g wit2unVre contractors do not have access t th gu n. f
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;Signature of A�gentlOwne ignature of contraxcto