HomeMy WebLinkAboutBuilding Permit #Exception - 20 SAW MILL ROAD 5/1/2018 00RTF1
BUILDING PERMIT ?ob tt��o ,6 gti°o
r ► TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration, No. of units: Commercial
Le air re lacem Assessory Bldg Others:
Demolition Other
eptrc "well F1
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V1��terlSewr=
DESCRIPTION OF WORKTO BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: 'Sinn,R-r (j)ti Phone:
Address:-
40
ddress: . Pce: ' .8" 316
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ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 3('O' S-b" FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
10
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
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water $ Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
:FIRE `EATM1T -.TerraOurppster ora site �eS Y no
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Fire Dep;aft+enttignatuvoldate
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