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HomeMy WebLinkAboutBuilding Permit #975-16 - 22 HARKAWAY ROAD 5/1/2018 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION a � ermit NO: 7 S Date Received �j C I.9 p�AATlO I.P��'�I Date Issued: 1� SSACHus� IMPORTANT:Applicant must complete all items on this page LOCATION 22- � R n Print PROPERTY OWNER 1A11o`f I LS7V " Print �d vY/- MAP r MAP NO: _PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family N4ddition &''Fwo or more family ❑ Industrial ❑Alteration No. of units: 9 ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain 0 Wetlands 0 Watershed District 0 Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: A�xeti &Iey Phone: ��8" `�l — 'B-Sb Address: Z2 P0,'rkJWgW Atm CONTRACTOR Name: Phone: 900 B(A IN-t, NA+gG, Address: 1'© aox 13Z AN Z>)4e- H4, of eg-5-- Supervisor's �Supervisor's Construction License: Exp. Date: 131155� It V9 Home Improvement License: Oi(o Exp. Date: ARCHITECT/ENGINEER �f 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: $ a S. q on � FEE: $ , Check No.: Receipt No.: _� % -7 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 1' ignature of Agent/Owner Signature of contractor �� -�