HomeMy WebLinkAboutBuilding Permit #477-2011 - 23 STACY DRIVE 12/10/2010flr9 /� a,r
` TOWN OF NORTH .ANDOVER t�
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APPLICATION FOR PLAN EXAMINATION
Permit NO: 7 7 oll Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION i -9 _iS - 2-5 Stacy lir. tPresed+t Vi 1far,P
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PROPERTY OWNER
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MAP NO: �� �� PARCEL: �� ZONING DISTRICT: Historic District yes no
` Machine Shop -Village yes no
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TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
N One family
❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Commercial
N Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
`0'Septic D�Well❑F
am Wetlands ;
�'❑'WatershedDistrict�,< R
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DESCRIPTION OF WORK TO BE PERFORMED:
1n all new roof ricice- veni-s.
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTOR Name: lohnsfon Construction Co- "rnc Phone: 978:135.3223
Address: Ren RCS PeeLbod , MA oiyce
Supervisor's Construction License: c s.9 19 o o Exp. Date: 9.3
Home Improvement License: ; Z3 1 Z14 Exp. Date: 17 z- 10,
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT.- $92.00 PER $1000.00 OF -THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F.
Total Project Cost: $ ; t�,l o a - FEE: $ -add
Check No.: 1�571 a ? Receipt No.: V-? 77e
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NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund /�