HomeMy WebLinkAboutBuilding Permit #Exception - 245 BOXFORD STREET 8/9/2013 r
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BUILDING PERMIT .c..'h �6 AL
TOWN OF NORTH ANDOVER ° t
APPLICATION FOR PLAN EXAMINA O 4 -
Permit NO: Date Receive �°
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Date"I,s�- 9S8 CHUB:
IMPORTANT:Applicant must complete all items on this page
LOCATION ,4/5 6e„x 4r,-A Alar-t'k ,q rclU``-e� ;A19
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PROPERTY OWNER c,e-"5
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MAP NO: PARCEL: ZONING DISTRICT: Historic District yes n D
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building One family
OAddition ❑ Two or more family ❑ Industrial
VAlteration No. of units:
❑ Repair, replacemen"
❑ Demolition
❑ Septic ❑ Well
❑Water/Sewer
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OWNER: Name: �—
Address:
CONTRACTOR Name
Address: 6
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Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER � - ircck�^;LkSy►� Phone: old? , C�'°j5
Address: Reg. No. 3S 7
FEE SCHEDULE:BULDING PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $_I'--!l i a(5- FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature 4KAgen Owner Y v Signature of contractor
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