HomeMy WebLinkAboutBuilding Permit #638-16 - 25 FERNCROFT CIRCLE 11/23/2015'p, NCD /1-2s ^ /s`
Permit NO:
Date Issued:-
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ssued:
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
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IMPORTANT: Applicant must complete all items on this nage
LOCATION__Z2_ _44ef n c-ro �+ C \cc(_k
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PROPERTY OWNER_ _ Ch , ,D Y) C Co LO -)-e fZ
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MAP NO.: J PARCEL: ZONING DISTRICT:
TYPE, AND INF. nF RiTTr.nnvr_
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TYPE OF IMPROVEMENT
PROPOSED USE
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Residential
Non- Residential
❑ New Building
,-One family
Date: & /gey 7
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❑ Addition
❑ Two or more family
❑ Industrial
❑ Alteration
No. of units:
❑ Assessory Bldg
kRepair, replacement
0 Commercial
❑ Demolition
❑ Moving relocation
❑ Other
❑ Others:
❑ Foundation only
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Identification Please Type or Pint Clearly)
OWNER: Name: C -)-\',Q (a Phone:
Address:
CONTRACTOR N
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Supervisor's Construction License:
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Q r7 a S Exp.
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Home Improvement License:
Exp.
Date: & /gey 7
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ARCHITECUENGINEER
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Name: Phone:
Address: Reg. No
FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $25.00 PER S.F.
Total Project Cost/: $ 0 oo O x 12.00=FEE: $ D �
Check No.: [ Receipt No.:L
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