HomeMy WebLinkAboutBuilding Permit #Exception - 26 STANTON WAY 5/1/2018 f
BUILDING PERMIT 0 SORT b�ti
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TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: Date Received, TED P
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Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION /Urno
PROPERTY OWNER WV
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Print 100 Year Structure yes no
MAP PARCEL: ZONING DISTRICT: Historic District ye no
Machine Shop Village ye no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition Other 'WIrMMIAJ(r _
Septic O'1Nell ❑ FL.00tlplainT Weflands .❑ Watershed Distract
u Water/Sewer_ __r_- � - _'
'� � �r DESCRIPTION OF WORK TO BE P �FOR ED:
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Ide fication- Please Type or Print Clearly
OWNER: Name: 3tLL I li`I) Phone:dn -5qb ._w
Address: �/1/� . he
Contractor Name: 0U97)1/q � Phone:
Email: tie CL ,
Address: `533 C 416 �
Supervisor's Construction License: .lDlf� > Exp. Date: Z.
Home.Improvement License: �2 � Exp. Date: h
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ARCHITECT/ENGINEER Phone: 777 —0)l ^
AddressA06 SW 5E, NReg. No. "5p `
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FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $
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lw) FEE: $
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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 ❑
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 a U FORM
XPLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
WEALTH Reviewed on Signature
lVtef5COMMENTS T f(a 5 S Q �y� !� �� 4�v(,-")
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Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water& Sewer Connection/Signature& Date DrivewaV Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
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