HomeMy WebLinkAboutBuilding Permit #Exception - 26 STANTON WAY 5/1/2018 (4) TOWN OF NORTH ANDOVER
' APPLICATION FOR PLAN EXAMINATION
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Permit NO: Date Received
Dare Issued:
IMPORTANT Applicant most complete all items on this page
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TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
)KNew Building Xone family
❑Addition 0 Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
0 Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PERFORMED:
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Identification Plear Print Clearly)
OWNER: Name: t 61, 'W241, 6ruai i- Phone:
Address: cr. t 'ic /-,�797 1b&11Wor iVJr a3&oL
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ARCHITECT/ENGINEER %Ns1 �t-y j Phone:
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Address: S& Reg. No. 30167
FEE SCHEDULE;BULDING PERMIT.$12.00 PER$1000.00.OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ �)� 3 75' FEE: $ �
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered ontractors do not have access to the guaranty fund
Signature of Agent/Owner ,, - igiature of contractor . .
Plans Submitted Plans Waived 0 Certified Plot Plan Stamaed Plans
Plans Submitted'[] ' Plans V1/aived-❑ Certified Plot Plan ❑ Stamped Plans ❑
TlrPi E_OF'.SEVi�RAGEDiSPOSAL'
Public Sewer ❑ Tanning/MassageBodyArt C7. Swimming Pools El
Well ❑. -Tobacco.Sales ❑ Food Packaging/Sales ❑
Private.(septic tank,etc_. - Permanent Dumpster ori Site ❑
THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U.FORM
..,....DATE REJECTED DATEAPPR.OVED
PLANNING &'DEVELOPMENT ❑ f.z/�P*
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COMMENTS C � �► pre-')
:CONSERVATION Reviewed on � ^r� C�- Si nature =A_ �
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COMMENTS ;� 7_Z1 2 —
HEALTH Reviewed on `d Signature
COMMENT
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Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Commen -_
Water & Sewer Connection/si nate& Date (Driveway Permit ,
DPW Taw u,
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e',_ Engineer:g r: Signature•
oc to 384 Osgood Street
FIRE DEPARTMr'NT - Ternp Du pster on site yes no.
Located-at 124 Meir, Street
-Fire Departrrie►`it signature/date-
COMMENTS
--Dimension,
rasion
Number of Stories: /�- Total square feet of floor area based on
Exterior dimensions..
.Total land area; sq. ft.:
ELECTRICAL: Movement of'Meter location, mast or service drop requires approval of
Electrical Inspector Yes - No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A--F and G min.$100-$1000.fine
NOTES and DATA— (For department use
® Notified for pickup - Date
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)oc.Building Permit Revised 2010
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