HomeMy WebLinkAboutBuilding Permit #Exception - 272 BRIDGES LANE 5/1/2018 BUILDING PERMIT NORTFe q
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TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION ` ry
Permit NO: Date Received ��SsgcHus���y
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION L..cL"e X sc>. AA 0t G4-Sr
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PROPERTY OWNER r_",,,✓ Ji,
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MAP NO: k049 PARCEL: 121 ZONING DISTRICT: Historic District yes no
Machine Shop Village yes o
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building 4aLamil
ddition Two or more family Industrial
A eration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED: „
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Identification Please Type or Print Clearly)
OWNER: Name: •+✓ Phone: tA 7 7—A 084
Address: 4
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ONTRACTOR Name: Sot .►�h�S Ins- Phone: '1451 9ddress: D
W%.%^ �' 4: 1/3ot-3,1-,-v% /LI O.t SQ t
Supervisor's Construction License:-0-7a I q Exp. Date: 1T&1 I i
Home Improvement License: Exp. Date: 1 ( I3
ARCHITECT/ENGINEER "✓ww La - cAa.n Phone:
Address: f67v%, AAA Reg. No. 10107.
FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
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Total Project Cost: $ 'Z�?� got-1 . FEE: $
Check No.: Receipt No.:
NOTE: Persons contractin with un r g' tered contractors do not have access to the guar n fund
Signature of Agen e of contractor _