HomeMy WebLinkAboutBuilding Permit #Exception - 315 SOUTH BRADFORD STREET 3/21/2016 ` %AORTy
4 ✓r/ BUILDING PERMIT o� yt,s. 6"6
—= TOWN OF NORTH ANDOVER ►-
APPLICATION FOR PLAN EXAMINA I I • NIAI
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Permit NO: Date Received l 1 <a,.<�.�.
DAATED 0 �y
4SSacHUS
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION
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PROPERTY OWNER. ! t 1 t C�ICi.� M i)� ,k
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MAP NO: �_PARCEJ ZONING DISTRICT: Historic District yes n
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
X Addition D, Two or more family E Industrial
0 Alteration No. of units: 0 Commercial
0 Repair, replacement ❑Assessory Bldg 0 Others:
0 Demolition ❑ Other
0 Septic 0 Well [I Floodplain El Wetlands ❑ Watershed District
11 Water/Sewer
CJ re l 'I? w 'X ('g2t'i �0 0 o
Cm i(460,r
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Identification jPlease Type or Print Clearly) r�
1 IC
OWNER: Name: SAC��� �Ya)t� �� Phone:
Address:
CONTRACTOR Name: Phone. � �- 33-a
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Address: r_
w t� o n 2,np.gr4I d 6
Supervisor's Construction License: Exp. Date
Horne Improvement License: Exp. Date
ARCHITECT/ENGINEER 0(a eicq 0)Icy.4iri o Phone: �r� �. `/Vr�-9-51V Vii'
Address: 31), C k► oav 7,0 ('„=a a YYicw. Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ �� ~' FEE: $ 41r .
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
re of A ent/Owner: Signature of contractor 0,,&Z
Signature. g ,�
`Plans Submitted Plans Waived F1Certified Plot Plan El Stamped Plans El
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ I Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
C MENTS
CONSERVATION El
MMENTS
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DATE REJECTED DATE APPR VED
HEALTH '❑
MENTS _ - `e� t(� G
lILW �o
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature&Date Driveway Permit
Located at 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS