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HomeMy WebLinkAboutBuilding Permit #Exception - 33 EAST PASTURE CIRCLE 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 2�1� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 3 ;�-�' i1 c��_ ��,L�G �0, &�N-x> Print _PROPERTY OWNER AWQ�v tq c `J0_13-�N\J N&VLL_Lz_-, Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Cnc� Machine Shop Village yes 6� 100 year-old structure yes 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 XIAssessory Bldg "r ❑ Others: ❑ Demolition ❑ Other eptic ❑Well ❑.Eloodpl'am DV K Watershed9isti a 0 Water/Sewer• DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please T pe or Print Clearly) OWNER: Name: Phone: Address:- w-GRf, O(XLitk A tit, k4 lFyL— CONTRACTOR Name: It f r+W Phone: y 0A Address: ml GLM SSS (d�ns� ►�5'f���TN r� G��'� i Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.,$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ,ego "� FEE: $ i� Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of contractor Signature of Agent/Ovvner _. r ----- .!.�� 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 - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Si natur COMMENTS_ //-v I�67,`�" Tilz�L. 'Sb,'" Llbscv -z lilfl� 401 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date 0MMENTS IT sailN V W p� 0,961 88` 5t'ob1 �O ~ \ tw \ � y `� J 581 O,O~.'rb y•Sb1 '�� a � 2YJ i m ,, ��I£s--- I s'ksl AA LA -0©01 ir - - - - - - - leery_ �4sr ,�°tiy \ a 9l i ti e6l ,