HomeMy WebLinkAboutBuilding Permit #Exception - 35 STANTON WAY 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit�0Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
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r�AZQN I4DISTRICT '` riHistonc District yes no
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TYPE OF IMPROVEMENT PR`OPOSED USE
Residential Non- Residential
.2r,New Building Sk*One family
D Addition IWTwo or more family 11 Industrial
D Alteration No. of units: El Commercial
D Repair, replacement El Assessory Bldg El Others:
D Demolition El Other
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Floodplain Wed W at6rg
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Sewer.
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DESCRIPTION OF WORK TO BE PERFORMED:
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6-7,
Identification Please T or.Print Clearly)
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OWNER: Name:jQ26E�L�_Jlz �_Zv,� Z;Vr &,rLZJ i- ec. Phone
Address:_z�' 4- M"'A090"r-J"
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`NameAIone
'CONTRACTOR
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Address` !" /9
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.Home Improverri`ent License ,... : Etc Date
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ARCHITECT/ENGINEER hX1L^)1!V Phone: &?f-, V11 - 95x5_9
Address: Reg. No. 30 7
FEE SCHEDULE:BULDING 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: $
r� FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregisteredxontractors do not have access to the guaranty fund
Signature of Agent/Owhe ?��A'/- /"S-ignature of contactorZ.
Plans Submitted Plans Waived F1 Certified Plot Plan Stamr)ed Plans
Plans Submitted ❑` ' Plans Waived-❑ n Certified Plot Plan Stamped Plans
TYPE_OF SEVJE AGEDISPOSAL
Public Sewer ❑ Tanning/Massage/BodyArt ❑. .. .Swimming Pools ❑
Welly
❑. Tobacco.Sales ❑ Food Packaging/Sales ElPrivate(septic tank, etc... Permanent Dumpster on Site ❑
THE.FOLLOWING SECTIONS FOR OFFICE.USE ONLY
INTERDEPARTMENTAL SIGN OFF - U.FORM
;.-DATE REJECTED DAT EAPPR6VEp
PLANNING & DEVELOPMENT- ❑ # `2
COMMENTS
:CONSERVATION Reviewed on -c-,� l Si
nature
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COMMENTS .
HEALTH Reviewed on Si nature
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COMMENTS n
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Zoning Board of Appeals: variance, Petition No: Zoning Decision/receipt submitted yes .-
Planning Board Decision: Comments
Conservation Decision: Comments
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WaterSealer C®nnecti®u/Si natPteron
Drivewa Permi DPW Town Engineer° SignaturesLocated 384 Os ood Street
FIRE DEPARTI�ENT Temp Dum yes no
Located at 124 Mair Street _. _.
fire'DepaatMe►+t sighatureldate
COMMENTS