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HomeMy WebLinkAboutBuilding Permit #Exception - 357 CANDLESTICK ROAD 7/28/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IWORTANT:Applicant must com lete all items on this page LOCATION 35:1 A 1(_rs� lL����i� t� � ('_r �— Print PROPERTY OWNER 7pdM r6a/l ! lel,/ Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no it Machine Shop Village 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 ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ' -£7�T7"�Y y--•+F�1-�r! �-T wl ... 17j ®i5eptic, (7�Well FpE�loodpla�n�, +Wetlands �Wateished►Distr t ,©.'�IiTatPr/�avaer'-' ._ - • . ., r DESCRP T ION OF WORK TO BE P ERiiOIRWL�D: y (Id tification Please a or Print Clearly) OWNER: Name: PSK CO/ljl C, �1�?�-I,�t) �51�� Phone: ' Address: 3S-1 C.- AA J9 t, �v vs- CONTRACTOR 7'sCONTRACTOR Name: , .'( S Phone: Z Address: �y C) �� �`/ A iN80 ur Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCH ITECUENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT•$92.000-P••.�ER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER SF. Total Project Cosi: $ , l 1 FEE: Check No.: Receipt No.: NOTE: Persons contractin d with eggs red contractors do not have access to the guaranty fund Sinature:;of•Agent�Qvirn - _ __ _ �= Slgnatuce of contractor =" 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 Si nature COMMENTS HEALTH Reviewed on Signature COMMENTS _ - -1 �� �-� ✓� Zoning Board of Appeals:Variance, Petition No: Zoning Decision/recelpt 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 COMMENTS