HomeMy WebLinkAboutBuilding Permit #341-13 - 36 SAWYER ROAD 10/24/2012 4 0� NtCaoTh �M
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BUILDING PERMIT
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TOWN OF NORTH ANDOVER ;o
APPLICATION FOR PLAN EXAMINATION
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Permit NO: Date Received
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Date Issued: /`D/217, �Ss,�CHus��
IMPORTANT: A22licant must complete all items on this page
LOCATION 9c),
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PROPERTY
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MAP NO:0J.—PARCEL-.a-
TYPE
—PARCEL TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building e<Ge family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
epair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
D Septic ❑Well 0 Floodplain .0 Wetlands D W8ter$hedDi$#kJ
0 Water/Sewer
,n DESCRIPTION OF ORK TO BE PREFORMED:
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`Identification Please Type or Print Clearly)
OWNER: Name: P� (\�c,k/k �, , ��, Phone: I2—e—la RL - 1 a3)
Address: 6mn get S
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Home Improvement License: ) t J exp. Date:
ARCHITECT/ENGINEER Phone:
Address: 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: $_ 1 L(, 5-�y, u a FEE: $ I �s.03
Check No.: (, 8,-11 Receipt No.: o ,
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
ignature A Agent/owner -S' nature of contractor
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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 ❑ ❑
CWMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
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 Depairtin+ent signatureldate
COMMENTS . }