HomeMy WebLinkAboutBuilding Permit #Exception - 379 BOXFORD STREET 5/9/2014 VtORTH
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINAT
Permit NO: Date Received t 4•�w••-�;�' �
�9'TSAC►R!`�Fi
Date Issued:
IMPORTANT:Applicant mustcomplete Tete all items on this page
LOCATION
Pr'tn`tr
PRbPERTY OWNER Ir1e W` I �4�le? �J[�l C
- Print
MAP NO:, PARCEL _ZONING DISTRICT: Hrstonc Distract lyes . no '
- - Machine Sho Vai[a a es no
p`, 9 Y.a
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
0 New Building 0 One family
El Addition El Two or more family ❑Industrial
El Alteration No.of units: ❑Commercial
.'gRepair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition O Other
[l Septic 1Nell` , Flood:plain ❑Wetlands Jq,yWatershed Dsthct
o_Vlla#er/Sewer . 3 3
10 �:
KF MOVA L 01P `�a7`ty 1;1100 0 N\ ; P,I_ A.T 1 D Ab
la) W s'?I Ski' hJ �t,9�\ Oc7
Identification Please Type or Print Clearly)
OWNER: Name: Lrc'icfi� Phone: �''I—ate/dl`s
Address:
�CTO--- R. fV-ame._-
. Phone
CONTR4
1 C,O Rr i L�iti[� A ave '' n+aosr"I 1'h(td
Address f
h1AV 1- k?t No -N /�►t�i �l
Supervisor's Construction License Exp Date
116 L49.
Home Improvement,License 3 SExp Date ,
ARCHITECT/ENGINEER €Q 1 4�. Phone:
Address: Reg. No.
FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 13i iso - go FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner _ . Signature of,contractor,
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ qE01Foo7dPackagmg/Sales
g Pools ❑
Tanning/Massage/Body Art
well ❑ Tobacco 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
V,P/CANNING & DEVELOPMENT ❑ ❑
COMENTS
NSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ - ❑ l l
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 Department signaturefdate /
COMMENTS
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BOXFORD STREET
1.= 44. 7' 105. 33
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DWELL��J 4
UNDER
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a'3 7OP OF FOU OArl U,11``1 '
ELEV. = 9 .�0
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/500 GAL.
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a Pty(. Edx
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LOT E
SD, Z36 S.F
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