HomeMy WebLinkAboutBuilding Permit #Exception - 4 MAIN STREET 5/1/2018 BUILDING PERMIT °F NORTH A
TOWN OF NORTH ANDOVER �? = . °.
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APPLICATION FOR PLAN EXAMINATION =
Permit NO: Date Received '
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
epair lacemen Assessory Bldg Others: I
Demolition Other
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Please Type or Priq Clearly)
OWNER: Name: £ Phone:q)8•-697'��V6
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Address: f��� S r iD iJ S j a,�'Wyel d -
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ARCHITECT/ENGINEER 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.
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Total Project Cost: $ -7, FEE: $
Check No.: 05, Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty,fund
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