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HomeMy WebLinkAboutBuilding Permit #Exception - 400 SHARPNERS POND ROAD 3/10/2014 Y TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received—Z1® Date Issued: IMPORTANT: Applicant must complete all items on this page Pnnt1 a Le FROPER1TYs'01NNER J __ ._ _ q Pr 100rY,ear�Oltl Structure'9 yes) n- TYPE } MAP'NO:; t�_--PARCEL: �l ZONI;NG�DIS:TtRICT HistoncaDistncta yes', i MachineShop;Village# yes OF IMPROVEMENT PROPOSE-D USE Resid al Non- Residential ❑ New Building be6ne family O Ad - ion ❑Two or more family El Industrial Zer ion No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ®1Nate!r/S e ell �' CFloodplain ®aUl/etlands� i fi --4i Water h d�©istr ct` l DESCRIPTION OF WORK TO BE PERFORMED: ?/ v Idem ication Please Type or Print Clearly) OWNER: Name: e Ed1 vt Phone:d Address: 0 wr cl oW� � C,ON)TI A Tt®•R ?Name,_ a _Le r,l- _ _�lPl oneK- b l Lf� Address - a r� _ cx t s Spelsor ury 's ConstrucflonQicense a( M1Y Exp ,4Date< Hornelmprovement LicenseF, (:/� gx p IGate �:.a...�-s .w.� rss,d�..r.-.oar. 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. Total Project Cost: $ ` 5,0 a 0 '�" FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access u n Signature of Agent/Owner Sig tafure of contractor . Plans Submittep�,, Plans Waived ❑ Certified Plot Plan ❑ tamped Plans ❑ 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 Signature COMMENTS EALTH Reviewed on Signature 1 COMMENTSr' �� 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 DPW Toivva: ]Engineer: Signature: Located 384 Osgood Street FIRE:DEPARTMENT '- Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS