HomeMy WebLinkAboutBuilding Permit #119-14 - 41 CROSSBOW LANE 8/5/2013 11
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BUILDING PERMIT ,,� .1. . .6 °0
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TOWN OF NORTH ANDOVER o
L it APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received a C—...—
Date Issued: H�
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IMPORTANT:Applicant must complete all items on this page
LOCATION / 6055 ZO A) 4a pte A/
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PROPERTY OWNER AM �N d- 4T/J � PCL VJ I
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MAP NO:��WARCE ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building One family
❑addition ❑Two or more family ❑ Industrial
Id Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ emolition ❑Other
Septic ❑Well Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer Ze
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Identification Please Type or Print Clearly)
�O,OWNE Name: _A kit r
A aNy-� ucN eL-,)31 Phone:
Address: �''a 55�uvw a /V, '471eq v�Y'
CONTRACTOR Name: �.. � S�Phone:
Address: -- /^ �
4)n . /y�o SY`� {///
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER /V � 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.
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Total Project Cost: $ 000 -f -3r- FEE: $
Check No.: ? � Receipt No.:
NOTE: Person contrac g with unregistered contractors do not have ac s t the aranty fund '
i ne, ure of Agent/Owner Signature of contractor