HomeMy WebLinkAboutBuilding Permit #807-12 - 412 MASSACHUSETTS AVENUE 5/8/2012BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: 0 / Date Received
Date Issued•
0
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T IMPORTANT• Applicant must complete all items on this page
t'LOCATION
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�PRO.RERTY OWNER, •
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'MAP N0 7w1?ARCELl�i(J7 ZONING DISTRICT . Histone Districts ; yes no
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TYPE OF IMPROVEMENT
PROPOSED USE
'
Residential
Non- Residential
New Building
One family
on
Two or more family
Industrial
Iteration
No. of units:
Commercial
Repair, replacement
Assessory Bldg
Others:
Demolition
Other
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Septic' V11ell .
(Floodplain` Wetlands
Watershed ,Disteict
1Nater%Sewer,
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Identification
OWNER: Name: Gsr; moi)
or Print Clearly)
Address:
Nid"�Rh6nb-,
CONTRACTOR -,Name:.
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Address: C'O's Mut' / '�9✓J
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Supervisor's•Cofnstruction License::<,�7���1- `EXp� iD`ate
Home Improvement License :;. %-3��1s
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Exp::Date:
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: $ 2 0 7Sq FEE: $
Check No.: t2 Receipt No.:
NOTE: Persons contractin at unregistere contractors do not have access th g ara
Signature of
gen Own r ature :of :contracto