HomeMy WebLinkAboutBuilding Permit #Exception - 42 STANTON WAY 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT:Applicant most complete all items on this page
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Maill
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,�._,, s. � •�� �..� t.�f`ti � �¢ � r Machine Shop Village yes no
TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
ew Building >�One family
❑Addition 0 Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement 0 Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
',, Se~tic;,; ❑Well r ❑�Flootlplam fl Wetlands � � ❑ VVatersf�ed District
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DESCRIPTION OF WORK TO BE PERFORMED: F
4
Identification Please Ty74/0e
r Print Clearly)
OWNER: Name: �2� '4Qu4i i- ev, Phone: 'jam =i W2.,.,L
Address: 1..;'97 Jr ewsme�L
CONTRACTOR Prhone'� 7 '��
Ad�ressr` !<' 1 f
At
11 08—M.Y-1-
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�xs�r
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ARCHITECT/ENGINEERPhone: 3`
Address: 9YZn"f'c:` ik4N Reg. No. 3b
FEE SCHEDULE;BULDING PERMIT.$92.00 PER$9000.00.OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Gost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered ontractors do not have access to the guaranty fund
Signature of Agent/Owner .signature of contractor
Plans Submitted LJ . Plans Waived ElCertified Plot Plan El Stamped Pians El
Plans Submitted ❑ Plans Waived ❑ C-ertified 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
HEALTH Reviewed on Si nature
COMMENTS a- ���� � z- � , ,'�r- a� '�ycc�• •-�s
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
j Water & Sewer Connection/Si na &,/ate . ` Drivewa Permit
DPW Tow;2 Engineer: Signature:
Located 384 Osgood Street
FIRE-DEPARTMENT - Temp Dum sten on site yes no
Located'at 124 Mair, Street
Fire Department signature/date
COMMENTS