HomeMy WebLinkAboutBuilding Permit #Exception - 45 WINDKIST FARM ROAD 5/1/2018 BUILDING PERMIT of NORTH qti
TOWN OF NORTH ANDOVER o�
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received 0'
7a p�R4TE0•� .�5
SSACHUSE�
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION �T X11�tJ�tST �'l �
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PROPERTY OWNER 2-t-Vp1 -i-/
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MAP NO: _PARCEL:ZONING DISTRICT: 2— Historic District yeso
!Machine Shop Village yes o
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other c,(;,, , 4,— &f
Septic Well Floodplain Wetlands Watershed District
Water/Sewer
DESCRIPTION OF WORK TO-BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: �. , Phone: ' !
Address:—Al u Y-%S "�..
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CONTRACTOR Name: (f/AWmeh ZA 2X1e.. Phone: 9 ',Z0ZaXD
Address: ; )'JWAOC't. f 7 . z`{
Supervisor's Construction License: CS-4' 7� ` Exp. Date: Z
Home Improvement License: O' Exp. Date: ? Z�
ARCHITECT/ENGINEER Phone:
Address: 61t 4. r'21,x ,iL -- Reg. No. 4 s e
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F..
Total Project Cost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the gua nd
Y 1-
Signature of Agent/Owner. ignature of contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/MassageBody 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 7/25 / Si nature
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COMMENTS
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HEALTH Reviewed on Signature
COMMENTS
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 Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signatureldate
COMMENTS
ASSESSOR•
MAP 109, L 0T 49 NorEs•
1 1. THIS PLAN IS NOT TO BE CONSIDERED AN
RESIDENTIAL 2 ALTA/ACSM LAND TITLE SURVEY, NOR IS IT TO BE
USED FOR RETRACEMENT OF PROPERTY LINES
�FERENGES• 2. SEPTIC SYSTEM TAKEN FROM PLAN ENTITLED
DEED BOOK 13159, PAGE 288 '�4S—BUIL T SUBSURFACE DISPOSAL SYSTEM" PREPARED
PLAN #12957 B Y MERRIMA CK ENGINEERING SER VICES INC. DA TED
NO VEMBER 3, 2000, PROVIDED BY BOARD OF HEAL TH..
J. UTILITIES SHOWN HEREON FROM FIELD LOCATION OF
SURFACE STRUCTURES NO UNDERGROUND UTILITIES
BE THE
INCLUDED AS PART OF THIS SURVEY. IT SHALL
O RESPONSIBILITY OF THE CONTRACTOR TO CALL
WERE
DIG—SAFE A T 811 A T LEAST 72 HOURS PRIOR TO
EXCA VA T/ON OR CONSTRUCTION.
4. BORDERING VEGETATED WETLANDS SHOWN HEREON
N-Ny WERE DEL INEA TED B Y HANCO CK ASSOCIA TES AND WERE
�N /�/s FIELD LOCA TED BY INSTRUMENT SURVEY.
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PLOT PLAN CHK. BY
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S= 45 W/NDKIST FARM ROAD, NORTH ANDOVER, MA
FL
JALSM PROPERTY OF COSTA TE STEPHEN DA
NbHANCO CK 7/24/13
Survey Associates, Inc. ,
SCALE. 1 = 30 JOB
ZJ� /„3 185 CENTRE STREET, DANVERS, MA. 01923 N0.
PROFESSIONA LAND SURVEYOR VOICE (978) 777--3050, FAX (978) 774-7816 p 15 30 60 175.
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