HomeMy WebLinkAboutBuilding Permit #Exception - 458 FOSTER STREET 5/1/2018 TOWN OF NORTH ANDOVER NORTH
APPLICATION FOR PLAN EXAMINATION °tam" '•��o '
O At ,
F-
7 Permit 'NO: Date Received
SCHUS�S'`y
Datc Issued:
IMPORTANT.- Applicant must complete all items on this page
LOCATION
T n Print
PROPERTY OWNER I
Print
P:WF.1.: ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES
TYPE OF IMPROVEMENT PROPOSED USE {
Residential Non- Residential
- New Building _ One family
;Addition =Two or more family Industrial
Alteration No. of units:
Repair, replacement Assessory Bldg - Commercial
Demolition
Moving(relocation) '-Other `5ta fe �, ` - Others:
Foundation only `
DESCRIPTION OF WORK TO BE PREFOR F/D
i
Identification Please Type or Print Clearly) C
(jam Phone:
OWNER: Name:— -�� � "
F0" t
Ile
Address:_
CONTR ACTOR Name: � r� �U �`- Rt • Phone:
Address:_ 1 L_ �C1,��°
Supervisor's Construction License: Exp. Date:
IIonic Imprw�umcnt License: Exp. Date: '
ARCI IITLCT. ENGINEER ` amc: Phone:
Address: ':.;g. No.
FEE SCHEDULE:BLZDIA PER,b IT:S/0. D PER S/300.00 OF THE TOT 4L ESTIMATED COST BASED 0A SI25.00 PF.R S.F.
Total Project Cost :� �( x12.00 FEE:
Check No.: Receipt No.:
TYPE OF SEW ERAGE DISPOSAL
Tanning, Massage Body Art Swimming Pools
Public Sewer
Tobacco Sales
Well Food Packaging Sales _
_ _.
Permanent Dumpster on Site
Private(septic tank.etc. Electric Meter location to
project
OTE: Persons eoalrac•liug Will unregivered conlrac•tors [SII Not have aec'ess to/ale guarualt-jltnd
Signature of Agent,Owner
0_1A ,•--�-- Signature of contractor
Plans Submitted Plans Wailed Certified Plot Plan
Stamped Plans
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF- U FORNI
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ F 1 �
i Water Shed Special Permit
Site Plan Special Permit j
i�! Other j
C0)MMENTS
T / JECTED DATE APPROVED i
CONSERVATItt %,X
Ol � V
COMMENTS j
i
DATE REJECTED DATE . PROVED
HEALTH J
7 Zb
COMMENTS �,n�i i-� 4z> L <
Zoning Board of.Appeals: ariance. Petition No:
ZoniniJ Dec i:;ion rcccipt submitted yvs
Manning, Board Decision: _ Comments
_011Sc1Aatiim Decision: _ Cl)Inments
liter& Sewcr connection.Signature& Date
Jri�ewa� Permit
cnlp Dumpster on site �es_no_ Fire Department signature date