HomeMy WebLinkAboutBuilding Permit #Exception - 50 JOHNNY CAKE STREET 5/1/2018 p►ORTIy
BUILDING PERMIT o�<t�`D •�'�'o
TOWN OF NORTH ANDOVER F i
APPLICATION FOR PLAN EXAMINATION
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Permit NO: Date Received
S�CHus
Date Issued:
IMPORTANT: Applicant must complete all items on this page
7-7-77
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building One family
El Addition ❑ Two or more family [I Industrial
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No. of units: El Commercial
❑ Repair, replacement 11Assessory Bldg El
Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PREFORM
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OWNER: Name:
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Address:
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Phone:
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ARCHITECT/ENGINEER 'Nva 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.
Total Project Cost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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Signature of,Agent/Qwner Signature cif contractor
Stamped Plans
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑
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 �-
E REJECTED DATE APPROVED
CONSERVATIO 17�
COMMENTS &I rZ' XM
DATE REJECTED DATE APPROVED
�( HEALTH ❑ ❑ �%�� I Edo '
OMMENTS
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
Located at 384 Osgood Street
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