HomeMy WebLinkAboutBuilding Permit #Exception - 50 STANTON WAY 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
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TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
)!(New Building Xone family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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"" Se tic' .❑Well 1 ` ;�Floodplain °�R❑1%l/etlancis, = r i �A Watershed District }�
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DESCRIPTION OF WORK TO BE PERFORMED:
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Identification Please Ty7,1/,
rPrint Clearly)OWNER: Name: A f�� N �r,,ZJ " e,. Phone:
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Address: .) /U// evs'&OL
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' � � .�� hoe � �CONTRAGTOR
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Hometlmprovement Licensee � +: __ ' -
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ARCHITECT/ENGINEER �� Nay `>Z/'��' Phone: C3.
Address: 5YQ /0- Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
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. Total Project Cost: $ '�'�=�7� �� FEE: $ 1
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered ontractors do not have access to the guaranty fund
Signature of Agent/Owrier "::S nature of contractor
Plans Submitted V Plans Waived ❑ Certified Plot Plan 200" Stamped Plans Imo'
Plans Submitted hd' Plans-Waived-[] Certified Plot Plan Stamped Plans u
-TYPE OF_SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑. . Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank, etc... Y_ Permanent Dumpster on Site ❑
THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U.FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ , �� ��
COMMENTS �i��z A-*JS
edri
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.CONSERVATION Reviewed on '� -1 ( Signature '
COMMENTS kng—sk S�i��.; i sr, �C c-,[c
HEALTH Reviewed on Si nature Y17
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COMMENTS
nater_ �iv Y 1"r�is [rte. �'
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Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submifted yes -
Planning Board Decision: Comments
Conservation Decision: :Comments-
Water & Sewer Con nection1S nat //aa�tbiEq Driveway Permit
DPW Tuwo Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp DumpWer on site yes no
Located-at 124 Mair, Street
Fire Departme►it signature/date
C011AM.ENTS .