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HomeMy WebLinkAboutBuilding Permit #Exception - 50 STANTON WAY 5/1/2018 (3) BUILDING PERMIT of NORTy q 616 TOWN OF NORTH ANDOVER 10 - - APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received °R,rEp SSACHUSE Date Issued: - IMPORTANT: Applicant must complete all items on this page LOCATION 30 Print PROPERTY OWNER Ci C;5 0 Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 9One family ❑Addition ❑Two or more family ❑ Industrial W Alteration No. of units: ❑ Commercial ❑ Repair, replacement - ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ;`®Septic "® ell "� �®FCoodp,,lairt�"' I�WekHands; ;'� 1/UAter hed ®strict ater/Sc } �I DESCRIPTION N OF WORK TO BE PERFORMED:, kT�'1Cx1 r1G extl �1ah�l�t� a.�. I�My,30 p w-c- lAcs� �i1C'6 ' CcQ4a t"l . 01 sctee,,eA in pocc k . Identification- Please Type or Print Clearly OWNER: Name: CMS\S [5 J1 L) Phone: Address: --6o zg tv N t,.3 c-Y== a\ t7 i 5 Contractor Name: Phone: X03 944 Email: Address: SL UeA\, �h�;n 5* S�Irm N R 6 0-79 Supervisor's Construction License: CS _ DSS �3�- Exp. Date:_ Home Improvement License: y$ Exp. Date: UZI it ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 0 o FEE: $ ' Check No.: 55.9 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted'9 Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ TanninglMassage/Body Art ❑ Swim�g 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 PLANNING & DEVELOPMENT Reviewed On l Si nature V COMMENTS )C(A .101� RV ey�yoacj� [d fn U I&11GCU} !i ft( tp��k eA\-3N '36M1,,W 416M� WA �V6qX.. rpxv �C6P� a0l �tru l h6u� rum J CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on (lJ Si na 4 ��,rzx� U COMMENTS �—O 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 FIREDE_PARTMETeinp Dumpster on,situ,gyes ,,, t-�, ta � i 'no � ' F : Lr"o aed at 12.4 Main t '�`, t Stree tr+ F�� p i nature/date �y t �• { .�yFire. g 5 ram - xTF+ t.i?'`'�..+ �'•scaw ,C+h',.a.9,tse., {.=.�, 3T ,�..��.� t �, t� � 7;.k ,Cr +w. � +"� {� i�tw.tu ijS�.tStiF .t.c.� �. � (.-'9 ����yam."... COIVIMENTS4�-'• -�a x. -'� Y"' �x ► ;�=�;ra '`�t , ► :,. ' .? Y3 �s ,`I c is rati2sE :a rk...c: J i �'_S��TCED�j6gc ! b ucopy PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE OF COMPLIANCE As of: 11/20/2014 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Complete Repair and Construction of an On-Site Sewage Disposal System By: Matthew Manning At: 50 Stanton Way Lot 16-5 Map 61 Lot 120 North Andover, MMA 01845 Iic s anc;,fthis c• 'ficdt��shall no be construed as a guarantee that the system will function satisfactorily. f A hele rantPublic Health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com i j