HomeMy WebLinkAboutBuilding Permit #752-14 - 51 STANTON WAY 4/25/2014 (3)f
Ir
Permit NO
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received -
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
)4�ew Building
XOne family
0 Addition
El Two or more family
0 Industrial
0 Alteration
No. of units:
El Commercial
El Repair, replacement
El Assessory Bldg
El Others:
0 Demolition
0 Other
1N hands
-2,15
M
DESCRIPTION OF WORK TO BE PERFORMED:
-j
Identification Please Type Print Clearly)
OWNER: Name: -:61a, A& " e"
ARCH ITECT/ENGINEER_ ��-VZIV Phone:
Address: 3 - 4?0
eblel:5. ea)26^W. Reg. No. 30
,0 _ �
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) ontractors do not have access to the guaranty fund
Signature of Adent/Owher -iginature of contractor.
Plans Submitted Plans Waived 0 Certified Plot Plan Stamped Plans
r
Plans Submitted -0 Plans -Waived,[]
-Certified Plot Plan ❑ Stamped Plans ❑
T-YPE_OP SEWERAGE:MP-OSAL
Public Sewer ❑
Tanning/MassageBodyArt ❑ ..
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- ❑ ❑ /'a
COMMENTS
.CONSERVATION Reviewed on Siqnature
COMMENTS
HEALTH
COMMENTS
Reviewed on
'&oEQ z_ /Z- )a r3/ V
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: :Comments
Mater & Sewer Connection/Sicinature & Wa
DPW Towi2 Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site yes
Located"at 124 Main Street
Fire Departrhe►it signature/date`
COMMENTS
4i-�3-I¢
Drivewa Permit
Located 384 Osgood Street
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