HomeMy WebLinkAboutBuilding Permit #327-13 - 53 OLD CART WAY 10/18/2012 j E TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issu d `
IMPORTANT: Applicant must complete all items on this page
LOCATION NA
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PROPERTY OWNER. L ( A�) CIap
PrImV J 100`Year,Old Structure yes no
MAP NO: PARCEL: ZON NG DISTRICT: Historic.District yes no,
Machine.Shop Village yes, no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition 0 Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement XAssessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands. ❑ Watershed District
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: + S Phone: I
Address: GSA (k
CONTRACTOR Name: Phone.-
Address:
hone:Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ o C) FEE: $ 3(Q a o
Check No.: Receipt No.: Q 23
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owne . Signature of contractor
Plans Submitted ❑ P ans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans
r 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
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on / o�l �/I Z- Signature .y✓Lz_���
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
I
Planning Board Decision: Comments
i
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT -temp Dumpster on site yes no
Located at:124 Main.Street
Fire Deparfinenf signature/date
COMMENTS
. . ..
COMM
,
1 6
BENCHMARK:
NAIL IN TRIPLE 10" OAK
ELEVATION = 214.00
i
4" PVC VENT PIPE
W/ CARBON FILTER , S
4" SOLID PVC MANIFOLD \
� I
o I I
12'_
PX.,
G)� ��• ALL LEACHING TRENCHES I I
ARE 4' WIDE.
I 12'
15.1 15.6' i r�9�
CONCRETE DISTRIBUTION
BOX WITH INLET TEE
70
J 1313 RCF
ASSESSOR MAP 107B PARCEL 29
PAUL AND MARYANN MAUS
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