HomeMy WebLinkAboutBuilding Permit #Exception - 54 PHILLIPS COURT 5/1/2018 M ft
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BUILDING PERMIT 3? y.- 0
TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION - -
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Permit NO: Date Received
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Date Issued: AC RUSE
IMPORTANT:Applicant must complete all items on this page
&J iOCATiION 661PHilios court- -
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iPROPERT,, i0,'.'NER-__- IRyan M.Schr..uender_
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
IN New Building � One family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑Sqptilc0 Well i, ❑LFloodpJain []UVefil'ands 11 Watershed[Disfiriet
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'2911 ',ater/Sewer
Identification Please Type or Print Clearly)
OWNER: Name: Ryan M.Schruender Phone: 978-869-6880
Address: 56 Phillips Court North Andover,MA 01845
"'C'O.NTRACTOR N:arme;: Phone: 97a-360,021:5
Stephen!M'.'Smolak
Ad.diress
762,Dale.Street North.Andever MA!01,8-45—
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SuPerviso,et ConstrutttOn License:: ,Exp. !Date. i
cs=0531.76 24,8417
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Nomel",mprove ,enV.LJcense;:, Exp. Date::
ARCHITECT/ENGINEER Martha Macinnis/Paul Marchionda Phone: 978-374-8719/(781)438-6121
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: $ $350,250 FEE: $ 4,200
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signatur-.e ofAgent/Owner - ignaiure of confractor _ i
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
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 ❑ ❑
COMENTS
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ ❑
COMMENTS
IZoning 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
AFIRE iDEPARTIM.EM -Te p,O mpster o.n site yes _ ono . I
Located_at 124'Main Street
EFtre-D`epartment,slgnature/d'ate
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Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— (For department use)
❑ Notified for pickup - Date
Doc.Building Permit Revised 2012
