HomeMy WebLinkAboutBuilding Permit #179 - 55 CORTLAND DRIVE 9/8/2000 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION ofN°RT" 'sti
0 A
Permit NO: Date Received * 's
Date Issued: "*g°
SS�GHUSS�
IMPORTANT: Applicant must complete all items on this page
LOCATION S SV41a J • zP � 44LJ-1r 3 M � [nuc mss)
PROPERTY OWNERkeeA
C
Print
MAP NO.: /�- PARCEL: ZONING DISTRICT:_R
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
)(New Building )(One family
Addition Two or more family Industrial
Alteration No. of units:
Repair, replacement J Assessory Bldg Commercial
Demolition
Moving(relocation) = Other Others:
Foundation only
DESCRIPTION OF WORK TO BE PREFORMS
.2ER _Deixrl & C,�a CM �,,';,'
Identification Please Type or Print Clearly)
OWNER: Name: M Phone:
Address: orll)) N.
CONTRACTOR Name: l 4 Ca (, l�j ,,,� �,� Phone: (g7-ZC15--'
Address: i L 1 CG/1�
Supervisor's Construction License: D,f ,� l Exp. Date: /
Horne 'improvement License: "✓/! 1 I-
Exp. Date:
:\RCI--[ITECT,'ENGINEER J�J Name: Phone:
Address: Reg. No.
FEE.SCHEDULE:BGLDLNG PERA11T.•512.11(I P R 51000.00 OF THE TOT.I L ESTIMATED COST BA SED 0,V$125.00 PER S.F.
Total Project Cost :$ 1)f Sf -f )zS 11 Utho x 12. Uy �z FEE:$ Z 9"* 7 . ou I, 1 ��y �LA10
Check No.: P?47- Receipt No.: 67:�6 ejb
..'T At_