HomeMy WebLinkAboutBuilding Permit #179 - 55 CORTLAND DRIVE 9/8/2000 (4) TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION of"�oT a 1tio
'e p
10 A
Permit NO: 1 7 f Date Received +'
Date Issued: C SscHuse
IMPORTANT: Applicant must complete all items on this page
LOCATION 5 .S c''�1 GI J
6' r r 3 N 2.
C01')1
Mie �xse tiws�
PROPERTY OWNER At C
Print
MAP NO.: I0II PARCEL: ZONING DISTRICT: P,
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
.'New Building ,(One family
C Addition -Two or more family - Industrial
Alteration No. of units:
Repair, replacement C Assessory Bldg Commercial
Demolition
Moving(relocation) Other - Others:
- Foundation only
DESCRIPTION OF WORK TO BE PREFORMED,
.SrR fie" c Goip -FrA,JL 11'�ZL�fLt�
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address: )Z- ' AIJ N. Alve A A
CONTRACTOR Name: ra , �l t�(� Phone: A •(97'LCZI'
Address: I I (G , 4
Supervisor's Construction License: D,j", � Exp. Date: /
Home Improvement License: �/�I? Exp. Date:
ARCHITECT/ENGINEER ��.�, Name: Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$12.00 P 'R 51000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost : P9)k SP X )Z-V llaeD A IZ• 06 �z FEES Z$�"� �� I I ob I�Vr"
I�l �� � � Uv cto
Check No.: Receipt No.:
v� .AL