HomeMy WebLinkAboutBuilding Permit #Exception - 562 TURNPIKE STREET 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
Date Issued:
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IMPORTANT Applicant must complete all items on this page
LOCATION T 2 S
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PROPERTY OWNER W i,1)1G2alUnitff c
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MAP N0: PARCEL: ZONING DISTRICT: � Machine Shop S
Historic District y
Shop
Village yes no
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100 year-old structure yes , o
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑New Building ❑One family
El Addition ElTwo or more family ❑ 1 dustrial
Alteration No. of units:
commercial
Repair, replacement ❑Assessory Bldg ❑ Others:
❑Demolition ❑Other .
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D SCRIPTION OF WORK D: r,
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`'' d ntificat'on Please Type or Print Clearly)
OWNER: Name: VY 'f S Phone: ADO
Address:
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Date:
Home Improvement License: - Exp. Date:
ARCHITECT/ENGINEER -: �/v�,'� Phone:^3/�-
Address: �' C 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: $ � f FEE:
Check No.: Receipt No.:
NOTE: Perso c tracting with unregistered contractors do not have access to the gua fund
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�S _. _ u _ nt/..Owne_r;..-:::: -: .. .-: . a ' ,.Signature of contractor��.-.►' `
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans d
TYPE OF SEWERAGE DISPOSAL
Public Sewer d 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 L-/)Z,3 2— Signature
COMMENTS —
Zoning 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
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date 0
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COMMENTS �LY-7-/�� 1i,t�