HomeMy WebLinkAboutBuilding Permit #728A - 57 LONG PASTURE ROAD 5/4/2011Permit NO: 'WA
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
' Date Received l�
Date Issued: 6- y o /Y
IMPORTANT: Applicant must
LOCATION
P't
fete all items on this
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MAP NO: 1106 PARCEL: J /6 ZONING DISTRICT:—ZL— Historic District yes uo
Machine Shop Village yes no
TYPE OF IMPROVEMENT
❑ New Building --
❑ Addition
;(Alteration
❑ Repair, replacement
❑ Demolition
0
PROPOSED USE
Residential
❑ One family
❑ Two or more family
No. of units:
❑ Assessory Bldg
❑ Other
DESCRIPTION OF WORK TO BE
Non- Residential
❑ Industrial
❑ Commercial
❑ Others:
DNTRACTOR Name:
idress:
pervisor's Construction License:
me Improvement License:
Exp. Date:
Exp. Date:
:CHITECT/ENGINEER Phone:
Phone:
dress: Reg. No. —
FEE
�S/CUED ULE: BULDINC PERMIT.• $12.00 PER $1000:00 OF THE TOTAL .ESTIMATED COST BASED ON $725.00 PER S.F.
FEE: $ &6—J. �d
:ck No.: Receipt No.
['E: -Persons contracting with unregistered contractors do not have access to the uaran
g tYfund
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F
PORT" TOWN OF NORTH ANDOVER
Q �.,IYD ,•� I�O -
�� OFFICE OF
lipp BUILDING DEPARTMENT
" ^ " 1600 Osgood Street
�pkj�y Building 20 Suite 2-36
Ar -Rus North Andover, Massachusetts 01845
Telephone (978) 688-9545
Gerald A. Brown Fax (978) 688-9542
Inspector of Buildings
AFFIDAVIT FOR FINAL COST OF CONSTRUCTION
In accordance with the provisions o the Massachusetts State Building Code, Article 1, Section 110.4
--A 11 A ry I-- 11. 1, .
;tion costs* of the
amounts to
being the person referred to as the owner
identified below, do solemnly swear that the statements made herein are strictly true and correct and
made in good faith.
*Related construction costs included all work done with or concurrently with the work contemplated
by the Building Permit including demolition, plumbing, heating, electrical, air conditioning, painting,
carpentry, landscaping, site improvement, etc. Furnishings and portable equipment are not part of the
total construction. costs.
• r�
COMMONWEALTH OF MASSACHUSETTS Si ture o Owne
S
Then personally appeared the able named
and
� E
Location S�� n�� G P lj
No. Date
XA�
O:NOA)h TOWN OF NORTH ANDOVER
•t�•e :•'�.y0
•
n : i
Certificate of Occupancy $
sCs Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL�ii{�r $
Check # �Z� U /
24 4 l
�• Building Inspector
Before, Me,
tts
otary Public
�V 0/ V ®6)
68-9540 PLANNING 688-9535