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HomeMy WebLinkAboutBuilding Permit #Exception - 57 LONG PASTURE ROAD 5/1/2018 4 pORTH BUILDING PERMIT O� (SLED �batio TOWN OF NORTH ANDOVER 32 h�''( - ' 10� ° ; . . :.w , APPLICATION FOR PLAN EXAMINATION * _ Date Received � � ,> Permit No#: � '°°R,TED�P '(5 SsgCHUS� Date Issued: IMPORTANT:Applicant must complete all items on this page DCATION --s -- 46. not PROPERTY OWNER - - . ._ __ n �°' -1©0 YeF Stcuctdre LL Yom- no P (J _ PAREt:vONI!NG DISTRICz`. Historic District yes no MA _ Machine Shop Village yes, no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One'family El Addition El Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ¢ ❑i Septic ❑Well D Floodplain ❑Wetlands ❑i Watershed District ❑i Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: < 22- C i . fn Identification- Pease Type,or Print learly / OWNER: Name: Phone: �a S �� ) Address: Contractor Name: N Phone: , Address: Superviisorp's Construction License: . Exp. Date: Florae Improvement License: _ _ — Exp. Bate:___- ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Si nature of A-emt/CI ►ruer Sic nat_ure of contractor � Plans Submitted ❑ Plans Waived ❑. Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL ❑ Swimming pools Public Sewer ❑ Tanning/MassageBody Art 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 /PLANNING & DEVELOPMENT Reviewed On �l jy Signature_ COMMENTS Reviewed Signature , /ZNSERVATION COMMENTS r ' HEALTH Reviewed on j Si nature -rop-' COMMENTS L157� r� Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments � Conservation Decision: Comments Driveway Permit Water & Sewer Connection/Si nature&Date DPW Town Engineer: Signature: Located 384 Osgood Street em Dumps =on 'y -.= �- T ter site } � nog ._ I�--I +E+E DEPARTMENT - p - _ ocafed at 124rMam Street - - a_ ��...��nonar+ment,s�q_ INV_ 'OF�i 1 11 INV.. OF 1 1 II INV. OF INV. OF , I LOUIS/G. & 1 I PAMELA E. RESETTA II INV. IN TC 1 I I BOTTOM , 1 I ALL E Pi EDGE v OF SAND c, BACKFILL INV. OF INV. OF cn D—BOX PTGk -� INV. OF ®� �0 P 96-12A INV OF P lid. C ' ® 6cPa tit ALL E _ _PTIC 38.0p 6 p _ i NK ,-' ~ TP 3 ®®® TP 9b�`1 z ' 69.6' 43 i°nPT t-i P 96-12 srEv�!f ANGELA QUICK-4 STANDARD MONITORING CHAMBERS WELL (6 ROWS OF ,s y 9 CHAMBERS) BENCHMARK .-Q OG�� 1-]f2"L CH TCUT SPIKE SET 40 PVC 14" OAK UP 1.0' EL.=151.72 FORCE MAIN , C PUMP UNIT NO —10 L.F. 4" SCH 40 PVC PIPE CA A GF � I s+ l +r O d 23.3,