HomeMy WebLinkAboutBuilding Permit #251-15 - 575 OSGOOD STREET 9/15/2014 r�.. tAORTH
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BUILDING PERMIT �? a�Rt`!o
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION -
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Permit NO: Date Received0,04
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Date Issued:—aLS
M RTANT: Applicant must complete all items on this 2age SAC HV 5���5
LOCATION��
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PROPERTY OWNER
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MAP NO: PARCEL:-ZONING DISTRICT Historic Qisfrict yes no
3 Machine Shop Village yes no
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
0 Addition 0 Two or more family ❑ Industrial
Alteration No. of units: ❑Commercial
0 Repair, replacement 0 Assessory Bldg ❑ Others:
❑ Demolition 0 Other
0 Septic D Well Floodplain 0 Wetlands € Watershed District
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D Water/Sewer
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Identification Please Type or Print Clearly)
OWNER: Name.- 2JC(rrCe4i(eW efVLCM&ZL)4-VPhone:
Address: `~(��c� (J > > >4
CONTRACTOR Name: _ v Phone:
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Address: _ A
Supervisor's Construction License , Exp Date: '
Home ImprovemenfLicense: n Exp. Date:
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ARCHITECT/ENGINPhone: � "���-C q0
Address: 2SCO/!54-19 7�'Y'/cR-Q Reg. No. 75 5�
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ /l[ll. 000 FEE: $ 55Z
Check No.: S Receipt No.: W-00
NOTE: Persons contrae rig with unregistered contractors do not have access to the guaranty fund
-Signature of Aga-Aignnei 4, F ature ofcontractor