HomeMy WebLinkAboutBuilding Permit #514-2016 - 575 OSGOOD STREET 10/26/2015r `!t
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
06� Q
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Date Issued: I
IMPORTANT: Applicant must complete all items on this page
LOCATION S'75 0330Ud S4-
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PROPERTY OWNER 'C 4C,(-U�d RG -H jK {�c..4 (oM w, u w
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MAP NO:PARCEL: ZONING DISTRICT: Historic District yesno
Machine Shop Villaqe ves no
TYPE OF IMPROVEMENT
PROPOSED USE
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AC -
C -
Residential
Non- Residential
❑ New Building
❑ One family
I I Addition
I I Two or more family
❑ 1 dustrial
❑ Alteration
No. of units:
I C mmercial
E�FRepair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands
❑ Water/Sewer n JZ
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STMR AWP /GE /(Abd _B1 / P/A/Gs /000 - 2000
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Identification Please Type or Print C
OWNER:
Name: C:: d
A Eck 00iQ
AC -
C -
Address:
Address:
.-7 .S'' 056006
9T , t0,90 -T H /WQ,90i.
CONTRACTOR Name:�� SC 6� Phi
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Address: 2S7 11� �+2a1 .3 C`tc�y4t�o��j�
Supervisor's Construction License: 0 9 9 6 V9 Exp. Date:
Home Improvement License:
/s'7 Y Y7
Z-28-ZO/,b
Exp. Date:
/0 -Z-ZO/
ARCHITECT/ENGINEER Phone:
Address: 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: $ 9l, yz . 0FEE: $ '
Check No.: Z3ci0 Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to;#e guarantyfund
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