HomeMy WebLinkAboutBuilding Permit #Exception - 58 COUNTRY CLUB CIRCLE 5/1/2018 (2) Of Np RT b qti
BUILDING PERMIT 3i 4. .�_ =6 oG
TOWN OF NORTH ANDOVER °
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received X0, C4T P
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Date Issued:
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IlVIPORTANT: Applicant must complete all items on this page
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LOCATION 5.8 COUNTRY CLUB CIRCLE - _
PROPI=RTY'OWNEft DONALD D STANLEY
MA`I?NO 64 PARCEL ` 150, ZONING=E?I``STRICT R_1 ,Elstonc�D�strict yes ono r
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: 0 Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑.Sept►c
dwell` ❑ Floodplain_ ❑1Netlands
VlfD VlJatershed District
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❑ ater/Sewer
CONSTRUCT INGROUND POOL & SPA, SEGMENTED BLOCK RETAINING WALL
AND FENCE ENCLOSURE, PARTIALLY WITHIN THE NON-DISTUCRBANCE ZONE
Identification Please Type or Print Clearly)
OWNER: Name: DONALD D. STANLEY Phone: 978-857-1959
Address: 58 COUNTRY CLUB CIRCLE
CONTRACTOR Name = Phone: -
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Supervisor's Construction License IM1 Exp Date
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GEORGE J. ZAMBOURAS, P.E.
ARCHITECT/ENGINEER ATLANTIC ENGINEERING & SURVEY Phone: 978-352-7870
Address: 97 TENNY STREET, GEORGETOWN, MA 01833 Reg. No. MA 36230
FEE SCHEDULE:BULDING 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 w- u r d contractors do not have access to the guaranty fund
Signature o Agen wn Signature of contractor