HomeMy WebLinkAboutBuilding Permit #Exception - 595 SALEM STREET 5/1/2018 BUILDING PERMIT 0 "ORTH qti
TOWN OF NORTH ANDOVER
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Permit NO: Date Received 7pA�wArlo
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
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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: ❑ Commercial
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'Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PREFORMED:
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OWNER: Name: C y / 3/i
Address: 5� S1,11 S
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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: $ At2 — C)C) FEE: $ '�-7r
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of=Agent/0wn ' Sig3nature of'co"ntractor
NORTH
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TOWN OF NORTH ANDOVER
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Permit NO: Date Received �'9Ssgroo
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
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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: ❑ Commercial
'Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other q �?
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: Jt ( C hal Phone: 'F7.fs 95CP-7"10 j
Address:
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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: $TFEE: $ / �r7i
Check No.: Receipt No.: G
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature f Agent/Cwne/ J Signature'of
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
1 TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
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
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
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TE REJECTED DATE APPROVED
�CONSERVATIO y
COMMENTS--W GI I�' :105r l !{�
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DATE REJECTED DATE APPROVED
�( HEALTH ,l ❑ []!5",,21 , C1 `il—
/ \ COMMENTS
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Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: r Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature$ Date Driveway Permit
Located at 384 Osgood Street
FIRt DEPARTMNfi� emDumpster
located at 1`24 iVlarn Stleet s a xw a 3 F { max 3 f yi'I
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— For department use
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❑ Notified for pickup - Date
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Doc.Building Permit Revised 2007
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zI CERTIFY THAT TK3 LOT 13 NOT IN THF- FJ-,O,. CERTIFIED PLOT PLAN
FLOOD '7ARD ZONE. TM CERTFICATION I3 CA3ED OF LAND IN
ON TM SURVEY MARKER3 OF OTHERS, AND Gl NOT
A PROPERTY 3URVEY,FOR MORTGAGE PURPOSE3 ONLY.
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1 CERTIFY THAT THE MX-MG3 ARE LOCATED A3 SHOWN, AS DRAWN FOR
AND TMAT THEY COWDRM9D TO THE20NwG DY-LAWS
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OF THE CY/TOWN Ior TH L Naov� a. HQ�/ x-4-1I Ll-
WHEN CONSTRUCTED. --
SCALE 1" TTA��6KI ,drye—,&.Kl
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DEED BOOK PAGE ^�I
AREA 1;I 11-145 � �O�T1-� !�-n�DOS IZ � M.& `
PLAN 2843 7 F" \J L)
ASSESSOR MAP -56 P.
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BLOCK - r� ,r - R.A.M. ENGINEERING
160 MAIN STREET
LOT HAVERHILL, MA.
508-372-0449