HomeMy WebLinkAboutBuilding Permit #Exception - 60 SHERWOOD DRIVE 5/1/2018 , C
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•J TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
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PROPEFRreyr VNER
P==rmt° 4(j 'Y OId,Structure� es ono^
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_YPE OF IMPROVEMENT PROPOSED USE
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Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
KA-Iteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
Septic ❑,1Ne�l1 Floodpla ri :Wetlands "❑ ;INate shed Dis__tn�ta�Y `
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❑!Water/Sewer _ - _
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DESCRIPTION OF WORK TO BE PERFORMED:
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Identification Please Type or Print C early)
WNER: Name: m. Phone: 4T� QbZ c�
ddress:Y Ga
jiN7�RA�CT®R��Name ��
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Phone:..,
�tlretss � � c.ts =hoe
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apenriso��s�Gonstruct on�;l?icense s,.�,C�
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�rnellmlruve�mentLic e
ZCHITECT/ENGINEER Phone:
Idress: Reg. No.
FEE SCHEDULE:BULDINGgERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Ial Project Cost: $- t FEE: $
peck No.: Receipt No.:
)TE: Persons contracting with unregistered contractors do not have access to the guaranty fund
mature Agent/Ovv ,� -t----,
mature of�contractor�
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ins Submitted ❑ Plans Waived I-1 C'.ArFifiPrl Pint Plan n c+.,.,,� .,� �� __ n
Plans Submitted ❑ Plans Waived,[] Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL'-
Public Sewer ❑ Tanning/Massage/BodyArt ❑. . . 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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CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on 7 ,' Si natur
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COMMENTS :� �► � �� j� z�v�zl . .�� ��
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes .
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/signature& Date Driveway Permit
DPW Tow;! Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT Temp Dumpster on site yes no
Located at 124tMair, Street:.:.
Fire 0e1jartmei' signatu"re/date'''
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COMMENTS
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