HomeMy WebLinkAboutBuilding Permit #Exception - 62 SUTTON HILL ROAD 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received `� 'L
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER -((� � ') 6 Unit#
Print
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
100 year-old structure yes no
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 11 Other
Septic Well D Floodplain 0 Wetlands 0 Watershed District
Water/Sewer- --- ---
�~ DESCRIPTION OF WORK TO BE PERFORMED:
�A F2-
` (Identification Please Type or Print Clearl ;
OWNER: Name: � f ! c am le,( S . h u Z.bc"
Address:
CONTRACTOR Name: 2,P, CC I(y & l S Phone:
n
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULD/NG PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER s,F.
Total Project Cost: 0-,`�3 FEE: $ � �—
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
_ ,._ . ......
-ignatue of Agent/Qwner. .
- Signature of conif ctor,
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Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales 0 Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ _ y
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THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM j
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION Reviewed on 2 I Signature
COMMENTS 7� IOU,
HEALTH Reviewed on Signature
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COMMENTS — �� �� ,- ! :�vv�v�
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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 Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT -Temp Dumpster on site yes no i
Located at 124 Main Street
Fire Department signature/date
COMMENTS
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MERRIMACK ENGINEERING•,SERVICES, INC.
PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS
66 PARK STREET • ANDOVER. MASSACHUSETTS 01810 u TEL (617) 475-3553. 373-3721
s ""M"GT
E K SURVEY INC
4 HAVERFULL,MA i
Phone 978.469.1985 Fax 978-461;`7046
MORTGAGOR A 14MW _— DEED REF. A5/!S PG.
ADDRESS OF PRINCIPLE SUfLDING PLAN REf z SL
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CERTIFICATION TO: �t.�.,,� � RUDEt '"
This M �� No.3DEL The location of the principle structurets
oIrt lle Plot Plan was prepared specific*for Oo�J6ed�t
mortgage purpose's ontY and it is not Intended or representedt'tC15f t�� �� with the focal zoning
to be a property tine Or land survey.This plan Is not to be used Jai 8 bylaws in effect when constructed
to establish any Of the property Imes for any purpose,No ~'u tl�N�S and/or is exempt from violation enforcemnenl
responsibr7hy is extended tq;he land Omrer Or occupant. aCtiol Under Maas B.L. Title VII,Chap.40A,Sec..l-
This certification is based on the location of su ®Subject building iS not in a Flood Hazard Anes.
of others. rueY marker D Subject building is In a Flood Hazard Area.
Flood Hazard determined from the FIRM map*.
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