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HomeMy WebLinkAboutBuilding Permit #Exception - 66 EQUESTRIAN DRIVE 5/1/2018 (3) y�ORTH BUILDING PERMIT w TOWN OF NORTH ANDOVER TION APPLICATION FOR PLAN EXAMIN Date Received us� Permit No#: Date Issued: Applicant must complete all items on this page IMPORTANT: App lDb LOCATION rint L c el yes no eC 100 Year Structure PROPERTY OWNER Print Historic District yes MAP �—PARCEL:�-- ZONING DISTRICT: Machine Shop Village yes: PROPOSED USE Non- Residential TYPE OF IMPROVEMENT Residential ne family ❑ Industrial ❑ New Building ❑Two or more family ❑ Commercial ❑Addition No. of units: ❑ Others: ❑Alteration ❑Assessory Bldg Repair, replacement ❑ Other Demolition _ ❑Wetlands ❑ Watershed District D - - ❑ Floodplain Septic ❑Well Water/Sewer DE CRS TION OF WO�GK TO BE P�EORMED [j �` 1 - Pleas Type or Print Clearly hone: Ident}ficatio r OWNER: Name: eA Address: U Phone: IZi - 2 2f� • � z Contractor e: - c ,� Email: Address: C Z 2-01 7 U'�Z l Exp. Date: Supervisor's Construction License: f• . L�, 2�>t 7 Home Improvement License:. I to Z Z 3 Exp. Date: Phone: ARCHITECT/ENGINEER Reg. No. , Address: LDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. FEE SCHEDULE:BU I l0 FEE: $ Total Project Cost: $ ©lJ Receipt No.: Check No.: nre istered contractors do no have access to the guardintY fund NOTE: Persons contracting with unregistered --- _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Starnped Plans ❑ TYPE OF SEWERAGE DIS7OSAL Public Sewer nning/Massage/Body Art ❑ SWim1ingPools ❑Well bacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on �1 1 l� Si nature COMMENTS sL — 1�- HEALTH Reviewed on Si nature C MMENTS 1CaKu S I � E P Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/sDriveway Permit _ DPW Town Engineer: Signature: F E DEPA "� R�TMEIVtY Temp ©urnpsterontisite yes _ Located 384 Osgood Street •� i tedlaf'�124�IVIainkSt�eet ne(D e p a rtiYi e n tsi'g n at u re/d a teg. r . .. 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