HomeMy WebLinkAboutBuilding Permit #496 - 7 MILLPOND 12/12/2013b.,4 -i
Permit NO:.
Date Issued
LOCATIOI
BUILDING PERMIT ottt<<D16
"ate
TOWN OF NORTH ANDOVER °
APPLICATION FOR PLAN EXAMINATION " -
H
Date ReceivedA�4
�l ADRATID
9SS�CHuS��
IMPORTANT: Applicant must complete all items on this page
a,-ij h -V, L -L ?b �io� �J
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Print
PROPERTY OWNER fyV
Print
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
-54�o or more family//�
64
[IIndustrial
El Alteration Alteration
No. of units: C0
❑ Commercial
repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
❑ Watershed District
11 Water/Sewer
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Identification Please Type or Print Clearly)
OWNER: Name:
r
Address: I j-,za-
CONTRACTOR Name: <
Address:
OO
MAM
Supervisor's Construction License:q t3 Exp. Date: 003 1 ao)3
Home Improvement License: y �a � � Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE. • BULDING PERMIT. $12. 0 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
1
Total Project Cost:. $ti booFEE: $ 1 �I
Check No.: /,,57-,o Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have ac ess tot g aranty fund
a ure of Agent/Owner �S gnature of contractor
Permit
Date Issued
LOCAT
BUILDING PERMIT
TOWN OF NORTH ANDOVER °
APPLICATION FOR PLAN EXAMINATION - -
*
Date Received 09:
�gwTeP /.f .(5
9SS�tCMlS��
IMPORTANT: Applicant must complete all items on this page
I aaj h-\� LL ?b �io� I—Lot �J GIZJ�x AVo6i <,/t
PROPERTY OWNER
Print
MAP NO: PARCEL: ZONING DISTRICT- Historic District yes no
Machine Shop Village _ yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
'54wo or more family
i�
❑ Industrial
El Alteration
.No. of units: � U1—)
❑ Commercial
1;25epair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑ Septic ❑ Well
❑ Floodplain ❑ Wetlands
0 Watershed District
❑ Water/Sewer
/3
U} k C Location
Date
�� it- �C�l� = No. _
41 .
TOWN OF NORTH ANDOVER
OWNER: Name:
'1r
Address:
CONTRACTOR Name: <
Address:
Supervisor's Construction
Home Improvement License:
ARCH ITECT/ENGINEE
Address:
Check #I—U--
27176.
6.
Certificate of Occupancy $ �=
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Building Inspector
FEE SCHEDULE. BULDING PERMIT. $12. 0 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ Kia FEE:
Check No.: ,L�'d Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have ac ess toy / aranty fund
. ature of Agent/Owner Signature of contractor