HomeMy WebLinkAboutBuilding Permit #Exception - 733 TURNPIKE STREET 5/1/2018 (2) RECEIVED
TOWN OF NORTH ANDOVER -7
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APPLICATION FOR PLAN EXAMINATION UUL
_ TOWN OF NORTH ANDOVER
Permit NO: Date Received I HEALTH DEPARTMENT
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION i' r Y� ` ►- er ►/'�
pit
PROPERTY OWNER /44/ b LLCUnit#
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 K42a-vv V&,1 ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg �9 Others:
❑ Demolition ❑ Other
❑ Septic Well ❑Floodplain ❑ Wetland's, q' Watershed District
❑Water/Sewer
DESCRIPTION OF WORD TO BE PERFO `�D: j
C' , a� e M C. cr� V�-, l 1 t�.i -�-C L S r N e rr e UJ
U.I of
djentifichtioIease Type or P ' t C early)
OWNER: Name: 14 ny"t Phone: 7 -1 t'. <D I ��
Address: d 5 dU C� � �
CONTRACTOR Name: T, 1 v[ q,,,qd C n s gid►-Phone: I - 1-2— 0 (Z
Address: c
Supervisor's Construction License: 1 5 Exp. Date: 0/2
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Tc m e- D- ,Sv4J/n Phone: 15a
/14 W . �cvs I,t�l'e
Address: Ca Reg. No.
FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $_ �, O� p 0 U FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/®wner, Signature,of contractor
i
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
"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
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on i Si nature
COMMENTS _0 d
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
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions. 9 S F
Total land area, sq. ft.: f�
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— CFor department use
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2011 June/mi