HomeMy WebLinkAboutBuilding Permit #Exception - 733 TURNPIKE STREET 5/1/2018 (3) i
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT:Applicant must complete all items on this page
4, Q AT 1 .0,N 4 r-11 P Fk 4- Lf-51-
Pnnti
P.ROPERTsYrO1NNER _ 5- VNTJ
_. Piint� 100 Year OeStructure yes, no)
MARINO, PARCEL':_. ZONINGgDISJTRICT:_ . Historic.Distriet. yes, no)
Machine ShoprVillage yes. no:
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addiion El Two or more family El Industrial
ter tion No. of units: �ercial
epair, replacement ElAssessory Bldg El Others:
El Demolition El Other
0 Septic'; ❑VWell' q Floodplain; [I Wetlands F ❑ Watersh-ed District'
_ ._❑'V1/ater/Sewer'. _
DESCRIPTION OF WORK TO BE PERFORMED:
-9-a� 14-'*� A F
IeAdy" yli b �`f
Identification P ease Type or Print Clearly) f
OWNER: Name: Cr. Phone:
Address:
C.QNTRACTQR Name:_... . [G Phone; cl,
Addi-ess: ���k I�a� �� ► -- bZ I
S,upervisorrs Construction License: Cl-;� '4 . 0 Exp: Date: _ to y
Home,,Impro-rnent"L-itense: Exp:, Date:
ARCHITECT/ENGINEER14 +�t Phone: 6 f 7- F7- 1
Address:
1-5-
a,,. Reg. No. �r
.FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 0 FEE: $
r
Check No.: Receipt No.:
NOTE: Persons contracting wit un gistered contractors do not have access to the guaranty fund
Signature of Agerit/bWner Signature_of contractorJ-Smped
Plans Submitted� P ans Waived ❑ CertifiedPlot Plan [E] Pla s ❑
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE-OF SEWERAGE DISPOSA
Tanning/Massage/Body
Public SewerArt ElSwimming Pools El
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOVRT
G SECTIONS FOR OFFICE USE ONLY
INTER® MENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DE OPMENT' El ❑
COMME S
CONSER ION Reviewed on Signature
OMMENTS
HEALTH Reviewed on Si nature 6�4
NTS
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 MainStreet
Fire Department signatureldate
COMMENTS