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HomeMy WebLinkAboutBuilding Permit #Exception - 781 WINTER STREET 5/1/2018 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION •q%." '• Permit NO: Date Received–­­­— Too #�♦' "�" ' �iBncfaus� Date Issued: IMPORTANT:Applicant must complete all items on this VaRc I,Y//�T�� LOCATION 1 Print I {PROPERTY OWNER VNL-1 Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Non-Residential Residential ❑New Building Bone family ' ❑ Industrial ❑ Addition ❑Two or more family j NSKAlteration No.of units: ❑ Repair,ep ,reP lacement ❑Assessory Bldg [I commercial ❑ Demolition ❑ Others: ❑Movin relocation 0 Other ❑Foundation only DESCRIPTI N OF WORK TO BE PREF WD e C c��►p/ o '2 Identification Please Type or Print Clearly) OWNER: Name: /��� Lel�l '� L Phone: Address: c�-S L Phone. CONTRACTOR Name: Address: �fc�C v?62rs Supervisor's Construction License: q/000 Exp. Date: O �O �e� ! ' Home Improvement License: / 3-7 Exp. Date: f 2©o Zt ARCHITECT/ENGINEER Name: Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:512.00 PER SI00Q00 OF'THE TOTAL ESTIMATED COST BASED ON 51200 PED SF: Total Project Cost : FEE:$ Check No.: Receipt No.: i Pop lof'4 TYPE OF SEWERAGE DISPOSAL TanninglMassagelBody Art ❑ Swimming Pools ❑ Public Sewer ❑ ❑ ❑ Tobacco Sales Food Packaging/Sales ❑ Well Permanent Dempster on Site ❑ Private(septic tank,etc. Electric Meter location to Project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ ti THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING&DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DA PROVED ❑ Z /Cj1e> -7 HEALTH l COMMENTS Yom -1 FIRE DEPARTMENT -Temp Dumpster on site yes no Fire Department signature/date COMMENTS Zoning Board of Appeals:Variance,Petition No: Decision/receipt submitted yes Zoning p Planning Board Decision: Comments Conservation Decision: Commenb Driveway Permit Water& Sewer Connection/signature Date