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HomeMy WebLinkAboutBuilding Permit #546 - 790-800 WAVERLY ROAD 2/9/2007/ IN TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Issued: . IMPORTANT: Applicant LOCATION SD® ��� vel _I Min PROPERTY OWNER L o Print MAP NO.: a7 PARC L:_ 2 O li as�a TVID , ANM 11407 nV III TIT-11ING Date Received © 7 must complete all items on this DISTRICT: MRTORir T11CTRirT VER n t N. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building 0 Addition 0 Alteration 0 One family 0 Two or more family No. of units: _ 0 Industrial O Repair, replacement 0 Demolition 0 Assessory Bldg 0 Commercial 0 Moving (relocation) 0 Other 0 Others: 0 Foundation onl DESCRIPT O cU oWUKK�'U 13 FKErc�itM %I.IALrrP�'c� � u s -1L Identification Please Type or Print Clearly) OWNER: Name: k1 C N� Na Am Jn ve `- L L C - Phone: LJy, - S/ Address: _ - Q M 40,0� UP Supervisor's Supervisor's Construction License: CS a,3 7 7 9B Exp. Date:/ ,,� _0..09, Home Improvement License:_ Exp. Date: ARCHITECUENGINEERName: Phone: Address: 1-171 W, 2czr `_�TL�1 ,l� rA)� 1_Reg. No. 42�, ` FEE SCHEDULE: BULDING PERMIT: 511.00 PER $1000.00 OF THE TOTAL ESTIMATED COST" BASED ON $175.00 PERS F. Total Project Cost :$ FEE:_ y Check No.: Reco.:- a� Page I of 4 � �-�41;� 2 - 11 0 I TYPE OF SEWERAGE DISPOSAL Art Elg Swimming Pools 0 Public Sewer 11Tanning/MassagelBody Well ElTobacco Sales ElFood Packaging/Sales 0 {septic tank, etc. ❑ Permanent Dumpster on Site ElPrivate Electric Meter location to project INU t r:: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Plans Submitted ❑ Signature of contractor. Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ 196--AyZO COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS HEALTH COMMENTS FIRE DEPAI Fire Departn COMMENTS DATE REJECTED DATE'P OVED ❑ 9�� 7 r i / Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signalure & Date Driveway Permit a TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date issued: 7 TYPE AND USE OF BUILDING Date Received 1 D HISTORIC DISTRICT YES n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ew Building 0 Addition 0 Alteration 0 One family 0 Two or more family No. of units: _ 0 Industrial 0 Repair, replacement 0 Demolition 0 Assessory Bldg 0 Commercial 0 Moving (relocation) 0 Other 0 Others: 0 Foundation only lll SCRIF1 ON O/' WUKK h �U 13 FKE;1 KM L) `t/ cOai ? i S f 4 Id Identification Please Type or Print Clearly) OWNER: Name: - o, Ic u e Jn Ye L C Phone:33Z- �� 114 Address: CONTR Address: Supervisor's Construction License: C. ; 7 7 98 Exp. Date:/I 2 UDg_ Home Improvement License:_ Exp. Date: ARCHITECT/ENGINEER Pkj1r._lPtAr� tu!:_g�Name: Phone:_ 2..12-RG.17-iT�ooC�, Address: i5 �'' 2�1; ,:k],N/62y,T�Iy 10MI Reg. No. qac FEE SCHEDULE. BULDING PERMIT. 512.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON S125.00 PER S.F. Total Project Cost :$ FEE:$ Check No.: Page I of 4 a7' TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Well ❑ Private {septic tank, etc. ❑ Tanning/Massage/Body Art . ❑ Swimming Pools Tobacco Sales ❑ Food Packaging/Sales Permanent Dumpster on Site ❑ D Electric Meter location to prof ect NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ crc-tr--o 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 DAT OVED HEALTH ❑ 9�� % > COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date ,/ w'74 77 COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/SiHnature &Date Driveway Permit