HomeMy WebLinkAboutBuilding Permit #370-16 - 88 ADAMS AVENUE 9/22/2015 Sc����•Eo 9l�9/1s-
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BUILDING PERMIT
TOWN OF NORTH ANDOVER _ y p
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
-1 9SS�I `�E�
Date Issued: l� CHU
IMPORTANT:Applicant must complete all items on this page
LOCATION
/ Print
PROPERTY OWNER Ak�N LUC-�k��ly
,, Print
MAP NO: �S✓✓'PARCEL: IJ ZONING DISTRICT: Historic District yesno
Machine Shop Village yes( no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑Commercial
NRepair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
Identification Please Type or Print Clearly)
OWNER: Name: AOA.� Zlc�hzllo Phone:
1
Address:
CONTRACTOR Name: Phone:
Address
N C__ 4e 441
Supervisor's Construction License: Exp. Date.
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ / FEE: $
Check No'®- Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have acce s to a guarantyfund
ignature of Agent%Own6 Signature of contractor �!
I'
Location Av-r-44,7 _
No. lb
Date a
TOWN OF NORTH ANDOVER
r3=t� Certificate of Occupancy $
Building/Frame-Permit Fee
Foundation Permit Fee $
e Other Permit Fee $
,. TOTAL $
Check# j
y , uilding Inspector
2 ; 3 7/ v