HomeMy WebLinkAboutBuilding Permit #Exception - 88 DUNCAN DRIVE 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION
FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION b� (,!An
4
Print.
PROPERTY OWNER P44-k, At S+.� Wale o)P n,n
Print 100 Year Old Structure yes
MAP NO: OSA PARCEL: ZONING DISTRICT:it_Historic District yes
Machine Shop Village yes 49)
TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
❑ New Building ;R One family
,Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
'XSeptic )!Well ❑ Floodplain Wetlands ❑ Watershed District
0 Water/Sewer
DESCRI TION OF WORK TO BE•PERFORMED:
.--- - - _
Identification Please Type or Print Clearly)
OWNER: Name: 4- o Phone: " 3S
Address: Ow-Ac
CONTRACTOR Name: zLeAn�&�-.',e-rYPhone: �1
V ` rn
Address: I 1= C�
Supervisor's Construction License: (.� � I Exp. Date:
Home Improvement License: Exp. Date: I be 11'4
ARCHITECT/ENGINEER �F 1��-1 Phone: 1-n—
Address:T F�f l--�t . 61"4t_ \A 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: $ f��y 6 `E FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have acceso he fund
Signature of Agent/Owner Signature of contractor
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped P s
_ ,..::..Plans-Submitted. ❑ -RlansWaived,E- .:-..Certified Plot Plan ❑ Stamped Plans ❑
:TYPE QF�SEWERAGEDISPOSAL"
.Public Sewer ❑ Tanning/MassageBodyArt ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑
Food PackaginglSales ❑ .
-Private(septic tank,etc__ . Permanent Di mpster on-Site ❑
_. THE_.FOLLOWING SECTIONS FOR-OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF U FORM
DATE REJECTED . DATE APED / .-.
PLANNING & DEVELOPMENT- ❑ CP—�'1q ,
COMMENTS
CONSERVATION Reviewed on Signature A I (, l �
COMMENTS_ ._:�, y ��
HEALTH Reviewed on Signature -
COMMENTS_ �.p.n`C-- S � C�C� �5�'rl.U( 5c�rOomS (ice
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 Todv� Engineer: Signature: �
Located 384 Osgood Street
.. FIRE DEPARTW� NT :- Tem.p Dumpster on site yes no
Located-at 124 Mair Street
-Fire Departme►.it signature/date
COMMENTS