HomeMy WebLinkAboutBuilding Permit #Exception - 89 BRIDGES LANE 5/1/2018 i
BUILDING PERMIT '
D.161 61"YO
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t TOWN OF NORTH ANDOVER ��`�;y'`
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received 74g6RgTED
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Date Issued: AC US
IMPORTANT:Applicant must complete all items on this page
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i 'PROPERTY'.OWNERk Vt.�/t�C-P -1
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'NIAP)NQ I?ARCEL _ ZONIRGDISTRICT�: _ Histone Distract; yes; noR
lMaehme;ShopJVillage --yes-1
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
r Se tic Well w -
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<P_ j `FloodPlam Vl/etlarnds, Watersheds®istrict`
I.-_ .-Water/Sewer4. .. _
DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTIQR Name; _.
Phone
Supervisor`"s;ConsttuctionrLicense p' 'Da
EX te:
,Ho me.linProvementSLicenseEzp Date '.:,i
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: A Receipt No.:
NOTE: Persons contracting ith I stered contractors do not have access to the guaranty fund
Signature of Agent/Owner gnature 6f contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales
Private(septic tank,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS _ _ �� , •
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HEALTH Reviewed on I O Si nature �l l
COMMENTS �- 1 ILCsI��l �— G:�✓ . i
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_ Tempbumpsterbn' site yes `
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Located at l24Mam,Street.' z
Fire1Departffi "ri gnature1datey -i� o,*' `� ;. f
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