HomeMy WebLinkAboutBuilding Permit #Exception - 9 LACONIA CIRCLE 5/1/2018 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received
Date Issued:. .
IMPORTANT: Applicant must complete all items on this page
4 cont'r
LOCATION_
Print.
PROPERTY OWNER XOh1 62�11_1 - -
Print 100 Year Old Structure yes no
MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no
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
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
Q Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
❑Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly) G,
OWNER: Name: f PhoJ(
Address:
CONTRACTOR Name:----_ __ Phone:
Address:
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 access to the guaranty fund
Signature-offAgent/Owner Signature of contractor
_. _ _. .. .. n n
-: Plans Submitted-❑ Plans Vllaived❑ ''Certi�'ied Plot Plan ❑ Stamped Plans ❑
TYPEOI{SEWERA-EDiSPOEAL
Swimming Pools
Public Sewer Tanning/Tanning/Massage/Body Art El
Well Tobacco.Sales -1?oodPackaging/Sales 0
Private(septic tank,etc PermanentUimpster on Site
THE.-FOLLOW �E�TI:®NS F®R OFFICE.USE ONLY
INTERDEPARTMENTAL SIGN.OFF - U FORM
-DATE REJECTED: . DAT.E:APPROVER
PLANNING'& DEVELOPMENT ❑
COMMENTS
,CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Si nature /
Sry
COMMENTS
ba
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes .
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection
- Driveway Permit
DPW TowX,! Engineer: Signature: Located 384 osgood Street
SIRE DEPART,M, NT :T.ernp Dumps pr on side :yes
no
-ocated-bt:124 Mair Street
Fire Depar"tine►it signatureldate
SEPTIC AS-BUILT
PLAN OF LAND
IN
INVERT. ELEVATIONS NORTH ANDOVER, MASS.
OUT OF HSE.=129.38 OWNED BY
INTO TANK=129.05
OUT OF TANK=128.80 PETER MURPHY
INTO D. BOX=128.32 SCALE. I"=20' DATE:12/5/2005
OUT OFD. BOX=128.16
END OF PIPE=127.53 Scott L. Giles R.P.L.S.
END OF PIPE=127.55 Frank. S. Giles R.P.L.S.
50 Deer Meadow Road
North Andover, Mass.
LA CONIA
R=705.43' CIRCLE
L-=150.00'
N
N
EXPAOSjON AREA
EXIST,2��X55
PROP.WATER LIN /� EXIST,
_ 30'
EXIST.[)IST,
IST _ /H FI
- EXI20,)'(501
X
55 L�
�7,
Q
O EXIST. 00 GAL.SEPTIC TANK
3�
13' -
B.M.=135.08 T.O.W�
51'+I-
NO
E)OST. HSE.
FND.
00
33'+A
N)
w
LOT#14 N
43,840 S.F. ti
-PLAN#70-5—NEE .
AS SOA MAP 1�68,PA CEL 119
I CERTIFY THAT THIS AS-BUILT INFORMATION
e ��,btot OF
WAS TAKEN ON 12/5/2005 BY ME. a
13072
RECEIVED01SzE��°,��
L LAID
MAY 12 2006
TOWN OF NORTH ANI
HEALTH EEPARTPv'!_r,