HomeMy WebLinkAboutBuilding Permit #Exception - 92 COLONIAL AVENUE 5/1/2018 Of Noor61H
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit N0: Date Received 0
�r Date Issued:
cHus t
UYIPORTANT:Applicant must complete all items on this page
LOCATION__qZ C (or% i Q v
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PROPERTY OWNER Ktar 7,tekl
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MAP NO: 6 PARCEL: ZONING DISTRICT: Historic District yes
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Resid ntial Non-Residential
❑ New Building WOne family
0 Addition [I Two or more family E Industrial
❑AI ration No. of units: ❑Commercial
w1kepair, replacement El Assessory Bldg ❑ Others:
❑ Demolition ❑Other
Septic E Well E Floodplain ^Wetlands 11 Watershed District
Water/Sewer 1
C► h cov nillierd,
N s
AD I CA CIO
:51 1 d f n -�
Identification Please Type or Print Clearly)
OWNER: Name: � 'Ci�?�Q l Phone: q�g
Address:
CONTRACTOR Name: Wif p✓►'t � Phone: 9�; , ,
Address: 1!
Supervisor's Const ction Li nse: Exp. Date:
GS-68541
Home Improvement License: D Z Exp. Date:
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: $ 1FEE: $
Check No.: Receipt No.:
NOTE: Persons contractiwith u egistered contractors do not have access to the guaranty fund
Signature of Agent/Owner Signature of contractor
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Plans Submitted Plans Waived ❑ Certified Plot Pian ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well P 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 ❑ ❑
COMENTS
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APP OVE
HEALTH ® ® .
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COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision Comments
Conservation Decision: Comments
Water&Sewer Connection/s�nature Date. Dr�eway Permit
Located at 384 Osgood Street
`FIRE DEPARTMENT Temp Dempster on site yes recti;
Located at 124 Main:Street
Fire Department signatureldate /
COMMENTS'
B w Y, &Z6 , 197, Ll-q
3y Z ' I7,S ' l S."[" I 9'7. Z4,
D - Sox 241, 0' �� D' pv� �.'f" 157,00
5�ID 7ZV `7q,Z' 52,01 1i l._,D-Sdx - ISS �S
37,Z' lam,g -- OVrD--BDx = l S6, Z7
1 S6, 1 7
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1'7
T-Zo
,A. 17.7'
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- 35'
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AS BUILT PLAN
OF
;SUBSURFACE DISPOSAL SYSTEM
;LOCATED IN
KORTH M.} OVER, 1-IA .
AS PREPARED FOR
A. C . SU 1 LIDE-:rR S INC .
DATE: 30, lq�7
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SCALE: I � �f
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MERRIMACK ENGINEERING SERVICES
66 PARK STREET-
ANDO VER, MASSACHUSETTS 01810