HomeMy WebLinkAboutbuilding permit - Permits - 37 WELLINGTON WAY 8/8/2019 BUILDING PERMIT of Noery
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
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Permit No#:_ Date received �,9qb'+�rEo
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION '° 06/_L19E Ioa/J UJAY
P`int.,
PROPERTY OWNER C S A it e o+
Print 100 Year structure yes
MAP 5C PARCEL: ZONING DISTRICT: Historic District yes n
Machine Shop Village yes'
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building XOne family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No, of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Ty a or Print Clearly
OWNER: Name:�s�J14 n � /tJC 9 Phone
Address: S )J 6& 0G A)D
Contractor Name: sla�� Phone:
Email: 85� G- ,r 6 [
Address"9-72.W 5
Supervisor's Construction License.CS;F,4 Exp. Date: . F ,3/ /Ib
Home Improvement Licenser Exp. Date: 11 1 q l
ARCHITECT/ENGINEER € v Phone:92tg-9,5-2,— 93/8
Address: 4110 IV J4A.6 P Reg. No. 2,? 74��
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ aT5�_0003� FEE: $ _5j'5_` &4.x
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Plan•-9-if `rnitted`r Plans Waived ❑ Certified Plot Plan Stamped Pfans
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F SEWERAGE DISPOSAL
ewer ❑ Tanning/Massage/Body Art ❑ Swiimning Pools ❑❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private(septic tank,etc. Permanent Dumpster on Site ❑ '
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF m D FORM
PLANNING DEVELOPMENT Reviewed On Signature_
COMMENTS
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CONSERVATION Reviewed on Signature
COMMENTS
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WEALTH Reviewed ok—L d DJ Sic
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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/si nature&Date
DrivewayPermit _
DPW Town Engineer: Signature:
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; s Located 384 sgo Street
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