Loading...
HomeMy WebLinkAbout2017-04-11 Land Disturbance Permit Application • 1 IIAIR r39 r A PLANNING DEPARTMENT Community& Economic Development Division Land Disturbance Permit Application 0 Please type or print clearly. 1, Petitioner; IV I NGS-/-0N EVJ i C01zp Petitioner's Address � Telephone number: ""EuJKS 4),e D F7,G 2. Owners of the Land: �� 7 Address: C C[ Number of years of ownership: 441 3.Address of Pr operty Being Affected:!4 S cS,quF M 57 . akA 5�7L Zoning District: -2- Assessors Map: 1068 Lot#: Registry of Deeds Book#: 3�5- T Page#: -3.53 C F14Sr RiYu'�, 4. Description of Project: CKarD INJG o2� -LOT- r)2 so16 IVts a 12 ' [VEV[JA�! Cnn1s7&.0.,,C2-17 V 5. Total Area to be Disturbed 6 2- cke I<, 6. Has there been a previous application (Special Permit or Definitive Subdivision)from the Planning Board on these premises? 'IC-S If so,.when and for what type of construction? 5Ec 7. Has there been a previous application (NOIIRDA, Small Project, Certificate of Compliance)from the Conservation Commission on these premises? E-5 If so, when and what type? 001 1 n1 C ---5 7. Petitioner and Landowner signature(s): Every application for a Land Disturbance Permit shall be made on this form, which is the official form of the Planning Board. Every application shall be filed with the Town Clerk's office. It shall be the responsibility of the petitioner to furnish all supporting documentation with this application. The dated copy of this application received by the Town Clerk or Planning Office does not absolve the Page 1 of 2 120 Main Street, Planning Dept., North Andover, Massachusetts 01845 Phone 978,688.9535 Fax 978.688.9542 Web www.northandoverma.gov applicant from this responsibility. The petitioner shall be responsible for all expenses for filing and legal notification. Failure.!and'?gg0ply with application requirements, as cited herein and in the Plan ` Roa�fRutes Regulations may result in a dismissal by the Planning Board of this applicb' n as incomplete. Petitioner's Signature; Print or type name here: S60 Owner's Signature., ----------- Print or type name here: to N§ V\,O%SC) 8. Please list title of plans and documents you will be attaching to this application. Pe .� lit Page 2 of 2 120 Main Street, Planning Dept,, North Andover, Massachusetts 01845 Phone 978.688.9535 Fax 978.688.9542 Web www.northandoverma.goy �I 11 41f 9s, PLANNING DEPARTMENT Community& Economic Development Division Land Disturbance Permit Application Please type or print clearly. 1. Petitioner: 106S77DNL f00-P Petitioner's Addres&K�-D Telephone number: 7',aJKS J2 61 F71, 2. Owners of the land: �D Address Number of years of ownership: 49 Me, 3, Address of Property Being Affected: Ig7J W- M 57, �� - ��lP� S�7' Zoning District: _Z Assessors Map: , 1068 Lot#: Registry of Deeds: Book#: 3.5- 3 q Page#: --36-3 Si P/ Wc,&-Z) 4. Description of Project: CaA4Q /rJ 6SuPPo2T� 3 -CDT , Ati2 5yg rycs 10 NC t V EW,1��L Co tl s c 5. Total Area to be Disturbed J ,6 2- 0C 1�' S - - 6, Has there been a previous application (Special Permit or Definitive Subdivision)from the Planning Board on these premises? E S if so,when and for what type of construction? SEE ATTACNaD 7. Has there been a previous application (NOURDA, Small Project, Certificate of Compliance)from the Conservation Commission on these premises?, `(ES If so, when and what type? © n) c Cs 7, Petitioner and landowner signature(s): Every application for a Land Disturbance Permit shall be made on this form, which is the official form of the Planning Board. Every application shall be filed with the Town Clerk's office. it shall be the responsibility of the petitioner to furnish all supporting documentation with this application. The dated copy of this application received by the Town Clerk or Planning Office does not absolve the Page I of 2 120 Main Street, Planning Dept., North Andover, Massachusetts 01845 Phone 978,688,9535 Fax 978.688.9542 Web www,northandoverma.gov applicant from this resp sibility. The petitioner shall be responsible for all expenses for filing and legal notific comply with application requirements, as cited herein and in the PlanV4,lPoaM.-Rules and Regulations may result in a dismissal by the Planning Hoard of this Wcalion as incomplete. Petitioner's Signature: Print or type name here: 7-,9c2 M,4_c, 14C'�,fl SGI-) Owner's Signature; `�����``� �✓ ----�, Print or type name here: �-. E PAS \Ad)S 8. Please list title of plans and documents you will be attaching to this application. e CAL .L_ -e tL t1 r Page 2 of 2 120 Main Street, Planning Dept., North Andover, Massachusetts 01845 Phone 978.688.9535 Fax 978,688,9542 Web www.northandoverma. oy - ... .......... . ....... ................ . - - ..... . 6/16/2017 Town of North Andover Mail-Erosion control permit Salem St North Andover NORTHANPO'VER Massachusetts Rebecca Oldham <roldham@norfhandoverma.gov> Erosion control permit Salem St North Andover 1 message Thomas Hodgson <livingstonedev@icioud.com> Fri, Jun 16, 2017 at 5:59 AM To: roldham@northandoverma.gov Cc: Christian Sergi <Phil@csi-engr.com> I authorize the office of Christiansen and Sergi to obtain the necessary permits on my behave. Sincerely Thomas Hodgson Livingstone Dev. 978-815-4847 Sent from my Phone https:/!mail.google.com/mail/u/01?L i=2&i k=ab4f3cb798&view=pt&search=i nbox&th=16ob0583cf9Dd701&si m l=15cbO583cf9Od701 1/1