HomeMy WebLinkAboutBuilding Permit # 6/12/2015 i,
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BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit 140:-/ `'�� /`� Date Received
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Date Issued,
IMPORTANT:A2plicant must complete all items on this page
LOCATION i �'2 -Ju��.'I�� �''r'�7�°, f
PROPERTY OWNER r -'>r�1GYf ✓lIC'�"rC�'
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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
L Addition I Two or more family ❑Industrial
Iteration No.of units: ''Commercial
❑Repair,replacement L Assessory Bldg a Others:
L Demolition L Other
n Septic ❑Well C Flo6dplain D'Wetlands ❑Watershed District
0 Water/S2wer
CJI ) �1Cll(K4 -SfX C qJC�`/L-�Y�)�L�
Identificatiio�o77n Please Type or Print Clearly) 77
OWNER: Name: I �Cl'�. ���� PhonefT (�"�7 �1"t��� ��
Address. ,, .��� '1%e )
CONTRACTOR Name: Pbon
Address.
Supervisors Construction License: Exp Date;
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Home Improvement License: Exp Date.
ARCHITECT/ENGINEE 1LJ�,I�k'7( 5 ��1�7(�C (��Phone.--16
Address: Irr-I 51-21,Z�- tLX AAS' ��' Reg No._
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BB $1 too PER S.F.
Total Project Cost:$ %� Or -�20 FEE:$ _
Check No.: Recei}ot.,No'
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NOTE: Persons con acting with t tnreges Bred contractors do not have access to the or 1,f
Signature of Agent/Owner2 Signature ofcontractor ,_.�....