HomeMy WebLinkAboutBuilding Permit # 7/8/2015 .........._......
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BUILDING PERMIT
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TOWN OF NORTHANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: �" Date ReceivedE°
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Date Issued:
IMPORTANT: Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building kOne 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:
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Identification- Please Type or Print Clearly
OWNER: Name: Z CLC Phone: CIO
Address:
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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: $ F00JJDATrVN PC-2�T_TFEE: $
Check No.: E S/ Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guTanty filmed)
Ownerte/i
Signature,ofsRgent/ r „ : ;Signature of,contractor i
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Sw"'uning Pools ❑
Well ❑ 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
PLANNING & DEVELOPMENT Reviewed Ong1?
Signafiure_ '
COMMENTS zL! , 4 la
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CONSERVATION Reviewed on signature
COMMENTS DEE
HEALTH Reviewed on Si nature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: /VLA Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: I Comments
Water & Sewer Connectionisignature& 046e " nrivpwav Permit
DPW Town Engineer: Signature: ��'��m°����� m;:��
Located 384 Osgood Street
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BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
THIS CERTIFIES THAT
\#—1 ��� BUILDING INSPECTOR
..........................:.... ...............t..... ................................... ...... .................
...���..L �... .... Foundation
has permission to erect .......................... buildings on .... ... ....................... ....
Rough
tobe occupied as .......... � .... ... ........................................................... Chimney
provided that the person accepting this permit shall in every resp conform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR -
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
LESS CONSTRUCTIO ARTS Rough
...................... Service
.............I ..... .................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Reguired to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.