HomeMy WebLinkAboutBuilding Permit # 7/20/2015 _ BUILDING PERMIT
04 DHS
TOWN OF NORTH ANDOVER
pp APPLICATION FOR PLAN EXAMINATION
Permit No#: Y" Date Received
'y SNCHa`+E
Date Issued:_
llVIPORTANT:Appticant��nm�ust complete all items on this page
LOCATION 1 3`I W 2I eV- Sf. Al,.ti,,,,e ^IA 01,?95
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PROPERTY OWNER 0eg Print�i d?lh2e=
Print 100 Year Structure yes
MAP 0 PARCEL:W ZONING DISTRICT:_ _Historic District yes
Machine Shop Village yes �'n��o�)
TYPE OF IMPROVEMENT_ PROPOSED USE
_ Residential Non-Residential
D New Building D One family
D Addition D TWO or more family D Industrial
D Alteration No,of units: D Commercial _.
[,'Repair replacement Ll Assessory Bldg D Others
D Demolition u,6ther
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' DE CRIPTION OF WORK TO BE PERFORMED:
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Identification-Please Type or Print Clearly R/9J
OWNER: Name: H Q(g�E, WL Joe.- Phone:
Address: )3'7 n"f'2v YL 1, Anbg C, Gn'I/I `901f-
Contractor
9(11Contractor Na wc(, Kf Phone'
Email:Wri .a '®
Address: ✓er:ASA 0184S"
Supervisor's Construction License: CS--10x663 Exp. Date:
Home Improvement..License 11950_ _. _. Exp. Date:
ARCH ITECT/ENGI IN F�iik Phone:
Address: Reg.No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost:$JL), X00®O FEE:$ 7'L.,
S�^''� `22r LI 2u.
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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