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BUILDING PERMIT I
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TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
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Permit No#: Date Received ,TEoC50
Date Issued:
C US
IMPORTANT: Applicant must complete all items on this page
LOCATION
Print
PROPERTY OWNER ..,,
Print 100 Year Structure yes no
MAP PARCEL: ZONING DISTRICT: Historic District y S no
Machine Shop Village ye no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
El New Building El One family
Li Addition El Two or more family 11 Industrial
[I Alteration No. of units: El Commercial
[I Repair, replacement El Assessory Bldg El Others:
Li Demolition Other
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DESCRIPTION OF WORK TO BE PERFORMED,
Identification- Please Type or Print Clearly
2 L. '.-.
S 11
OWNER: Name 7�u e, Phone:d,��'
Address:
Contractor Name:
Phone:
Email:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BULDING PERMIT. $IZOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $ N - �.6_t) f
Check No.: t L-M 2-(,o Receipt No.: Z-?t (,;)
NOTE: Persons contra ting with unregistered contractors do not have access to the guaranty fund
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FORTH
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LA � h ver, Mass,
CoCKICNEWICK y��
U BOARD OF HEALTH
Food/Kitchen
rERMIT L �D Septic System
- BUILDING INSPECTOR
THISCERTIFIES THAT ................P.;AbA...... ............. .... ...........................................................
Foundation
has permission to erect ....................... .. buildings on ...I. ...... .. ..... •. • •�
Rough
to be occupied as ........ .... . . . . C.. . . . ..... .. ��15...`......!�.. .�...... •. Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the applicati n 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
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STA T Rough
Service
......................... ...... . ....................... Final
BUIL ING IN PECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Islay 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.