HomeMy WebLinkAboutBuilding Permit # 8/14/2015 i
BUILDINGIT ®� `�°��Y,g��o
TOWN OF NORTHAI
APPLICATION FOR PLAN EXAMINATION ® `_ A
Permit No#: Date Received 7d�aDRATEFD
iSSACNUsb�
Date Issued:
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 yes
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
Ad New Building Y One 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:
Identification- Please Type or Print Clearly
OWNER: Name: TK7— k-LC, Phone:417E -
Address: 4 + - r
Contractor Name: Phone:
Email: a
Address: E
Supervisor's Construction License: Exp. Date:
Home Improvement License: - Exp. Date:
mow ._...
ARCHITECT/ENGINEER Phone: °
Address: Reg. No. °
FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 ER S,F,
Total Project Cost: 060. FEE: $ (01
Check No.: Receipt No.: 6
NOTE: Persons contracting with unregistered c tractors do not have access to the guaranty fu
t%ORTH fiad '-- ver
Town -of
No. 1q'i . -
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COC MICet@WOCx �1.
,9 A°"'•ire®
U ® BOARD OF HEALTH
PERMIT T Lj Food/Kitchen
Septic System
THIS CERTIFIES THAT ... BUILDING INSPECTOR
............ ................. ...... ............ ...................
.. .... ....
Foundation
has permission to erect.......................... buildings on . ................................................................
Rough
tobe occupied as ....... ,� .... ..:....C.. .. ..........'.........................................................'........ chimney
provided that the person acceptifig this permit shall i every respect 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
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMITI IN 6 MONTHS ELECTRICAL INSPECTOR
LESS C T C I T Rough
Service
.. ... ,.... .................. Final
UILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Requiredto ccupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Miall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
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LAKE
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LOT 33.
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FOUNDATION LOCATION s i=►F 4t `�;. t F�vir,-€Y€�f.�x�_} f�,} �, `
CLIENT, TKZ,LLQ
1..;,rfyxs:�vr.Tt 11�e,.yl._.k'r�l('�a�;/ t�,Rtci:rkryry ��tyy(:}}3s:..
LCA AT 6`�t'x;1'09171'AND0 ti`l+.,l`ASS
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C}=$TE 7 M(05 SCALE; V-1W
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*R -T HAVER!4.41.,p tr'.V�H els olllt d
` 4fea44u`.G` {> $1frR_4 t
TEL 9- 76-3Y3,0310FAX uMM'RK)
VAIJOO:1.1-1131 ifibi-w4
Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Swimming 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 On Ij Signature_ '
COMMENTS IJ��
e /
CONSERVATION Reviewed c.o a Signature
COMMENTS
HEALTH Reviewed on Si nature 1� w
COMMENTS
Zoning Board of Appeals:Variance, Petition No: N Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: L� ( �� Comments
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Water&Sewer Connection/Si nature&,Di e7� „ 4 DrivewaV Permit
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DPW Town Engineer: Signature: _
ff �" Located 384 Osgood Street
FIREDEPARTMENT Temp )'u eteron site – —
Located t124 Main Street "
�F�re Department s�gna.�ureldate ��� � '
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