HomeMy WebLinkAboutBuilding Permit # 9/15/2015 (4) BUILDING PERMIT ®1"®DT 6��0
TOWN OF NORTH AV
APPLICATION FOR PLAN EXAMINATION ® F
Permit No#: Date Received 7�Q�RATEDWP
qSS 9 C Fid-5
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOC
Pn t
PROPERTY OWNER + 41V 4,<
Pnht '0 Year Structure yes no "
MP,P'. _ Histo'ric''District yes no
r
PARCEL ,. ZONING DISTRICT
Machine Shop Village yes n
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
ew Building ❑ One family
❑Addition o or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District
134N'ater/Sewer
,,�ma-yy
DESCRIPTION OF WORK TO E PERFORMED:
t�-OA/:5-kyt,r--4 ,6 eft excy,, vi , e00,51 S/n 0 F' zz 5-9j, : eztit�.
Identification- Please Type or Print Clearly'
OWNER: Name: gar d0 , 1 d(Vto 5 Phone: - ya6
Address: PV d-C�'( ° e - c t144A 0 t I
Contractor Name:81 "Phone: '0 - Of
Address: ' L �' n
Supervisor's Co"nstriaction License , , 4 J Exp. Date:
Home Improvement License: . Exp Date:
ARCHITECT/ENGINEER IVicL M . 14d�►�c ��ic e Phone: L2&3,--
Address: 'P. 0.. & LCOJU Rea. No. V 14 3 1,23
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$129.00 PER S.F.
Total Project'Cost: $ FEE: $
t
Check No.: I Receipt No.:
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NOTE: .persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Own" Signature.of`contractor T
- t%O R '
v ' r
0 own ot
Cl
® =
LAK. h
ver Mass,
COCMICNlW CK ��•
A04ATED 0.1? J
S U BOARD OF HEALTH
PER LU Food/Kitchen
Septic System
.. . BUILDING INSPECTOR
THISCERTIFIES_THAT .........W. ...... . ... .. ... .. ..... ...... ........ . ............ . ......................... _
... Foundation
has permission to erect .......................... buil Ings on .....ve.... .. ........... .....4 .... .....
o Rough
to be occupied as ..1. . .... Chimney
................. .. ...... ....... ......... .. ...... .......t...................
provided that the person accepting this permit shall in every respect conform to t 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 OS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS Rough
Service
................................................................................ Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildin Rough
Displayin a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approvedy the Building Inspector. Burner
Street No.
Smoke Det.
%AORTH
own of lictover
O ® T
15. 2.
�O LAKEh h ♦ er, Mass,
CoCKICKl WICK
A0QATE D 01P�`�.(5
� U
BOARD OF HEALTH
Food/Kitchen
PF. RMIT T L Septic System
THIS CERTIFIES THAT .......... BUILDING INSPECTOR
...... . .. X11.4. ..... .... ........... ..................
Foundation
has permission to erect .......................... buil Ings on ..... .. ..... .. ........... ...... .... mmj
Rough
tobe occupied as .................ff.... ..1. ........ 4AI......... .. . ..... .................................... Chimney
provided that the person accepting this permit shall in every respect conform to t 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 I 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS Rough
Service
................................................................................ Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required t® 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.