Loading...
HomeMy WebLinkAboutBuilding Permit # 10/7/2015 t3UILUINU VhKIVII I UU1, TO OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date ReceivedPermit NO: Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATIONi. L yawal1 'Print PROPERTY OWNER:` Ptfrt=` MAP NO; :'PARCEL: t?NING DISTRICT Histanc€Yistrict yes no Machine Shop Village yes! no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential LI New Building One family ❑Addition Two or more family Industrial ❑Alteration No.of units: ❑Commercial Repair,replacement ❑Assessory Bldg E Others: Demolition ❑Other q Septic E Well U Floodplain Q Wetlands', (7 Watershed District: 0 Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: c 4, c_4 t Phone Ili i Address: ` - GONTRAGTOR 1ai?t . Phone: �7 i ! Address I .. . Supervisor's Coh�truciirzn Lid6hse: - Exp.'Date:. f . Home Improveme�ilicense: a Exp, Data: ARCHITECT/ENGINEER Phone: Address: Reg.No. '. FEE SCHEDULE:SULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ MIV FEE:$ a" Check No.: �2 Receipt No.: 99gF NOTE: Persons eontracdng with unrea©stered contractors do not have access to the guaranty fund Signature of Agent/Owner�.F)� Signatureof contractorr rsull_.uorvv Ntrt'vla i UU-1 TOWN OF NORTH ANDOVERAPPLICA-TIONFOR PLAN EXAMINATION Date Received Permit N®: Date Issued: L%IPORTANT:Applicant must complete all items on this paae LOCATION 9'YktE} :yt. r� Pant PROPERTYOWNER'' G'�fI+12a �i MAP,NO; PARCEL: .= .ZONING}DISTRICT: . Historic Districtyes no Machine Shop Village,,yes .no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑Addition C Two or more family ❑Industrial Alteration No.of units: ❑Commercial Repair,replacement ❑Assessory Bldg ❑ Others: ❑Demolition ❑Other Septic Dwell ❑Floodplain ❑Wetlands;. J =-Watershed District Li Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: �t P ::.i Phone:9 j ' I j Address: CONTRACTOR Nam Phon 7El9~-' 1�` Addressi if �� Supervisor's Construction License Exp. pate: :S L! Home lrnprovementi[cense: Exp. Date: JL ARCHITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ ;"I'. FEE:$ '3 ° I Check No.: 2'z Receipt No.: 99gf? i9OTE: Persons contracting with unregistered contractors do not have access to the guarantyJund Signature of AgentiOwnerA-�- - Signature,of contractor "- f