HomeMy WebLinkAboutBuilding Permit # 1/11/2016 BUILDING PERMIT
TOWN OF NORTH ANDOVER o
APPLICATION FOR PLAN EXAMINATION
Permit No#: Y—;''fit b Date Received e,9ss,r,e z�
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Date Issued:
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ORTAiNT:Applicant must complete all items on this page
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
9 New Building lirOne 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:
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Iden8llca1i m-Please Type or Print Clearly
OWNER: Name: K L C Phone `?;Ar
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Address: �`=°_ ! �76a
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ARCHITECT/ENGINEER Phone:—�
Address: Reg.No. '—
FEE SCHEDULE;BULLING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost:$ FEE:$ i o,.cID
Check No.: itv Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund l
Plans Submitted Plans Waived❑ Certified Plot Plan❑ Stamped Plans❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ® Tanning/Massage/nedy Art ❑ ""mc ag Pools ❑
Wll ❑ Tobacco Sales ❑ Food Packaging/Sates ❑
Private(septic tank,etc. ❑ PermanentDumpster on site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM /
PLANNING&DEVELOPMENT Reviewed On 11'I?/lo Signature__1n/.�j'','G^' �7&'
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COMMENTS=::st, '49 �s'z.,.;a at;SW
CONSERVATION Reviewed on f I Siprtature'" t.t,.� n7,.�
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COMMENTS &r3.. 2 +. grief _I•aT `
HEALTH Reviewed on Si ure j v'
COMMENTS ?)
Zoning Board of Appeals:Variance,Petition No: Qt`A Zoning Decision/receipt submitted yes
Planning Board Decision:Xz,,t 5 '11r*141 Comments
Conservation Decision:: 2 _I Commen "�.
Water&Sewer Connectlon/s'iinnature a Date ✓ Z fs" Driveway Permit k
DPW Town Engineer Signa tnrey� '
Located 384 Osgood Street
Locafc. �a� S❑eE _� - _ _
�re-De a_f�fTie ,�rt3lttre/ de_=_
tAORTH
Town of Andover
No.
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4 o6
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BOARD OF HEALTH
Food/Kitchen
Septic
System RMIT T ILD
THIS CERTIFIES THAT .......................... ................ BUILDING INSPECTOR
has permission to erect..........................buildings on 9/v'aE Fodati
to be occupied as /7�— �y/( C4'-P Rough
.... ........................ .............. ch'.-Y
provided that the person accepting this permit shall in eV/.ry respect conform to the terms of the application Fin.[
on file in this office,and to the provisions of the Codesrand 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
Fin.[
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS Rough
Servire
........ ..
.................. ...,.................
BUILDING INSPECTOR
GASINSPECrOR
Occupancy Permit Required to Occupy Building R.,,gh
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. 13.,
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CS-055417
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78 G..'
P—d Road
NOlth And—MA 0I845
04105/2016
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