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HomeMy WebLinkAboutBuilding Permit #623-15 - Exception 1/23/2015V BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date! Issued:— MPOIRSANT: Applicant must coMplete.,all items on this page /C V to _-LU-A - 4�2-_ 4 rrl -t� 0% i t C� L WR .r I fXD� RA, 7__ ONIXd I,,$- TT x 1, C& TT. W Nsfo,, P . I-." w.0 "6 0 0 I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building D One family D Addition 0 Two or more family 11 Industrial 0 Alteration No. of units: D commercial 0 Repair, replacement 0 Assessory Bldg 0 Others: D Demolition— 0 Other �6�Jfffb—_61--Nl --q3ff z _Ic 11 $_tridtl 'A- ,F:Tq g,7 ZMW ,f �,7 r-F7V icl h -T 57 7 r L , 0W ;%(te,#�Se7—W r__ RIFTIUN UF' VV ao,i")i .4 i u mPERFORiviEu. I , r- k7 ( A d & 1&pot azry U9, Identification - Please Type or Print Clearly' OWNER: Name: Phone: Address: W tLyff ri INSI'Ane V, `Phone UP i,%upe v rfs- WN, AL ARCHITECT/ENGINEER — Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT: MOO PER $1000-00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ Check Nb.: Receipt No.: the t NOTE: - Persons contracting with, unregistered contractors do not have cess to my fund in th Signature 0t/M, h� mfnA WE IE 0 E a _ cc a� 00 L 0 CF) •0 N a� t 0 Z O Q J O 0 Lu (L z WMM _/ /w. z �- 5O O CD Z V Cl) U x- W V , H Cl) az M, w I E O z Q O N cn n c ._ CD 0 .... 0 CD Cc a � i w 0 �+ CD 0 m O CL CL Q. Q 0 O V Jto -a .� o a; �z O V U) O cc C. F=- J W s LL. D O m t O LCL. N ? N fZ In 00 U O. z Z m O 2 7 LL 7 O W A C L U (6 O LL 1-u U LJ d z Z C ..t o 7 O W C 11 W N z J U W W t to.i 7 O w L) O N O LL W O U a y z t 7 O OC f9 O LL Z W o~c Q p ui °c L- v i O CO Z N Ul N N Y O E N 0 E a _ cc a� 00 L 0 CF) •0 N a� t 0 Z O Q J O 0 Lu (L z WMM _/ /w. z �- 5O O CD Z V Cl) U x- W V , H Cl) az M, w I E O z Q O N cn n c ._ CD 0 .... 0 CD Cc a � i w 0 �+ CD 0 m O CL CL Q. Q 0 O V Jto -a .� o a; �z O V U) O cc C.