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HomeMy WebLinkAboutApplication - 158 OLYMPIC LANE 2/3/2006 w�w�r � t �( �i�ai� �i �ty lvek)pi M Mn. ta'tt�t tocd�tServices 1_,)iv iS iol-i 100 0SG4701) S 'RF F T ucUf , taw t.7vf 1 11'('t'rl f.tta 0 1 S 1:7 CMU' ' ()88-"-),5-10 - Phone f)iA�3� trliFi w'r51;? Fit-v Date: Address: � ,. ° � ,North Andover MA 01845 Application � Pp n for: � � Dear: Your application for at 5 r", has been reviewed by the Health Department. The application was denied on, 2004 for the following reasons: 1. R,/ Missing information 2. 0 Passing Title 5 inspection of septic system required 3. 0 Location of structure not acceptable 4. 0 Undersized septic system. To address the problem(s): If#1 is chec,ked, please supply: �4,,.,, Floor plan of existing and proposed addition—all rooms b., Certified plot plan showing house, septic system and proposed project in scale If#2 is checked: a. Have the septic system inspected by a certified Title 5 inspector to determine the size of the system and whether it is operating properly: OR b. Tie-in to municipal sewer If#3 is checked: a. Relocate the project If#4 is checked: a. Provide additional information proving that the existing septic system meets current capacity requirements. Please consult an engineer to determine the flow capacity of the septic system. Please feel free to call the Health.Office at 978-688-9540 with any questions you may have. Sincerely, Reviewer '— ----- -� Cc: Building Department File NORTH sa0 p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION y9SSACHUSE 1 Date Received Permit NO: ' Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 0 Print PROPERTY OWNER om ,Typzgam' _ Print MAP NO.: 06 W"9 PARCEL: 125 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Non_ Residential Residential ❑New Building ©--One family ,.�sAddition [I Two or more family ❑ Industrial ❑ Alteration No. of units: ❑Assessor Bldg ❑Commercial .P-Repair, replacem y g ent Demolition 0 Others: ❑ Moving(relocation) ❑ Other ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED l, - t,. - :�>`q �r�`IrIL y'cz - W Identification Please Type or Print Clearly) Phone• 1�_ OWNER: Name: A'+A J V?J Signature Address: CONTRACTOR Name: �c ca °- iii?- =1 Address: 00 >lt'`"'t Supervisor's Construction License: Exp. Date: . ., Exp. Date: Home Improvement License: /7 r�c= ARCHITECT/ENGINEER 0AYi NI&ZNKName: Phone: !' )�l� SCE Address: Add 46"t �1 Reg.No. FEE SCHEDULE:BULDING PERMIT:$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON $12.5.00 PER S.F. , / (? x10.00-FEE:$ Total Project Cost :$ f ' Check No.: Receipt No.: Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: 2— Total square feet of floor area, based on Exterior dimensions. G` Total land area,sq. ft.: 6� NOTES and DATA—(For department use) r ` s r7 .�f'��tom' ,?�jC✓.(J_�!, �� -t %i�:�-=~�. �-"Yl,:F /�-�"r;-��.�L..�sr�.2�� /°.-I-" K") ":V? . tj� / e' Y(q�/.'" //"�/!may _ �._/(--� � � r I.��� ( 1 C/''I! J �'.1_.f!.✓4/ � � 1.°LL'd / / �C.Y°� Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art ❑i Swimming Pools ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales 1 Well Permanent Dumpster on Site 71 Private(septic tank, etc. �; NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fi{hc C 0 1 ,7- , ,j Signature of Agent/Owner .Y Signature of Contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED N'�'PLAI\1I�iIl`1G & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED jJ CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED I0,HEALTH COMMENTSE Zoning Board of Appeals: Variance, Petition No: V Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature&date Temp Dumpster on site yes no_ Fire Department signature/date Building Permit Approved and Issued by: ................ L ®wry a a j / a �f; i Y ' y t t i ' 1 i r. t � -- ',........ . j � -, ._ �................. _, �- ._..�____...� i I � ..._. ._-._-.. _..,,} I 1 ..:.. _ ... j � � ( . ,,�,.. 1 , � � i � . -�_ ------ � �''� mt ' � , �'�� `� y�` 1 ; ;�! ;� !; _� J � _.... _ { ' ( � V ` d �,_ E ----. -- __ — � . . , �. . _ _ _ ,. _� - ` �_ �, _ i ; , I { r \ � �. _.-- ._ ,lit' . .. ... . -..._r�-- .__.�_._ ---._... _'. -_.: .------- ''. I � 4 � � i 0 � :.' _ � � .. , � � i 77­7- f r I I , I !- it h ( � i -' ---- -- i� G i F Z/ /` � j a I 1 : r Y , 1 ... - I _ t Ctl I a ' s a — -min ivyi t t