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Home My WebLink AboutBuilding Permit #048 - 437 WAVERLY ROAD 7/28/2006 i L I TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION o Pe rmit NO: Date Received Date Issued: Akkz "�s CHU IMPORTANT: Applicant must complete all items on this page 113 7 LOCATION Print PROPERTY OWNER E _ Print MAP NO.: e22- PARCEL: 3 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ew Building 11 One family ❑Addition ❑Two or more family ❑Industrial ❑Alteration No. of units: ❑Repair,replacement ❑Assessory Bldg ❑Commercial ❑Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED � upi &�e Identification Please Typ or Print Clearly) OWNER: Name: , 9W 91' Phone: Address: �� 1,e CONTRACTOR Name: Phone: Address: 7ne & Ex Date: tion License: P• Supervisor's Construction Home Improvement License: Exp. Date: I G/" �'t �Name:ARCHITECT/ENGINEER � � Phone: Address: r Reg.No. FEE SCHEDULE.BULDING PERM/T.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BIS 0,`,$125.00 PER S.F. Total Project Cost :$ Z, 2 (�C�� x12.00=FEE:$ '7�1� Check No.: /�0O Receipt No.: / Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ u�( Tanning/Massage/Body Art ❑ g Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ' ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unre istere cont acto s not have access to the gu#pped d Signature of A ent/Own r i � g S ature of contractor gn o Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Sts ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ElOther COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance,Petition No: r Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Si�nature&Date Driveway Permit Date Driveway Permit Temp Dumpster on site yes no Fire Department signature/date i Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided i Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: i NOTES and DATA—(For department use) I Page 3 of 4 Doe:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.1an.2006 Building Department � The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit Copy❑ Photo Co Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application li ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the is over. The applicant must then get this recorded at the Registry of Deeds. Board of Appeals that the appeal period One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 PAPP.4 of 4 L Location No. 041v Date �a�Th TOWN OF NORTH ANDOVER " Certificate of Occupancy $ Building/Frame Permit Fee $A7 s�cwus Foundation Permit Fee $ Other Permit Fee $ TOTAL $, Check # ` o 19287 /Iuilding Inspector ®RT H Town I of And No. C'1$ _ A 01A - y �, _ = dover, Mass., T 0 "- L A E �, COCMICKEWICK �ADRATE �S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT. .......S40O.W.I../to.. ............................................................... oundation b 'Idin s on S3) V*/ Y! permission to erect....Ve .............. .. g ........ .......... ............... ................. .. 1� hasp � to be occupied as....... ... ..... ..I ....,Z.. . ......4... E. provided that the er n ang fhi p d sha m every respect con m the ter�fs"of the application on file in Fin this office, and to the provisions of the Codes and By- relating to the Inspection, Alteration and Construction f Buildings in the Town of North Andover. I�pr•��,� ys VO `�`� P BING INSPECTOR VIOLATION of the Zoning or Building Regulations Void his Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC ON STARTS Rough Service UIED ECTOR ....... ....... Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. VORBACH ARCHITECTURE 58 MANCHESTER ST.,NASHUA,NEW HAMPSHIRE 03064-211.4 PHONE: 603-886-1738 E-MAIL:rivorbach@comcast.net ROBERT J. VORBACH - ARCHITECT Four Attached Units ( 1, 2, 3, 4 ) 425 Waverly Road North Andover, MA. i GROSS S.F. PER UNIT (INCLUDING GARAGES) UNIT 1: FIRST FLOOR = 1117 S.F. SECOND FLOOR = 1035 S.F. TOTAL =2152 S.F. UNIT 2: FIRST FLOOR = 1733 S.F. SECOND FLOOR = 1067 S.F. TOTAL =2800 S.F. UNIT 3: FIRST FLOOR = 1340 S.F. SECOND FLOOR = 1340 S.F. TOTAL =2680 S.F. UNIT 4: FIRST FLOOR = 1340 S.F. SECOND FLOOR = 1340 S.F. TOTAL =2680 S.F. PROJECT TOTAL GROSS S.F. = 10,312 S.F. I FOUNDATION AS—BUILT Sif- LOCATION: 425 WAVERLEY ROAD x NORTH ANDOVER, MA 100.00' DATE: FEBRUARY 16, 2006 SCALE: 1" = 40' 0 ZONING DISTRICT: R-4 27,5' 18.2' MINIMUM SETBACKS: FRONT YARD = 30' SIDE YARD = 15' REAR YARD = 30' 1 CERTIFY THAT THE FOUNDATION i 7.7 CONFORMS TO THE DIMENSIONAL SETBACKS OF THE ZONING BYLAW OF THE TOWN OF NORTH ANDOVER. I FURTHER CERTIFY THAT THIS PROPERTY DOES NOT LIE WITHIN A FLOOD HAZARD AREA AS SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL N NO. 250098 0003 C, DATED JUNE 2, 1993. rn � O � p EXISTING o �N OF tiygssq�, FOUNDATION, T.F. = 69.4' STEPHEN yGs o P. 27.0' Des Roche �o No.27699 ,o � 1 LANA i PROFE SIONAL LAND SURVEYOR DATE: w PREPARED BY ENCINEERINC & SURVEYING SERVICES 100.00' 70 BAILEY COURT HAVERHILL, MASSACHUSETTS 01832 WA VERL Y ROAD TELEPHONE: (978) 815-7835 GRAPHIC SCALE 0 20 40 80 IN CONJUNCTION WITH c IN FEET NEPONSET VALLEY SURVEY 1 Inch 40 fL 7il,_____ _.__ OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: PROJECT LOCATION: �- S sc,. �� e� �-V j "A NAME OF BUILDING: 4— NATURE OF PROJECT: 4- �'€�'�` �i4 , `A- , IN ACCORD NCE WITH ARTICLE 1.16 OF THE MASSACHUSETTS STATE BUILDING CODE, m I, Ro ,- - _37�N1A1A�j1 REGISTRATION NO. 90"&5 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT V ARCHITECTURAL 0 STRUCTURAL a MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL a OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO.SECTION.1.1.6.2 .2 1 SHALL SUBMIT WEEKLY , A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSP T. EDA� / UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPAN ey CD SIGNATURE S. SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF of MPSI NOTARY PUBLIC MY COMMISSION EXPIRES r ° I i MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I l I Checked by/Date I I i CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 9-12-2005 COMPLIANCE: PASSES Required UA = 550 Your Home = 446 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1835 30.0 0.0 65 WALLS: Wood Frame, 16" O.C. 2864 19.0 0.0 172 GLAZING: Windows or Doors 315 0.360 113 DOORS 99 0.360 36 FLOORS: Over Unconditioned Space 1835 30.0 0.0 60 HVAC EQUIPMENT: Furnace, 80.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of t e design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date HUN"J'aw ':,:HIvaqg WART. Abington s N4,insfield, �C� 300.00 3.£22a=ww nr.ar-Ecr3,coni AwuyxwAvld.n MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 9-12-2005 Bldg. 1 Dept. 1 Use I I I CEILINGS: [ ] I 1. R-30 1 Comments/Location I I WALLS: [ ] ( 1. Wood Frame, 16" O.C., R-19 I Comments/Location— WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.36 I For windows without labeled U-values, describe features: I # Panes Frame Type _ Thermal Break? [ J Yes [ ] No I Comments/Location i — I DOORS: [ ] I 1. U-value: 0.36 I Comments/Location_ I I FLOORS: [ ] I 1. Over Unconditioned Space, R-30 I Comments/Location I I HVAC EQUIPMENT: [ l I 1. Furnace, 80.0 AFUE or higher I Make and Model Number I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I i I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I I DUCT INSULATION: [ l I Ducts shall be insulated per Table J4.4.7.1. i I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return i ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed Iusing mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ l I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ l I Rated output capacity of the heating/cooling system is I not greater than 1250 of the design load as specified I in Sections 780CMR 1310 and J4.4. I [ ] I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I [ ] I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in. ) : I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 i [ ] I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in. ) : I I PIPE SIZES (in.) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 I ---tNOTES TO FIELD (Building Department Use Only)------------------------- D P I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I I Checked by/Date I I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 9-12-2005 COMPLIANCE: PASSES Required UA = 519 Your Home = 396 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA --------------------------------------------------'----------------------------- CEILINGS 1569 30.0 0.0 55 WALLS:. Wood Frame, 16" O.C. 2875 19.0 0.0 173 GLAZING: Windows or Doors 230 0.360 83 DOORS 95 0.360 34 FLOORS: Over Unconditioned Space 1569 30.0 0.0 51 HVAC EQUIPMENT: Furnace, 80.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer IF Date `®7.03 I �� bisigtt r7 R/larasfield ® F3OO.69&8225= nrvu na.rriEc;o.cc>rn Avw9°"mnlml6m I MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 DATE: 9-12-2005 Bldg. l Dept. l Use I I I CEILINGS: [ ] I 1. R-30 I Comments/Location I I WALLS: [ ) I 1. Wood Frame, 16" O.C. , R-19 I Comments/Location I I WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.36 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I -- I DOORS: [ l I 1. U-value: 0.36 I Comments/Location _ I I FLOORS: [ ) I 1. Over Unconditioned Space, R-30 I Comments/Location I — — I HVAC EQUIPMENT: [ ] I 1. Furnace, 80.0 AFUE or higher I Make and Model Number i AIR LEAKAGE: [ 7 I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: ( 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.999 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I MATERIALS IDENTIFICATION: [ 7 I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be 1 provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans 1 or specifications. I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ l I Rated output capacity of the heating/cooling system is I not greater than 1250 of the design load as specified I in Sections 780CMR 1310 and J4.4. I [ ] I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I [ ] I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids i below 55 F must be insulated to the following levels (in. ) : I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 1 COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I [ ] I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I PIPE SIZES (in.) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 1 1.0 1.5 2.0 I 140-160 0.5 1 0.5 1.0 1.5 I 100-130 0.5 1 0.5 0.5 1.0 I i 'A---NOTES TO FIELD (Building Department Use Only)------------------------- rUKm U - LU 1 KCLCAOC rvr%m INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT PHONE "l�LS LOCATION: Assessors Map Number 27 - PARCEL S BDIVISION LOT(S) U►��r 4 -�Zt_r 3 4� 43-7 �3�9,� STREET Gtt�P/P 1 �'' ST. NUMBER FQ 4 9 . 43 i vu'c� 1 • OFFICIAL USE ONL 0 NNS OF N AGENTS:02 C NSERVATION ADMINISTRATOR DATE APPROVED n DATE REJECTED COMMENTS TO PLANNER DATE APPROVED. . Xr DATE REJECTED COMMENTS A/® '&J-_ '2^°-�'� ( 6 FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED /^ COMMENTS � > �- PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT pliCz !!-8 r FIRE DEPARTMENT 7ECEIVED BY BUILDING INSPECTO - DATE Revi"d M97 IM