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No. FEE SCHEDULE:BULDlNG PERM/T.$12.00 PER$9000.00 OF THE TOTAL EST/MATED COST BASED ON$125,00 PER S.F. i Total Project Cost: FEE: $ Check No.: NOTE: Persons contracting with uniebaistered contractors do not have access to the au _ b alanty fund --J I Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer TanningWassageBodyArt Swimming pools Well Tobacco Sales E P 'rate(septic tank,etc• Food Packaging/Sales Permanent Dumpster on Site • i f THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF .U FORM DATE REJECTED PLANNING &:DEVELOPMENT DATE APPROVED- ------------ COMMENTS CONSERVATION Reviewed on Si nature COiV111iICN TS HEALTH Reviewed on Si nature COMMENTS 1 • Zoning Board ofAppeais;'�ariance, Petition No: Zoning Decision/receipt submitted yes Pfanni6v g aoard Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Si nature&Date Drivewa Permit DPW Town Engineer: Signature: !rRx.r;EP-A 'T�1Jli MEN- 3- - -- - -- Located :T ..;,r' ,.a;^=' _^'•�_'t , _ 364 Os ood _ _ . Ter �t:- t.. _e:;;�:•;r.:-':..:�-•-: - Street a: -'gy V" fe`= _ _ -._ ��_.s_., ,ate,.. t �,_:•.- - - �...-71i1` ..d-, _ ...�,�;;r _ �"v v —_ 4:•_: - - - -�..eY.—.. -.tag::d-.... =.:�~ _>~.: - _•.��- _ - - _ 'x� �cYA _ - -•-moi.: '•'. ..i,:...'......._�- 1 5 J eta' - =r-• .'_ter :.1=" _ - - _ = o.;y.4�•.�::w - _ ==.r-+..;.mss:.:=•> :v - cum:._,•. -- 'a. ::•Cam'_e�`• ,.f. :�.,. . ��:f..uil.i _ iJ- q't'l'4 _.l.':. -•�.it:.. _ yl. Dimension i Number of Stories: Total square feet of floor areaI based Total Land area, sq, ft„ on Exterior dimensions.__ N ELECTRICAL: Electrical InspMovement of Meter location, mast oector r se Yes rvice drop requires approval._ No of . DANGER ZONE LITERATURE: Yes MGL Chapter.166 section 21A—F and G min.$100-$1000 fine No NOTES and DATA—(For department use) i I ❑ Notified for pickup - Date II �I Doc.Buildin 1 1;Te rmit Revised 2010 _ II Building Department be filed out for the appropriate permit to be obtained. 5 to permits Licenses rk °? products Sire Department prior to issuance of Bldg Permit ty M " P� ped Work With Sprinkler Plan And pplicable) cts rtment prior to issuance of Bldg Permit ed) to Include Sprinkler Plan And ent prior to issuance of Bldg Permit etamP the decision from the Board of Appeals try of Deeds. One copy and proof of recording CERTIFIED PLOT PLAN Scott L. Giles R.P.L.S. LOCATED IN Frank. S. Giles R.P.L.S. NORTH ANDOVER, MASS. 50 Deer Meadow Road SCALE.1"=40` DATE:12113/10 North Andover, Mass. 196.65' LOT B PLAN 10918 �x 7 - H � - b QST.NSF tq 33+� #481 N 150.00' REA STREET -= I CERTIFY THAT "° Ee OFFSETS SHOWN ARE FOR THE USE THE OFFSETS b r: OF THE BUILDING INSPECTOR ONLY SHOWN COMPLY WITH THE ZONING AND SUCH USE IS FOR THE . DETERRI NATION OF ZONING BYLAWS OF CONFORMITY OR NON-CONFORMITY NORTH ANDO VER WHEN BUILT WHEN CONSTRUCTED. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 481 Rea Street Property Address Michael Connelly Owner Owner's Name information is required for North Andover MA 01845 11/22/2010 ._ . every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. 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