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Location
No. Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
FUlding/Frame Permit Fee $
reo dk n Permit Fee $
Hu
ot er ermit Fee $
Sewer Connection Fee $
xmr connection Fee $
TOVAL
Building Inspector
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Div. Public Works
,3,-ocation
No. Date
TOWN OF NORTH ANDOVER
0- 1 - - . . 0 -
Certificate offOccupancy $
A
Building/Frame Per:m it F�pe.$
U Foundation Permit ��Coz
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Other P�, ee $
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Sewer Qqnnection ee $
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Water ConnecUo�,Fedqqj $
TOTAL $ 6
Bull , din'd Inspe66r
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Div. Public Works
Location
No. Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Fo on Permit Fee $
sewer C�'A'n4gpp"on Fee $
j�14ter ConnectioPrLi", $
TAL $
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FORM U - LOT RELEASE FORM
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 local or state law,
regulations or requirements. w
****************Applicant fills out this section*****************
APPLICANT: Phone
LOCATION: Assessor's Map Number /0�/-0 Parcel / 7.2,
Subdivision J14 -:,o e 9-.r Lot (s) 9-0
Street ,�;v laic fi� /{d St. Number
""Official Use Only***********************
RECOM1qZNDATION5S O TOWN AGENTS:
i
Date Approved
Conservation Administrator Date Rejected
Comments
60)
Town Planner
Comments
(,Uk�-NAAWA
Health Agent,1 .
Comments
Date Approved Q
Date Rejected
Date Approved ' ✓ ✓ ��
Date Rejected
Public Works - sewer/water connections/pV's"-c VC 1 sswl/ 1
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driveway permit Pte.,,...,",. - ,, u. /1 Lly7 ( C��.�i1�cVl1 /lif y3
Fire Department , Z -
Received by Building Inspector Date
CERTIFIED FOUNDATION PLAN
LOCATED /N No. AumvEr-, Ma
SCALE : /". 4.c,' DATE-: 2.( z.�IaT—
Scott L. Gi/es R. L. S.
50 Deer Meoo'ow Rood
North Andover, Moss.
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THE OFFSETS OF THE SU/L DING /NSPEC TOR ONL Y
SHOWN COWL Y AND SUCH USE /S FOR THE
WITH THE ZONING DETERM/NAT/ON OF ZON/NG
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