The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 1212 SALEM STREET 4/30/2018 1 1212 SALEM STREET ` 210/106.A-0181-0000.0 I Location .� No. 9 Date NORTh TOWN OF NORTH ANDOVER f 9 4 Certificate of Occupancy $ ,SSACMUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ �—'• .5�,. TOTAL $ `rte b _ � Check # /,w, I 16579 Building Inspector r!/ TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: �y DATE ISSUED. ic SIGNATURE: Building Commissioner/Inspector of Buildings Date z SECTION 1-SITE INFORMATION O 1.1 Property Addr 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: -1 3 �*r. Zoning Distrid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water S ly M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: > Public Private 0 'Zone Outside Flood Zone Municipal ❑ On Site Disposal System SECTIO 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record 64w�c( 4W12-12— &46, 5/. Name(Print) —7 Address for Service 0 Signature Telephone 1 .) 2.2 Owner of Record: W Name Print Address for Service: O z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervi r: Not Applicable ❑ edua Licet}sed Construction S rvisor: � O /V 1Q. 4,.(4,,-- License Number Mn AdXs, L�, ® 6 -7-706 E �' �BL4D xpirati Dale � S' ature Telephone 3.2 Registered me Improvement Contractor Not Applicable ❑ --sly,. H Company Name m d�� 4,dod-�� Registration Number4� /4 fid' r " Expiration ate n� Si ele hone ", r SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) r Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buil ng permit. Signed affidavit Attached Yes....... No.......❑ SECTION 5 Description of Proposed Work check all a Hcable New Construction Ir Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: f m L^ SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIALUSE,ONLV Com leted by permit applicant ;... , 1. Building (a) Building Permit Fee OD L> Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC a 0-� 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Si nature of Owner Date SECTION 7b OWNER/AUTHOR ED AGENT DECLARATION I, R fr i as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Pitl'a h " ' Print Nam Si t1Aoo0'rdw441A e6t Date NO. OF STORIES SIZE j(a 7 BASEMENT OR SLAB 3 RD SIZE OF FLOOR TEVIBERS 0 1 �, 2 3 SPAN h.t DIMENSIONS OF SILLS r Z (o DIMENSIONS OF POSTS DIME-NSIONS OF GIRDERS 1-thIGHT OF FOUNDATION THICKNESS /V SIZE OF FOOTING Q Q X . MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND so IS BUILDING CONNECTED TO NATURAL GAS LINE FORM U - LOT RELEASE FORM p.._.... 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 Gdw d PHONE q78 azo LOCATION: Assessor's Map Number _ PARCEL SUBDIVISION _ LOT(S) STREET Z ?� vl, 4 ST. NUMBER�Z ********** ******* **********OFFICIAL USE ONLY*** **�►��**��****�*�� RECOM �NDATIONS OF TO N AGENTS: 5' CONSERVATION ADMINIST ATOR DATE APPROVED �-7O DATE REJECTED 'i COMMENTS ,r�t �e.f�Fe:�ce - �E� �' A4126 (��Cortuco f wred� ®i TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED �� SEPTIC I SPECTOR-HEALTH DATE APPROVED_ DATE-REJECTED COMMENTS6-1- � �- �,c+5�-. ted 1"'1-(e ,�� . ISN s C, l PUBLIC WORKS-SEWERAVATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR — DATE Revised 9W jm North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54,.a condition of Building Permit Number is that.the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11; S.150 A.. The debris will be disposed of in: (Location of Facility) I Sign r of Permit Applicant by ate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building Inspector _ a The Commonwealth of Massachusetts u, Department of Industrial Accidents L .... Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # QI am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for rry employees working on this job. . Companyname: SiA IV/, a, Address f City IV 0 J-E� ► 1t1 �' Phone "7 "7 Insurance.Co. -'. co Polia# Company name: Address City : Phone* Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to Wr4mition of criminal pernsaalties and/or one years'imprisorunent_as_vidLas_tial.)enaliesin-thelamo-f-a-STOPlN9RKDRDERand: -aj&W up to nip- I.Op understand that a copy of this statement may be forwarded to the Office of investigations of the DIA for �Y l overage verification. /do hereby certify un the and na of perjury that the Morrnabon provided above is true and correct. Signature D� 2- U J Print name , e.# E1_5 &(3-7-70- Official use only do not write in this area to be completed by city or town official' City or Town PerrnitUcensi El Building Dept E]Check if immediate response is required 0 Licensing Board p Selectman's Office Contact person: Phone#.- E] Health Department F, Other 2- r Town of North Andover NORTH Office of the Conservation Department o��°'�eD F- p Community Development and Services Division 27 Charles Street �RSSacouSEs Alison McKay North Andover,Massachusetts 01845 Telephone(978)688-9530 .Conservation Associate Fax(978)688-9542 December 9, 2002 Mr. Ted Hanley 1212 Salem Street North Andover, MA 01845 Dear Mr. Hanley: You had contacted this office on December 6, 2002 to request an extension to the Order of Conditions issued to you for the construction of a 20' x 16' addition with associated grading (DEP file#242-969). The Order of Conditions was issued on August 4, 1999 and expired 3 years from this date or on August 4, 2002. In accordance with the North Andover wetland Bylaw (section VIII, B.), the Conservation Commission may issue an Extension permit for a period of one year provided that a written request for an extension isfiled at least thirty (30)days prior to the expiration date of the Order of Conditions. The Bylaw also states that "No request for an Extension Permit will be granted for an expired Order of Conditions". Due to the circumstances that delayed the start and completion of the work under the above referenced Order of Conditions, I am hereby issuing the attached Enforcement Order for the completion of all work by September 1, 2003. The work shall comply with all conditions set forth in the expired Order of Conditions. If work can not be completed by this date, a new filing with the Conservation Commission would be required. Please feel free to contact me at any time or if you have further questions in this regard. Sincerely, Alison McKay Conservation Asso ate Cc: NACC DEP file BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PI.ANNING 688-9535 j I M PTO sc ' ° s1 011 o- ► i GK _S: J /-?I �{! `rr . 4 AV �J Seve fLv -D TV YA, ley 1�el , J ev?ce-,, q76 &62- 1161< 3 -Zx `6 lM c-Dx 2XID �►�� +�2--�nz AAA- /X3 , JkA710 �2, X e- )4 Cee 114p board 3 G Pl 04- i T J�ts� LN i x 01RTH ONM ofAndover :,. 0% s9 O� CocLA w�o dover, Mass., DRATED S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT...... �. .!!�.! ....r'..ZdwAR � �� y BUILDING INSPECTOR i/..................................... Foundation _I has permission to erect..�.`...x.a ............. buildings on ....'011.1a.......c .c1 ,�e .........6T Rough p rAM Roo a 4a/ 4 �, Chimney to be occupied as.......................................................... . .....d'`.......��... ... .... .. .... .S/C�r....O. ........ ....t tr l provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. IDJ A /181 -1 4/a p _ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN L MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR t Rough .... .... ..................... ........... Service BUILDING INSPECTOR 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 (Nall To Be Done "FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Date.................................. NORTI{ � TOWN OF NORTH ANDOVER o p PERMIT FOR WIRING CHU This certifies that .. ... .. .... .....p..........J ... ........... ................................. has permission to perform ....N .�..�t tJ...`.�........................................... wiring in the building of ��. n .E'.�f .:..... ............................................. at......R.�..� �` S (til...................................North Andover,Mass. Fee..................... Lic.No. �p`�.. .. ............. ................................... . . ................... ELECTRICALI PECTOR i Check # t>8 acs 4756 C�hF C�nmmnnwptti#I� t1fFI�Sc�rl�use##8 � Official Use Only Department of Fire Services Permit No. ,ZS6 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: A107—�{ /,�ti�� - =J To the Inspector of Wires• By this application of the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street& Number)L-1 J 2 ! � L 4S� 977 Owner orTenantD I N] !K ED yrfiV06 Telephone No. f7l, 482 - y02�- Owner's Address Is this permit in conjunction with a building permit? Yes [] No (Check Appropriate Box) Purpose of Building S//YGLE //ate t/fy 6//;, r Utility Authorization No. s Existing Service Amps 1 Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures 3 Swimming Pool Above In- No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1.3 No.of Oil Burners FIRE ALARMS No.of Zones No.of SwitchesNo.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pumpl N No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal Connection [:1 Other Po.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.of Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVI.AAGE:Unless waived by the owner,no permit for the performance of electrical wc.K may be issued unless the licensee pro- vides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such cov- erage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE C$ BOND❑ OTHER❑(Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) xplra to ate) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: CONTINO ELECTRIC LIC.NO.: 7� o : A S��T�� Licensee: LOUIS CONT I NO - Signature LIC.NO.: E 2 8 7 8 8 (if applicable, enter"exempt"in the license number line.) Bus.Tel.No.: 978-363-5420 Address: 1 nl7NC)yaN T)RT4E, WEST NFwRURY ma 01955 Alt.Tel.No.: .r OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law.By my signature below, I hereby waive this requirement.I am the(check one)❑owner ❑owner's agent. Owner/Agent "Signature Telephone No. PERMIT FEE:$ FORM F.P.11 HOBBS&WARREN-BOSTON (REV.11/991 TOWN OF NORTH ANDOVER le ` o PUBLIC HEALTH DEPARTMENT . 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01845 9S / SACHus Sandra Starr Telephone(978)688-9540 Public Health Director FAX(978)688-9542 August 5, 2003 Edward Hanley 1212 Salem Street North Andover, MA 01845 RE: Application for a building permit for an addition Dear Mr. Hanley: The Health Department has reviewed your application for a building permit to construct an addition to the existing dwelling on 1212 Salem Street. Unfortunately, under current Title 5 regulations the existing septic system does not have the capacity to handle the additional flow for your proposal, and would have to be upgraded before the Health Department could sign off on the building permit. I have enclosed some general information concerning additions and the septic system repair/upgrade process for your review. Please call the Health Department at the above number if you have further questions. Sincerely, la)rr, San R.S., C.H.O. Health Director W/enc. Cc: Building File Why do I need this approval? : The Health Department must approve all applications for additions to houses served by a septic system before the Building Department will issue any permit. This is because there are several things that the Health Department must check, namely: • Does the addition meet setback requirements? • Is the septic system working now? • Where exactly is the septic system? • Will there be more flow to the system? • Does the system currently comply with relevant regulations? • Is the system large enough to handle any extra flow? • Is there room enough on the lot for a new system and a reserve? All these questions address the problem of whether the septic 'system is or can be made large enough for the maximum number of people the house could hold. An addition of any kind when there is a septic system on the site is considered "new construction". What do I need?: You will need to submit floor plans for the proposed addition along with a complete floor plan of all floors of the house as it currently exists. The two plans should be in the same scale. You will also need a certified plot plan showing the outline of the existing house, the proposed addition, the location of the septic system, and any wells or pools on the site. These should all be to scale. It is also recommended that you have your septic system inspected by a certified Septic System Inspector. It is important that your inspector checks on the size of your septic system as well as how well it is working. Who do I see? See the Health Department if you cannot locate the septic system; there may be a plan on file. See the Zoning Officer to find out if your lot and the proposed addition meet Zoning requirements. Check with the Conservation Department to discover whether wetlands will be a factor in your project. Then submit your entire package to the Health Department for a decision on your septic system's fate. A Civil Engineer could help you with this process. How do I do this?: To start the process you must first go to the Building .Department and apply for a permit for an addition. You will pay a fee and receive some paperwork. You will probably have to go through the Conservation Commission process if there are any wetlands anywhere near your project site. If your site is located in the Lake Cochiewick watershed, then you should check with the Planning Department to see if you need a special permit. If you have submitted your application to the Board of Health, staff can be reviewing it while you are going through other departmental processes. A final approval and permission for a building permit will depend on the approval of all pertinent departments. Other References: • 310 CMR 15.000 Title 5 (You can download a copy of Title 5 at www.state.ma.us/dep/brp/wwm/t5pubs.h tm) • Town of North Andover Requirements for the Subsurface Disposal of Sewage List of properties in the Watershed (in the Community Development and Services office at 27 Charles Street) FORM U - LOT RELEASE FORM �,cic I 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. *****************************APPLICANTFILLS OU�TTHISSE�CTIO�N— �� APPLICANT Vc d PHONE '7 8 LOCATION: Assessor's Map Number _ PARCEL SUBDIVISION _ LOT(S) STREET ST. NUMBER 'L- USE ONLY********* ** *** RECOM. NIDATIONS OF TO N AGENTS: CONSERVATION ADMINIST ATOR DATE APPROVED rr DATE.REJECTED a 3 p3' COMMENTS r 9 �t �e �d2nc t. D� tf, 96 j t ConST�fK rye 1 TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECT - OR HEALTH DATE APPROVED -- DATE REJECTED SEPTIC I SPECTOR-HEALTH DATE APPROVED DATE-REJECTS COMMENTS JLQ_T7 f +✓ PUBLIC WORKS- SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9W im COMMONWEALTH OF MASSACHUSETTS A EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS w r + d DEPARTMENT OF ENVIRONMENTAL PROTECTION } FC Zr3 TITLE 5 �:__�.._ OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner's Name: Edward Hanley Owner's Address: Same Date of Inspection: 6-28-03 Name of Inspector: (please print) Paul Cardone Company Name: Septic Compliance,Inc. Mailing Address: 447 Boston Street Topsfield Ma.01983 Telephone Number: 978-887-8586 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper fimction and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority ils Inspector's Signature: Dater Z—v The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments this inspection was performed in order to put on an addition ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. i Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 j Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced j obstruction is removed Distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): Broken pipe(s)are replaced Obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOS - PART A CERTIFICATION(continued) Property-Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine iftlre system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15:393(1)(b)t#;it,thio --" system is not functioning in a manner which will protect public health,safety and the environme4f: _Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system-is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool No Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool N/A _Liquid depth in cesspool is less than 6"below invert or available volume is less than `h day flow No required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ No any portion of the SAS,cesspool or privy is below high ground water elevation. N/A _ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. N/A _ Any portion of a cesspool or privy is within a Zone 1 of a public well. N/A _ Any portion of a cesspool or privy is within 50 feet of a private water supply well. N/A _ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. . E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000' gpd. You must indicate either`yes"or"no?'to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Yes Pumping information was provided by the owner,occupant,or Board of Health No Were any of the system components pumped out in the previous two weeks Yes _ Has the system received normal flows in the previous two week period? No Have large volumes of water been introduced to the system recently or as part of this inspection? Yes-Partial plans _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) Yes _ Was the facility or dwelling inspected for signs of sewage back up? Yes _ Was the site inspected for signs of break out? Yes _ Were all system components,excluding the SAS,located on site? Yes _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the P Pe condition of the bales or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Yes Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? v The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes . no No Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION II� Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 Number of current residents: 5 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): No Last date of occupancy: Occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): and Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: According to the owner system is pumped every year,tank was pumped one year ago. Was system pumped as part of the inspection(yes or no): Yes If yes,volume pumped: 1250-1300 gallons--How was quantity pumped determined? Pump truck tube Reason for pumping: Routine pump,to check inside of the tank for any visible cracks or leaks TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system Single cesspool _Overflow cesspool _Privy Shared system (yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed-(if known)and source of information: 17 years of age Page 7 of 11 Were sewage odors detected when arriving at the site(yes or no): No OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 BUILDING SEWER(locate on site plan) Depth below grade: From top of foundation down to pipe 45" Materials of construction: X cast iron 40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): All in Good condition. SEPTIC TANK: yes (locate on site plan) Depth below grade: 2' Material of construction:—X—concrete—metal_fiberglass__polyethylene other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: 10'x 5' 8"x 5'5" Sludge depth: 3-5" Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 1-2- Distance from to of scum to to of outlet P p tee or battle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Septic Dip-Stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): We recommend tank be pumped once a year,baffles in good condition,liquid level was good no evidenced of any leakage GREASE TRAP: N/A (locate on site plan) Depth below grade: Material of construction:_concrete metal fiber lass (explain � Y Y of eth leve — — g _other Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanlev Date of Inspection: 6-30-03 TIGHT or HOLDING TANK: N/A. (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: Yes (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:_Appeared to be even Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): Ran a camera to the d-box PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS j SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 SOIL ABSORPTION SYSTEM(SAS): Yes (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: X leaching fields,number,dimensions: 1 field approx. 12'x40' overflow cesspool,number: innovative/alteinative system Type/name oftechnology: Comments(note condition of soil,signs of hydraulic faihu-e,l-evcf=ofpo g� p soil;conte-ofveg , etc.): Dry No None No elevated area on opposite side oMe driveway: CESSPOOLS: N/A (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid-to.-ink invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: -MatefiidIs of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: N/A (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 . OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1212 Salem Street No.Andover,Ma.0184 Owner: Edward Hanle Date of Inspection: 6-28-03 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 160 feet.Locate where public water supply enters the building. Page 11 of 11 . OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1212 Salem Street No.Andover,Ma.01845 Owner: Edward Hanley Date of Inspection: 6-28-03 SITE EXAM S1ope0-3% Surface waterNone Check cellarDry No sump pump Shallow wellsNone Estimated depth to ground water 10+ feet Please indicate(check)all methods used to determine the high ground water elevation: X Design plan owner had—went to B.O.H.nothing on file Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: All liquid levels were good,soil dry, no sump pump According to asbuilt no water observed(a)141.00 The addition they are planning to put on is on the apposite of where the septic system is. LOT A-9 Y� o 0 At W 04 cZ tc f lb' cl 1 � 3 00 A D po , V i OF R- (/50) x - /50 .. . . . . . .. . .. _ DES/GN EL Evd TION 4T. . . . ... . .(TOP OF STONE) No.xeses o i EX/5T11\16 ELEk1,d r/ON 47 . . . . . . . . . �2EQU/�C'ED F/LL DESIGN t1S 301L /NV P/PE OUT OF!/OUSE /50.7y / �e�� sz �� _ /NV P/PE INTO T<JNK . � �C /NVjv P/PE OUT OF TANK /5 I. S r✓TE !NV P/PE INTO D. BOX IN /NV P/PE OUT OF D. BOXE- • /NI! END Of P/PE Foe, W,\rea Ho '-4 Al k GV�1TEi� ELEV�IT/ON M.00 yi.d� ,4VE ?A E STONE �i�i�'�J`'rLL1NJ`' EN EN64vaC&PZ J. DEPT/ QT f',eOBE //4 XENOZ4 d VE. A41�'�i�°'N/LL, IYII NOTF 7-W/5 Rl-dN /5 NOT A 61,4,e ',4NTY �- OF TUT .4 j1,FR/F/ANION 1)F TUF land TION OF 79- CEX/ST : - The Commonwealth of Massachusetts Permit No. Office Use Onh 0;2J717-3 Occupancy & tee Checked l„ Department of public Safety 3/90 (leave blank) �,[L�j 77 00 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12 AP�LICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 2:00 (PLEASE PRINT IN INK OR TUE ALL INFOMIATI/ON) Date 6 7 'jtl�6. - City or Town Of ,( O Fd— To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below, Location (Street Number) 1 2 /Y-4 l 2—/Y Owner or Tenant � p - Owner's Address �1 F Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization NO. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Metes Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work j f (�G Q t/ �� AQ2 al No. of Lighting Outlets No. of Hot Tubs No. of Transformers TKVA1 ovIn- No. of Lighting Fixtures Swimming Pool Ab ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. o f Emergency Lighting BatterNo. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones i Total No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices No. of Disposals No. of Heat Total Total No. of Sounding Devices p Pumps Tons KW No. of Dishwashers Space/Area.Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers O Heating Devices KW Local❑ Municipal ❑other �Y g Connection No. of Water Heaters KW No, of No. of Low Voltage Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES[@ NO❑ I have submitted valid proof of same to this office. YES NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER ❑ (Please Specify) 9/16/9.1p Expiration Date Estimated Value of ElectXical Work S ,IiDY Work to Start Inspection Date Requested: Ro gh Final Signed under the penalties of perjury: FIRM NAME CONTINO ELECTRIC & CABLE INC. LIC. NA.A119g3 Licensee LOUIS. CONTINO Sigrtatur LIC. NO.E26788 Address 1 `DONOVAN DR. WEST NEWBURY, 01985 Bus. Tel. No. k D 0813 54= Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent aDate. -7 2473 NORTH TOWN O�Fp N/OysRdTH ANDOVER 3 O PERMIT FOR e INSTALLATIONS � 9 `y 9 This certifies that-. .t.. .G/�%��'�}.� �a has permission for �installati n : ! in the buildings o at ! 1. . •. . . . , North Andover,`Mass. Fee. . !/l! Lic.'No . . INSPECTOR WHITE:Applicant 1CANAR (�/Y$wilding Dept. PINK:Treasurer. GOLD:;File ..:rte..—,syr:>-,,,—ter.,- ._.. .:... __.,�fw�,r.�-.. ..�,,...�..,-a•^s-..wt�"'iaSf'd"'°"_"'_�...:.,. _. ..._r+:�...,.. . __ .. , 41K 1; Location' 24 No, / Date } NOR7M', TOWN OF NORTH ANDOVER o 3? �`, of Certificate of Occupancy $ Building/Frame Permit Fee $ � << cMusEsh Foundation Permit Fee $ . : } Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ ` TOTAL. $ . f � Building Inspector p(5ylI/glS 14:53 97.50 LAID ' j e7 # Cj Div. Public Works PERJiIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE MAP i4O. JO 6 LOT Ni . l / 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE ` I SUB DIV. LOT NO. F —I LOCATION / 7�7 S" �M < PURPOSE OF BUILDING - - OWNER'S NAMEZE NO. OF STORIES IwvSIIZfie✓ De.- - OWNER'S ADDRESS , j 5 5`• BASEMENT OR SLAB ARCHITECT'S NAME l 1 - SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMED ,I� �� r SPAN c„� e� DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS c� DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES J /Y?/ p•704 1 REAR / /-� GIRDERS AREA OF LOT '? /J/ FRONTAGE ( HEIGHT OF FOUNDATION KNESS IS BUILDING NEW �('� SIZE OF FOOTING xpj IS BUILDING ADDITION �pC - MATERIAL OF CHIMNEY IS BUILDING ALTERATION CC�/J IS BUILDING ON SOLID OR FILLED LAND • WILL BUILDING CONFORM TO REQUIREMENTS OF CODE l/�S IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST - SEE BOTH SIDES a-1 - -' EST. BLDG. COSTfl 41 bOV _.- -. ✓ PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. - PAGE 2 FILL OUT SECTIONS 1 - 12 - EST. BLDG. COST PER ROOM • SEPTIC PERMIT NO. - ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING - 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILEDiba!j /Z DUILDING INGP[CTOI SIGNATURE OF O ER OR AUTHOR ED EN F E E OWNERTEL.# PERMIT GRANTED ' CONTR.TEL.# 19 CONTR.LIC.k p ( 7 2-z H.I.C.k J 9,5 BUILDING RECORD 1 OCCUPANCY 12 _ SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM " MULTI. FAMILY OFFICESL LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B M T AREA _ 11 1/2 1/ FIN. ATTIC AREA N_O_B M T FIRE PLACES - HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH - ASPHALT SIDING HARDN!J'D ASBESTOS SIDING COMIAGN _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK N MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING , STONE ON FRAME SUPERIOR I� POOR _ AOEOUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ .. ,. ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS NO. OF ROOMS GAS B'M'T 2nd I_ ELECTRIC 1st 13rd NO HEATING ClR/SRWN,SEN 46)W&NEER//ti/G, //4 KENOZ-4 /22. 53 i 2.3.73 3 I S 98'`23 6'9 C/ LOT 16 v 41?, ,4 /30, 9S t s. EX/5T/NG FOUNDATION o / � x c- COQ 15 t 1 w LOT /5 �s MA 76/w. LAVR / CERT%F ' TVQ T .. OFFSETS S /O�!/N, ,dRE fOR T�/S_. LOT BU%LD/NG 5110,4 N ON 711.5 ZONING DETER�G1/N4T/0�1/ P M Q7 C -L.4N: ONFOfr'.GJ3. TO 77 IA67 .:ONL N; ZDN/NG TO E,5T4BL/;5f,� ;4 FLOOD OF X'.%4/1�O:Qt/ PRD— ,y�1Z,QR0< . r w�lEN CONSTRI/ITEO: ZONE /NES w 1 f a ,E i ZJxZ -Z \ c Na CLc,,/e.l, w, (o8z- qozS SPAS � �►�d �-�-,�, ��.�,�,ya,,, ; z X 1 41r- / 1 �-,.��L. F'ro 51' w A-11// o r C.v v�G-27�.. 61 o C4 1`4-11 51 ZX p I �la��L J 01ST 5 X `� xS !' C7 yWooC{ Z x V i� " b w,qj/ �z X c P JA-1 c,-1,470 A r i id®v iia _ 19 0 NO . `.. •-0(s" G :ace.. ?ni'�. •etP k - .tl�;�Jij' IT THIS CEEtTIF:ES Ti�:".v . ................................... ......... .. r`ectAP '.q,� .... build;,- s o: .......... ...�... ,...... has �erf`;j ;inn t0 t ... .......... } to occupied as ........................................�'t..v.A....... ilc in be applicat 'provided that :he person accepting this permit shall in every a this ottjce, and to the provisions of the Codes and BY-Laws , .. ctn n and Coy :ion of 7,71 y -0 R i - Bujidiings in the Town of North Andover. V g or Building Regulations Voic'a the % RMIT LXX UNLESS C'�'�: . _ X. . % LDING ,..TOR r _ Pe t�t�t •, nr l Occupancy a Conspicuous Plac At Rer 7 t No Lathing of r nf; pocted and App_ U tor: