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2101045.D-0016-0000.0
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PER111T No CZ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1
MAP NO. LOT NO. 2 RECORD OF OWNERSHIP iDAl-E BOOK PAGE
ZONE I SU V. LOT NO.
LOCATION PURPOSE OF BUILDING
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OWNER'S NAME 1 NO. OF STORIES IV SIZE
OWNER'S ADDRESS BASEMENT OR SLAB 7r � C{
_G•QQ &yL
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST ' 2ND 3RDV
BUILDER'S NAME SPAN
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES-SIDES// I REAR �Q '� GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 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
EST. BLDG. COST 2
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
PAGE 2 FILL OUT SECTIONS 1 - 12 /
/-e� _ _ ERMIT NO. ,04L4.2aZ
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING ((( 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS ME U ARvl:
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FI ED
= BOARD OF HEALTH
SWNATE O NER OR AUTHORIZED AGEyr
UR
719
FEE
PLANNING BOARD
PERMIT GRANTED
19
BOARD OF SELECTMEN
BUILDING INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY STORIES THIS SECTION MUSTSHOW EXACT DIMENSIONSOF LOT AND DISTANCE FROM
MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION $ INTERIOR FINISH
CONCRETE _ B 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HAP DW'D
PIERS PLASTER
-- -� DRY WALL
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'T' AREA _
y, /� '/ FIN. ATTIC AREA _
NO 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 HARDVV'D _
ASBESTOS SIDING COMMON _
VERT. SIDING ASPH.TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR I_
BRICK ON FRAME _
CONC. OR CINDER BLK. _
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR POOR
ADEQUATE
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH (3 FIX.) _
GAM
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 I MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING II 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
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC
1st 13rd I NO HEATING -
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