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HomeMy WebLinkAboutMiscellaneous - 140 Chickering Road r .,,. �� �_. r"a _� �1 //'�v 1'1 Date.................. ........................ �10RTF/ " ''�� TOWN OF NORTH ANDOVER c o ' PERMIT FOR WIRING ,SS�CHUS��< This certifies that .g................rD `e"' ............................................................ has permission to perform ... UCA......R�A. „D,,......, .... ,r............... /.p..... P c-1... wiring in the building of........................._..c... ................................ ...................................... at ...... `Y! e,o. ........ `�+ ........ ...................North Andover,Mass. Fee...... � .....Lic.No)7A.4 ....../J/� q f ':. ................................ �,...:.. ELECTRICAL INSPECTOR Check# I'!f:�6,D �LN Commonwealth of Massachusetts Official Use Only Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (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: JUNE 3 , 2015 City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 3 Location(Street&Number) 180 CHICKERING ROAD Owner or Tenant KI TTREDGE CROSSING Telephone No.978-453-6696 Owner's Address C/O PROPERTY MANAGEMENT OF ANDOVER Is this permit in conjunction with a building permit? Yes ❑ No X❑ (Check Appropriate Box) (J Purpose of Building RESIDENTIAL Utility Authorization No. Existing Service Amps / 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: INSTALLATION OF EMERGENCY STOP BUTTON FOR POOL PUMP MOTOR Completion of the followingtable maybe waived by the Inspector of Wires. _ No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Pool Above In o.o Emergency Lighting r g rnd. ❑ rnd. ❑ Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection I< No.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.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation'coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑X BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: CROWE & SONS ELECTRICAL CO LIC.NO.: 17168A Licensee: JAMES B. CROWE Signature LIC.NO.: 1716 8A (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.•9 7 8-453-6696 Address: 590 MIDDLESEX STREET, LOWELL, MA 01851 Alt.Tel.No.:978-453-6696 *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 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. 1 am the(check one)❑owner ❑owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 5 5 . 0 0 The Commonwealth of Massachusetts M�°"✓= _- Department of Industrial Accidents �r Office of Investigations 600 Washington Street rF Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): CROWE & SONS ELECTRICAL CORP. I Address: 590 MIDDLESEX STREET I City/State/Zip: LOWELL, MA 01851 Phone#: (978) 453-6696 Are you an employer? Check the appropriate box: Type of project(required): j 1.El stn a employer with 4. E] I am a general contractor and I 6. E] New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' y9. E] Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. [] We are a corporation and its WE Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] i *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. j #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site j information, Insurance Company Name: HARTFORD INS CO OF THE MIDWEST Policy#or Self-ins. Lic.#: 13WECBY9793 Expiration Date: 5/24/16 Job Site Address: 180 CHICKERING ROAD City/State/Zip: N. ANDOVER, MA 01845 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do herb ce ti ``under tdt pain and pens i of perjury td the information provided above is true and correct. Signature: v� Date: JUNE 3 , 2015 Phone#: 978) 453-6696 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: ACOOREP® DATE(MMIDD/YYYY) V� CERTIFICATE OF LIABILITY INSURANCE 6/3/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Clare Belfiore NAME: New Agency Partners, LLC (PAHOFA .o (973)588-1800 A/C No:(973)588-1801 99 Cherry Hill Road AIL ADDRESS:cbelfiore@newagencypartners.com Suite 200 INSURERS AFFORDING COVERAGE NAIC# Parsippany NJ 07054 INSURERA:Selective Ins Co of South Carolina 19259 INSURED INSURERB Hartford Ins Co of the Midwest CROWE & SONS ELECTRICAL CORP INSURERC: 590 MIDDLESEX ST INSURERD: INSURER E: LOWELL MA 01851-1428 INSURERF: COVERAGES CERTIFICATE NUMBER:15-16 Master rev'd REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE a OCCUR DAMAGES( RENTED 500,000 PREMISES Ea occurrence $ � S 2151503 3/22/2015 3/22/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS X AUTOS A 9093023 3/22/2015 3/22/2016 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident) ent $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION$ NONE S 2151503 3/22/2015 3/22/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA B (Mandatory in NH) 13WECBY9793 5/24/2015 5/24/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Electrical Inspector's Office ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street Suite 2035 AUTHORIZED REPRESENTATIVE N. Andover, MA 01845 Clare Belfiore/CIB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(9014011 Please visit our web site at http://www.mass.gov/dpl/boards/EL CROWE & SONS ELECTRICAL CORP JAMES B CROWE (EL) 590 MIDDLESEX STREET LOWELL MA 01851-1428 Fold,Then Detach Along All Perforations COMMONWEALTH OF A&USETT.S. D 0 0 0 0 ELECTRICIANS ISSUES„JH.E F0LLOWING `LICENSE AS: A . . REG1ISTERED MASTER....:ELECTRICIAN la , ;&ROW;E SONS ELECTRICAL CORP JAMES ,$«:._CROW S::*: y::. 590 MIDDLESEX STREET Imo.... i.7`-:4 01851-1428` 17168 A 07/31/16.: ; 57010 Town of North Andover ,;FORTH, Building Department , 27 Charles Street ; North Andover, Massachusetts 01845 _ (978) 688-9545 Fax(978) 688-9542 �` � - [OCNI[NL WK p CH�l��� APPLICATION FOR CERTIFICATE OF OCCUPANCY!INSPECTION ADDRESS I U CIA 7,--j 0�-r 'P..-b A;D 11 I fi l LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METE e�.DATE 1�.3 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED R TO INSPECTION REQUEST DA SIGNA DPW AUT ORIZATION Town of North Andover AORT Building Department °��Y` ° '�0 27 Charles Street 0 �- North Andover, Massachusetts 01845 n (978) 688-9545 Fax (978) 688-9542 ?, y -QA COC HICNC ivlCM` APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS t�,C) L�1CG k,GQ I O Cr .pb �� l l lot C LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOMED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITH[N THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER ATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO TEE INSPECTION REQUEST DATE. SIGNATURE/DPW ORIZATION Town of North Andover . ;�����► 3✓ Building Departments gti; ws 27 Charles Street 0 �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 •n -V Areo PIP COCH.[HL'NKN APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESSb �:���;���l iJ�T .pj,) An LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W.—WATER METER i -I' DA S �' TE 1 D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW �O�R�JZATION Town of North Andover "AORT1 Building Departments y�.,, �s 0 27 Charles Street .0 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 h CDCHi[H<ivKM 7 APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS � d l:��L��n 11}�r p6 A 1 4-� I 03 C ' LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W.—WATER METER_ nS f�c l��_.� DATE D.P.W. MUST INDICATE THAT TEE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUT ATION Town of North Andover ZA0RT Building Departments 27 Charles Street �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 CHUS 'QA CDCHI[ i'NKN APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS Cr pb 1�1� I (0 C- LOT LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS RE )UIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS RE TIME FRAME. A RE-INSPECTION ON FEE OF TWENTY FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER I nSfGt 1't DATE 1-2- D-P.W. D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. *IGNAZTURE/DPW A T RIZATION Town of North Andover01 tAOR � Building Department 0 27 Charles Street 0 �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 y 'Q4[OCMI[ ,WKM ti APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS j" c — C— LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE RE ADY FOR INSPECTION TO(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REpUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER �n d �� DATE D_P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE_ SI NATURE/DPW AU ATION Town of North Andover �� OO h � Building Department a ��Y` , , 27 Charles Street 0 �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 C. 4T PS CDgqC/N�tCeH't'wKM``7\ r� "9 i1..�aose��� APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS Ln LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN (IO)DAYS NOTICE PRIOR TO CLOSING DATE IS RE )UMED ALL WORK AND SIGN OFF'S MUST BE COMPLETED WITH N THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY--FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METERjhS-FCS I�� d DATE Z O D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI ATURE /DPW AUT-HO ATION Towyn of North Andover Building Department 01 27 Charles Street q �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 ?, ACHU [DCN[:iwK APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS � CJ �:�\L` kt 'l1.)CrI�1> /07 L LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF TBE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D-P. — W.. WATER METER � S-fGc.I f d DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. GNATURE/DPW AUTH ATION Town of North Andover 0ORT�, Building Department °�•�` ° Fg � 27 Charles Street o � North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 IAM! �A CDC NI[NC'NXM� 04 AT110 If APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS ,�d �.}��L��P ► } p� / 0 LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN 10 DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WIT ]O N THIS M4E FRAME. A RE-INSPECTION FEE OF TWENTY FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W.—WATER METER�� �-�� �I�cl DATE b D.P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO TM INSPECTION REQUEST DATE. SIGNATURE/DPW A ORIZATION Town of North Andover OR- Building Department 27 Charles Street 0 North Andover, Massachusetts 01845 ' (978) 688-9545 Fax (978) 688-9542 .. h Q IAHi 'QA,OCHIC HCIVKM OA?ATED APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS , d .��L��f'�I LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FAT ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER I rS falI-P cL DATE_I�l�/b D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED P R TO THE INSPECT ON REQUEST DATE. SIGNA /DPW AU ATION Town of North Andover tAORT Building Department " `E�' ,`,g '�c� 27 Charles Street e �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 Arm COCMI[X;'MXM APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS �C-r pb k DU U I l LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITI3[N THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25:)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER_ �n Sia l I z'� DATE /2 qU D_P.W_ MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO TOE INSPECTION REQUEST DATE. SIGNATURE/DPW AUT ATION Town of North Andover , OORTH Building Department °���`�° `g� �'o 27 Charles Street 0 4 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 iL y 'pQ CDCNICHi'NKM`y7' CHU APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN 10 DAYS NOTICE PRIOR TO CLOSIlVG D . ----� } ATE IS REQUIRED ALL WORD AND SIGN-OFFS MUST BE COMPLETED WITH3N THIS MM FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER Ito S+&, ['-r d DATE D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATLJRE/DPW AUTHO TION Town of North Andover . ;AORTH Building Department °2�s` ° g a'�0 27 Charles Street 0�- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 �y 'Q40 CDCNIC yR:vKF 7 APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS 1�d C,�I�L�'.��.I �Cr p 6 Ap ll LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WI THIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER DATE Z (� D.P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRI TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTH ATION Town of North Andover ORT o Building Department o �;A`` . o 27 Charles Streeter North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 ?, .. CDL N1L NiWKM 7 A�AµTlD APS`~ ? APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS 171 1.�Cr P6 Ael-) I C�2 (D I C. LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUMD ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY FIVE $25. DOLLARS OLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER �0S�� �� v1 1 � DATE � D� D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED P R TO THE INSPECTION REQUEST DATE. SIGNA /DPW H RIZATION Town of North Ando ��� ver 1 ;40� Building Department ° �54 ° 16 s,�,� a 27 Charles Street 0 ��- North Andover,Massachusetts O184 5 (978) 688-9545 Fax (978) 688-9542 .� Col _ COCMI[Ni"A.NF 7 � " QOR'STlD CHIJ APPLICATION FOR CERTIFICATE OF OCCUPANCY/-INSPECTION ADDRESS �T) LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE I i REOUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W_.—WATER METER�r'� �c� �� DATE � 3 0 D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI NATURE Z/DPW AUTHO TION Towyn of North Andover , ;��� �, Building Department ° ° ;gx� 0 �.. a 27 Charles Street 0 0�- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 .; , COCNI[(WKM 7 APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS It C— 20C— LOT LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN10 1 DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FE _ E OF TWENTY-FIVE 25 .)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE ODES SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W.-—WATER METER 0 S G' DATE_ 3/Q ?j D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNA DPW' &7HO TION Town of North Andover AORT Building Department 0.110-to F S 9 27 Charles Street - 0 : ��- North Andover, Massachusetts 01845 -W (978) 688-9545 Fax (978) 688-9542 ?, o COL HIL N2:vKM 1\ A APPLICATION FOR CERIMCATE OF OCCUPANCY/INSPECTION ADDRESS _ , d L, \C e n�j IJ�Y � l l f 4- C-Po`f" LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER /05+ct11-CP1 DATE_ 1 Z'3/0 -3 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNA /DPW AUTH ATION Town of North Andover a� . ORT Building Department 27 Charles Street �- d- North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 .� COCNK NNKM 7` Huse APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS C- pj-) A- l� i 0 C LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOuMED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D_P.W..—WATER METER In S+0-l 1-C f DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED P TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW A ATION Town of North Andover 0ORT ' Building Department n �Y�-° 'g , 27 Charles Street �. North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 'fib b 'SSA must APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS Igo C,�1Ck �j'�� I} �- 0 6 LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIl2ED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITH3N THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS TMWILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W_.—WATER METER -�a j �. DATE 1 Z/3 /O 3 D-P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHO A ION Town of North Andover Building Department 27 Charles Street 0 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 �A COLHI[ItwKN yi` CH APPLICATION FOR CERTMCATE OF OCCUPANCY/INSPECTION ADDRESS JO-7 C LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REo LIMED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TAM FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER d DATE IZ 3 (7 3 D-P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHO TION Town of North Andover � Building Department Ole 27 Charles Street - �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 IL 'QA cocHiK;wxx ti ACHU APPLICATION FOR CER'TIEICATE OF OCCUPANCY/INSPECTION ADDRESS {� 11 � yc� LOT NUMBER SUBDMSION • DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOVIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ********************* *************** ROUTING D.P.W..—WATER METER 61121 I� �� DATE I Z b D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHO TION Town of North Andover , 0ORTH Building DepartmentT`" � g..• s A 27 Charles Street r, �- North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 .. z ; Arm fl? . 'F1A[OL NI[HtWKN 4 APPLICATION FOR CERTIN'ICATE OF OCCUPANCY/INSPECTION ADDRESS ISO �n i ►J b LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN 10 DAYS NOTICE PRIOR T O CLOSING DATE I S REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W.—WATER METER Jr)S+6L1 I-e d DATE 12 3/p 3 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHO ION Town of North Andover r OORTH 4. Building Department �t T`-� 16 27 Charles Street 0 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 '{ COLHI(ry;:vKN 7 APPLICATION FOR CERTIFICATE OF OCCUPANCY/ INSPECTION ADDRESS ��UH�L��P�� ��Yn u ► _� � a 1� � LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS RE )UIItED ALL WORD AND SIGN-OFF'S MUST BE COMPUTED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W.—WATER METER_ ir)s--1)-r CL DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO Tj1E INSPECTION REQUEST DATE. SIGNATURE/DPW AUT ATION Town of North AndoverOORT� Building Department , ° �.. 27 Charles Street 0�- North Andover, Massachusetts 01845 W (978) 688-9545 Fax (978) 688-9542 .. y � QA coc HiiKii+ecw`yam � - Arm Pf' APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS tSd L \C�,eQ1 pbA LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN 10 DAYS NOTICE PRIOR TO CLOSING DATE IS RE � � OUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER Lr) +z1/1-ed DATE I z���0 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INPECTIO REQUEST DATE. C2 SIGNATURE/DPW AUTH TION Town of North Andover . tAORTH Building Department ` Y`-° Ig �'� 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 ?, y o � A^^RTlA y.P ACH APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS 1,71 IJ�r "pb I�D ( I T- I C- LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REOUMED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W.—WATER METER In Stet lI-e c- DATE 1-2-/3/o D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTIO REQUEST DATE. IGNATURE/DPW A O ATION Town of North Andover Building Department 0 27 Charles Street North Andover,Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 CtgqXNItN•.vlf N APPLICATION FOR CERTg+`ICATE OF OCCUPANCY/INSPECTION ADDRESS I S b U\G G .I 0(- 'P—b AD I T- © � LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN1I03 DAYS NOTICE PRIOR TO CLOSING DATE IS REQU GRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METE$ 6DATE �'�`'/41 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTH TION Town of North Andover Building Department b 27 Charles Street North Andover, Massachusetts Ol 845 _ (978) 688-9545 Fax(978) 688-9542 COCNICNR:VKM 7' �CHU APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS n-1 1.)Cr .P-b .A;D () 0 f T— 3 0 1")- C- LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN[IO)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAC. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..-WATER METER -- ATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED 7. Z0T]HE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHORI&TiON T'o'wn of North Andover !1440®�h � Building Departments 27 Charles Street North Andover, Massachusetts Q 1845 ` (978) 688-9545 Fax (978) 688-9542 _ ��CDCHII{IdiV1IM 4^i\ APPLICATION FOR CER CATE OF OCCUPANCY INSPECTION ADDRESS b L C k k f' cr ` �} 0 3 C LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN 10 DAYS NOTICE PRIOR TO CLOSING DAALL TE IS RE IJIRED WORK AND SIGN-OFFS MUST BE COMPLETED WITM TROE FRAME. A RE-INSPECTION FEE OF TWENTY-FIVETHIS W]LL CHARGED IF THE STRUCTURE DOES NOT MEETALLAPPLICABLE S �'L BE SIGNATURE CODES. OFFICIAL USE ONLY RO=UTING * ** D.P.W-.—WATER METER DATE D.P.W. MUST INDICATE THAT THE WATER ME PRIOR TO THE INSPECTION RE TER HAS BEEN INSTALLED QUEST DATE. SIGNATURE/DPW A ATION Town of North Andover r �flT Building Department °��-COSD Ig o g..,. fl 27 Charles Street 0 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 CHU r�CDCNI[CW![N y7\ APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESSn`l ►J�� " �v� C LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(1:0)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME.. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTINCT D.P.W. —WATER METER ATE D� D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRI TO THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHO TION Town of North AndoverOORTH Building Department a �tufo 27 Charles Street ` North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 r r yn � o z CHU w [OCNI[M1vKM 7\ C APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS ,�� �,H1C��kP�1 ►JET .Pb ren o 0 1 T- 0 5 C— LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FINE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES_ SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER - TATE lc3— D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. ,SI NA �/'DPW AUTIi ATION Town of North Andover Building Department 27 Charles Street , North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 y^ COCNICNC'NNq 7` �'3�$A-' HUS APPLICATION FOR CERTII+'ICATE OF OCCUPANCY/INSPECTION ADDRESS 1 g b CIA\Ck Erz1 L) k UI T LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(IQ)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI&AibiE/DPW AUTH TION Town of North Andover OORTH Building Department 27 Charles Street ; North Andover,Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 „y w CCILM[M:vlLN 7` f APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS CT,7-1 0 Cr _p-b K-n LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(10)DAYS NOTICE PRIOR TO CLOSING DATE IS REpUIItED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS Tr%dE FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIO O THE INSPECTION REQUEST DATE_ SIGNATURE/DPW AUTHO TION Town of North Andover Building Department °R `� 27 Charles Street ��- North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 r „ 'Q [n[Hit q[:VKM 7` CHU APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS I g b E C" 3o LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(103 DAYS NONCE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHLN THIS TIME FRAME. A RE INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METERDATE / -�dcv Z— D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNA.T J1 /DPW AUTHO ION Town of North Andover AoRr� Building Department z0��Y` ° PIS �.. " .e 0 27 Charles Street North Andover,Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 'p GDGNIt Ni1vKN '` CHUS APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS 1 ��1\c k Utz ►J {ATS U 0 1 r �j C LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN 10)DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN TMS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25•)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER DATEZW/ 03 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PR rLO,,,R TO THE INSPECTION REQUEST DATE. SIGNA /DPW A RIZATION i Town of North Andover , OOR�� Building Department o�iY`�� F� '� 27 Charles Street �� �:. ° 4 North Andover, Massachusetts 01845 •- (978) 688-9545 Fax(978) 688-9542 rQs i �hh ' y LAWS IWrFLN '\ 04 ATIP CHU APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS e�IGk �2� �T f fi LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN JO)DAYS NOTICE PRIOR TO CLOSING DATE IS R.EOTJIRED ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TAM FRAME. A RE-INSPECTION FEE OF-TWENTY-FINE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTIlVG D.P.W..—WATER METER DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED 4NATURE INSPECTION REQUEST DATE. SIGDPW T ORIZATION Town of North Andover 0.1 tAOR � Building Department 'JIU-° e '� 27 Charles Street 's ,6 to �. North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 ^^IN LM WYp V'\ HO APPLICATION FOR CERTIFICATE OF OCCUPAN ,Y/ NSPECT.ION ADDRESS 1 LN�CkGn�1 ►J�T U E T- .-3 C_ LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN(IO)DAYS NOTICE PRIOR To CLOSING DATE IS REO MED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER ATE D.P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNA /DPW A N