Loading...
HomeMy WebLinkAboutMiscellaneous - 171 LACONIA CIRCLE 4/30/2018 (2) 171 LACONIA CIRCLE / 210/105.D-007&0000.0 1 R�=CBI!!�D Commonwealth of Massachusetts City/Town of JUN u b 2012 System Pumping Record TOWN OF NORTH ANDOVER Form 4 HEALTH DEPARTMENT 4,M s DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/Right front of house, Left ight rear of hoOt Left/right side of house, Left/ Right side of building, Left/Right front of building, Le rearuilding, Under deck Address R d i Cityrrown (� State Zip Code 2. System Owner. Name Address(if different from location) City/Town Stat &6gp Code Telephone Number [[[q B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No i 5. ConditiSystem dU d� 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locatio contents were disposed: • S. Lowell Waste Water (a Sign t e Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 .. I Date. Of ,fORTM 1ti of TOWN OF NORTH ANDOV R 41 • PERMIT FOR GAS INSTATION �9SSAcmusEt f This certifies that . . . �!� ? �t. . . s�I r. . . . . . . . . , • has permission for gas installation . �s' . . . . . . . . . . . . . . . . . . . in the buildings of . . .PA4-A.X4 .7.AA . . . . . • . • . . . . . . . . , • • • • at . �l.`a.l. . .� �.�h.�.<.a. . .�.! f'. . . . . . . . North Andover, Mass. Fee. .3 . . . Lic. No.3 Y.`f.)— . . . . , . .�Lf. . . . . . AS INSPECTOR Check# )3 Ij y 6206 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) fJQ ELL AL06VCIL , Mass. Date Permit# Z O Building Location /7/ L AC61J/R Cie Owner's Name HilwJ g H tt 8HAT UA GA k, "" •• A)r�RT�I AkpoVa, ( �1 O)8`l5 Type of Occupancy KSSID�iU7I�l I� New ❑ Renovation ❑ Replacements Pians Submitted: Yes[] No ❑ N to W W t/) N N U z oCCC pf W W YN Oy O V O7 F- OO CC0 - O = F- Cr 'W d Z Uf A Wj Q W W W W .Z. Q Z R OC W Q: W N. W h S r K,..v d }- Z j h Z i,. cc W W d 0 > W t- V J }N. W Y Q at Q � �' >- N ap Z O Z W O Y Q ,W > W O Z. < Q Q Q O O W O p F- ¢ .Z O d = U. a 3 G d J V > A ti F- O SUB-8SMT. BASEMENT IST FLOOR 2ND FLOOR M 3RD FLOOR _ 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name BAY STATE GAS COMPANY Check one: Certificate # Address 55 MARSTON STREET �O Corporation 1862 LAWRENCE, MA 01840 ❑ Partnership Business Telephone 7 b—6 8,7-110 5 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Francis X. Corkery INSURANCE COVERAGE: I have acu renntt liability insoura❑nce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked ies, please indicate the type coverage by checking the appropriate box. A liability Insurance policy P< Other type of indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: ❑ Signature of Owner or Owner's Agent Owner❑ Agent i I hereby certify that all of the details and information I have submitted(or entered)in abo plication are true and accuWe to the best of my knowledge and that all plumbing work and installations performed under the permit iss f r this application will n mpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gene s. (/ BY T e of License: Title Plumber Signature of cense Plumber or PlumbGas 453 Gasfitter Cit /Town Master License Number_374"5 City/Town Journeyman APPROVED O FIC S ON I i I I• BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE N0. APPLICATION FOR PERMIT TO ADO GASFITTING NAME & TYPE OF BUILDING !F LOCATION OF BUILDING r., PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE_���19 GAS INSPECTOR Date.. NORTH TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION This certifies that . . . . . . . . . . . . . has permission for gas installation in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . .11' ., North Andover, Mass. Fee��j . Lic. No.. . . . . . . . . . . . . . . . . . . . lt��E�O� Check# 6064 MASSACHUSETTS UNIFORM APPUCATON FOR PERMrr TO DO GAS FITTING (Type or print) Date , 3 NORTH ANDOVER, MASSACHUSETTS / / Building Locations / �f�o7)4z— n� --le Permit# 116 Amount$ Owners Name New E] Renovation E] Replacement D Plans Submitted V W O 0 m H x F v7 F W O O O z V W Q x z F• v� o. a d G7F z F d x W oC W W W E•" 4, dZ d W d a F rn m Z O Z W p vFi x OV a > A a F O �- 0 SU B-BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7 T H . F L O O R 8TH . FLOOR (Print or type) Check one: Certificate Installing Company Name � Corp. Address ��A�� �r�- Partner. usinesTelephone ) r'._ Firm/Co. Name of Licensed Plumber or Gas Fitter 2� =Ica INSURANCE COVERAGE Check one: 1 have a current liability Insurance policy or it's substantial equivalent. Yes NoD If you have checked Yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnityD Bond D rOwner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner D Agent D 1 hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State G ode and Q1AAqL1A2 of I a General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title D Plumber 5:E-q(a City/Town D Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) Journeyman D f , Date..... :... ...... °.��``° '••"° TOWN OF NORTH ANDOVER 3? • .r -"..• ° p PERMIT FOR WIRING ,SSACMUS� r This certifies that ....i )-P.....:-�n ..... ...... has permission to perform ..... ........................................ wiring in the buildixig of.. .......................................................... at......17/.. ........................................................... ,North Andover,Mass. QQ�� Fee u". Lic.NaSa��-34�.. ..... . !' .... r.............. . ............ ......... ........... t ELEcrRicALINSPECCTOR r Check # 7543 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. � Occupancy and Fee Checked _ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]� (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: 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. Location(Street&Number) L Q !- Owner or Tenant (J C ,�}- �j h (,�"7`"X/G p R Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building �� !�� i�Tb i 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: c��o ��6 �T 4&1Wc leos Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans o. o Total 1 Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesSwimming Pool Above [IIn- ❑ o.o Emergency Lighting rnd. grnd. Battery Units No.of.Receptacle Outlets 7 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No. of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons K No.of elf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWLocal n�AVlunicipal ❑ Other 4� Connection No. of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No. of Water KW o.of --No.-OT Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring. No.of Devices or E uivalent °�- d OTHER: Z C 4- / Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of El ctrical Work: (When required by municipal policy.) Work to Start: ��(j 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 cover e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE OND ❑ OTHER ❑ (Specify:) t I certify,under the ins and penalties of erjury,that the information�on this application is true and complete. FIRM NAME: a-(, E� � t` /� �e�/F "Crz C o f`L.IC. NO.: yG l= a Licensee: ` i �, // �/ IInn Signature LIC. NO.: .2 Gr t i IN, tj b tS 4/ 2J Addrlicahle, enter "exempt'to the license number line.) Bus.Tel. No.•. . �.� CY-1Z Address: Alt.Tel. No.:9,>?-JV -3 7'L/' *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, 1 hereby waive this requirement. 1 am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ t r }� 1 � E9'I'� �� - I ClIx The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): da_t,-(c( Address: City/State/Zip: �,�� A; ' - Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. lew construction ployees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [ comp No workers' . insurance 5. ❑ We are a corporation and its 10. Electrical repairs or additions required.] officers have exercised their ❑ P 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' . insurance required.] 13.❑ Other comp. q ] *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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. i I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. r Insurance Company Name: v1 L c. Policy#or Self-ins. Lic. Z-/6 Expiration Date: Job Site Address: / 7 / OL C_ t?h ! Ct I City/State/Zip: 2c uRi- 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un the pai an enalties of perjury that the information provided above is true and correct. Signature: Date: /.2 7 Phone#: l Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print). NORTH ANDOVER,MASSACHUSETTS 1 Date � 5— Building Location i _ 1� �`!► C!tn, Owners Name 1-J y �2r Permit 35Yi Tyre of Occupancy Amount New Renovation Replacement �� Plans Submitted Yes No FIXTURES a E~ St$>eM WgAm to mm lb � ?rIl FIDQt 3M ROCIR 4HI HIM 5M 110M 6TH HIM 7IH HfM SIH Fi" (Print or type) } / Check one: Certificate Installing Company Name �✓ _SU�1 "� ��/ �L�- Corp. ddres `'V+ Partner. Business Telephone © Firm/Co. el— Name l-- Name of Licensed Plumber. /l Insurance Coverage: Indicate the rype of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work an installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mass hus S Plung Code and Chapter 142 of the General Laws. By: Ign ot LicenSeaum er Title Type of Plumbing License City/Town icense u er Master ❑ Journeyman APPROVED(OFFICE USE ONLY u LSA ?/ r'� 1 Date. R l� TOWN OF NORTHANDOVER PERMIT FOR PLUMBING SSACHUSE� This certifies that i .. .... . . .t.. ..! _ -t.. . . . . . . . . . . . . . . . has permission to perform . plumbing in the buildings of ? - - -!. . . . . . . . . . . . . . . . . . . . ., North Andover, Mass. k �U v FeLic. No: 1�4%. . �� '�1 'z� --. . . . . . . . . . /r f PLUMBING INSPECTOR Check # 7256 Location 17 �4(C) JI f1 r/ 'c ( E No. !-5 V Date NORT�y TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ,ssAtNUSEt� Foundation Permit Fee $ Other Permit Fee $ Z '` Sewer Connection Fee $ REcEiVED PAy Connection Fee , $ AM Y1 TOTAL I $ Z S . Building Inspector NO.AWOVer Colle �- �pr Div. Public Works i PERMIT NO./S APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP d40. LOT NO. >t 2 RECORD OF OWNERSHIP (DATE BOOK PAGE ZONE SUB DIV. LOT NO. b-13-8� � . oc o`V ' LOCATION PURPOSE OF BUILDING �I I Tl�A p I OWNER'S NAME M` �hNO. OF STORIES /T (SIZE I , OWNER'S ADDRESS) 1 ' i i BASEMENT OR SLAB yl T ARCHITECT'S NAME (Y 1UJA 0,D Q 9, SIZE OF FLOOR TIMBERS IST �\'� 2ND 3RD BUILDER'S NAME I t �iy� SPAN 2� 1 DISTANCETOTO NEAREST BUILDING W /,/ DIMENSIONS OF SILLS DISTANCE FROM STREET 1 0 POSTS 4� L DISTANCE FROM LOT LINES-SIDES REAR {� " GIRDERS 0441) AREA OF LOT FRONTAGE "T HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW D? SIZE OF FOOTING / � X IS BUILDING ADDITION /�✓ MATERIAL OF CHIMNEY IS BUILDING ALTERATION - /C• �/� ,� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE `t/) IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY (1;\ 1W IS BUILDING CONNECTED TO TOWN SEWER V� Kn 91J IS BUILDING CONNECTED TO NATURAL GAS LINE �t l INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH BIDES EST. BLDG. COST 0 Al ill v' 1 PAGE 1 FILL OUT SECTIONS 1 - 3 EST, BLDG. COST PER SQ. FT "l`'1 er I COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12EST. BLDG. y Oy 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 FILED BOARD OF HEALTH IGNA RE OF OWNER OR AUTH IZED AGENT OWNER TEL. Cl 61,66 F E E' Z S- �� CONTR.TEL. - 31107 CONTR.LIC.#0-30!V-3 PLANNING BOARD PERMIT G �Ig! I - i BOARD OF SELECTMEN 177 BUILDIN 1 ECTOR i BUILDING RECORD 1 OCCUPANCY 12 SI •� NGLE FAMILY ,,STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF 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 —I 8 INTERIOR FINISH CONCRETE a 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL _ FIN. B-M'TAREA FIN. ATTIC AREA _ N_O BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDINGCONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARD\!✓'D ASBESTOS SIDING _ COMMON _ VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME I - CONC. OR CINDER ELK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 M. ( GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE j + FORCED HOT AIR FURN. s' TIMBER BMS. 8 COLS. STEAM STEEL BMS. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL fu B'M'T 2nd _ ELECTRIC bz l 3rd NO HEATING f . .s COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY 1010 COMMONWEALTH AVE. s' OF BOSTON,MASS.02215 '� . MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER LICENSE FOR REQUIRED FEE, EXPIRATION DATE r, CONSTR. SUPERVISOR 06/30/1993 1' - 51 MADE PAYABLE TO RESTRICTIONS EFFECTIVE DATE LIC-NO. a NONE � 06/30/1991 030437 z "COMMISSIONER OF PUBLIC SAFETY" n m SCOTT R SEABOYER m (DO NOT SEND CASH). SS 0 025-52-2970 .25 HOLLYWOOD T R 0864 P EASE NOTE ­kiE INCREASE PHOTO(BLASTING OPR ONLY( FEE: 100. 00 E I FECTIMW14A 989 HEIGHT: =OFFICIALLY ISSIONER DOS: 10/07/1957 D NOT DEf ?AC_,H'iII 'ICENSE - STUB THIS DOCUMENT MUST BE IGNATURE OF LICENSEE SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF THE HOLDER WHEN ENGAG- OTHERS -RIGHT THUMB PRINT ED IN THIS OCCUPATION. - COMMISSIONER 200M-2-87.81429 y Y ni PGt Ml f X 1 Ato�_vSD � 3I t � i F ' -aJ -}...1 i• � � ;�� t .cam^: '�`� �2 - - - - -- 4'y 21 t �%SNS I �•Jn . i 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. ****************Applicant fills out this section***************** APPLICANT: Phone 72Y- V 9 6 4 LOCATION: Assessor' s Map Number /OS J7 Parcel 7 Subdivision Lot(s) /2. �} Street _14"CA /Al- C1 t L A^ St. Number ************************Official Use Only************************ RECO DATIONS OF TOWN AGENTS: Date ApprovedX �.0 Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments A 1 '\ Date Approved 3 Z ;Healthent ` Date Rejected Comments B 8Af/ lt� le:&�77,,v.57 Z1Ve—¢?70 A /�5v .701— ` T ocJ�ris Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date i Location No. � Date S1!:.57 f NORTh 1 TOWN OF NORTH ANDOVER 0.4 ��0 '�•�00 Certificate of Occupancy $ � A + ' Building/Frame Permit Fee $ }�'��•...J'"�* Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee $ Water Connectio Fee $ TOTAL $ Building Inspector 5158 Div.Public works r S HH' AL PLANNING VAORTH own o 6 n over Ir -liVEWAY ENTRY PERMIT K ■aye`` r Mass. 19St C �ME WICK �AoR SSA 'I BOARD OF HEALTH PERMIT LD THIS CERTIFIES THAT.. .... .1C�/1.� 1e .... .......... .. ............................ I *A BUILDING INSPECTOR has permission to ere ... o.. Rougha �� ,� Chimney occupied as.....................1�row. X........ . Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations V:idpsthisit. PERMIT EXPIRES TI�S ELECTRICAL INSPECTOR Rough UNLESS CONST -A Service Final age BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building ugh Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector