HomeMy WebLinkAboutMiscellaneous - 180 HICKORY HILL ROAD 4/30/2018N
r
Location
No. _r
J Date
,&pR7M
MTOWN OF NORTH ANDOVER
3?per,"•o- I•,ppt
F ; p Certificate of Occupancy $ `
> ?; Building/Frame Permit Fee $
CH
sAc►+usU Et �y� Foundation Permit Fee $
Other Permit Fee $
�Oe ,�ggti Sewer Connection Fee $
w ter Connection Fee $
OGS �\TOTAL $
Building Inspector ,
Div. Public Works
Location J -�
No. `, c?— Datez-
NORTH
TOWN OF NORTH ANDOVER
•r - `p
Certificate of Occupancy $
gr'ame Permit Fee $
Foundation Permit Fee $
�wus�
ermit Fee $
!t
t #f�
Sewer Connection Fee $ �� n
Water Connection Fee $
TOTAL $
Building Insj5ector
f/ Div. Public Works =�
Location "
i.
No. '� Date
Of TORT" TOWN OF NORTH ANDOVER
p Certificate of Occupancy $
•
} °Building/Frame•Permit Fee $
us Foundation Permit Fee $
s�cM
Other Perm! $ v
Se V66whection Fee $
Water Connection Fee $
TOTAL $ �
} Building Inspector
Div. Public Works
PEFt�TTT NO. 7 s�
m
9
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. � �%,�J% �% PAGE 1
MAP 4-40.
I
LOT NO. (^7
2 RECORD OF OWNERSHIP IDATE
BOOK 'PAGE
ZONE7
SUB DIV. LOT NO.
-7
7
LOCATION lG '
/i
PURPOSE OF BUILDING
1 Q�j `
OWNER'S NAME T�
Y 4
NO. OF STORIES SIZE /al � �^^
b 3'
OWNER'S ADDRESS /)
BASEMENT OR SLAB a �� �.. y
ARCHITECT'S NAME A)t -
a 2ND �y � 3RD
SIZE OF FLOOR TIMBERS IST 7,,f I�
/!
BUILDER'S NAME n+ +
,��i �,�
SPAN
1�
DISTANCE TO NEAREST BUILDING...
DISTANCE FROM STREET y-�3 / JJ
DIMENSIONS OF SILLS 7�
POST `rt`! `
DISTANCE FROM LOT LINES - SIDES{ `/'
REARJI/' i1 S
GIRDERS
AREA OF LOT ��� 0 S . in
i
FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW �tj t"
V•Jw
SIZE OF FOOTING (/ X )Oil
(•/
IS BUILDING ADDITION ��
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND d
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 oe
-
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
SEE BOTH SIDES'
PAGE 1 FILL OUT SECTIONS 1 - 3'' ~
PAGE 2 FILL OUT SECTIONS 1 - 12 y •`?':�� lel IQ
t
ELFw-TRIC METEPS MUST BE ON OUTSIDE OF BUILDING•... n
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILEANk?,
DAPPROVED BY BUILDING 1
��'
-DATE FILED
�
SIGNATURE FZWER OR AUT HO ED AGENT
OWNER TEL.
FEE
CONTR. LIC.
PERMIT GRANTED t�
51, — -'.). i 19
3. 1. PROPERTY INFORMATION
LAND COST L s: em, z -
EST. BLDG. BLDG. COST / oo f, !' 90 -
co
EST. BLDG. COST PER
LSQ. FT. j �.'� --�
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO. jo ^'-
4
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
(2 Bu1LD1 O INOPRETOR
BUILDING RECORD
1 -OCCUPANCY 12
SINGLE FAMILY
STORIES
MULTI. FAMILY
OFFICES
APARTMENTS
-
_
CONSTRUCTION
2 FOUNDATION
_
8 INTERIOR FINISH
CONCRETE
d
1
2
13
CONCRETE 8L K.
_
PINE
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
_
UNFIN.
3 BASEMENT
'
AREA FULL
FIN. B'M'TAREA
1/1 1/7 '/
FIN. ATTIC AREA
_
NO B M
FIRE PLACES
HEAD ROOM
-MODERN KITCHEN
4 WALLS I
9 FLOORS
CLAPBOARDS
B
ll�
1
2 3
�_
_
_
DROP SIDING
WOOD SHINGLES
CONCRETE
-EARTH
HARDW D
COMMCN
ASPH. TILE
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
_
STUCCO ON MASONRY
STUCCO ON FRAME
. - -
BRICKON-MASONRY
BRICK ON FRAME
_
ATTIC STIRS. & FLOOR I_
CONC. OR CINDER BILK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I- I POOR _
ADEQUATE NONE
5 ROOF
10 PLUMBING
GABLE
HIP
BATH Q FIX.)
71
GAMBREL
MANSARD
TOILET RM. I2 FIX.)
FLAT
I
ISHED
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
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBEICBMS, COLS.
STEAM
STEEL BW97. 8eCUL
Aof
HOT W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS
GOAL
B'M'T 2nd
13 d
EL
NOHEATING
THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
LOT LINES AND EXACT DIMENSIONS- OF BUILDINGS. WITH PORCHES. GA-
RAGES. ETC. SUPERIMPOSED. THIS REPLACES`PLOT PLAN.
N
f
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: h h c� .� .� L 1C3 Phone_� '- -2 3 S
LOCATION: Assessor'sMap Number R � Parcel
Subdivision Ni C'JL e �,�!/ Lot(s) 17
r �l &6
St. Numbe
Street r
************************Official Use Only************************
RECOMMENDAT ONS OF TOWN AGENTS:
--F-1 Date Approved
Conservation Administrator Date Rejected
Comments
Date Approved
Town Plann-r Date Rejected
Comments
Date Approved /
s• Health Agent Date Rejected
Comments
Public Works - sewer/water connections /�{ l$J Y )
- driveway permit
Lam. _/ _A
*- Fire Department >(
Received by Building Inspector
Date
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