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Home My WebLink AboutMiscellaneous - 23 HUCKLEBERRY LANE 4/30/2018 Ry�p,NE 23 NUCKIEBER p000.0 ` 2101065 �.`. �I l. I. `. i '�, �. �� i ,�' I, �. �� i '�� ti ,` i 1 N2 .1 5 2 3 Date......1�. .....(.. .... HORTM °!< °:•1"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ��sS�cMusf� This certifies ........... ... ......................................... has permission to perform ......cJ ► wiring in the building of......... �'?.�°.. .UU" ..... .... v...................... �f / u� �� at... ..........�;.�°.....�. ....... ............................ .... ,North Andover,Mass. Lic.No./[./.1'Z/.............................................................. (� (� q ELECTRICAL INSPECTOR G t� O (� /09/98 og:ti 225.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer of Office Use Only (��) ,� rL , oIle (tamilwilwealt1j of RaBliadjuattB Permit No. J 0cpurtutcut of Ilublic eafctU Occupancy,& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Y- 9_ �9 City or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a20-111C ermit to perform the electrical work described below. Location (Street & Number) L u�l6/ #z- #k f elle�ecrg 1 r�yt� Owner or Tenant / U, Owner's Address `✓��-� 12�a�1 Is this permit in conjunction with et building permit: YeS4 , No ❑ (Check Appropriate Box) Purpose of Building __S);)0-I Q- /,JZ //tJ C, Utility Authorization No. FO C7_y 3� Existing Service Amps / Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service ZLC AmpsJ� Volts Overhead ❑ Undgrnd [Z No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work AVL_D /).6(A.� No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners - Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal ❑Other ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW 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 CompI ted Operations Coverage or its substantial equivalent. YES NO ❑ 1 have submitted valid proof of same to the Office. YES NO ❑ If you have checked YES, please indicate the typ o coverage by checking the appr prate box. ��///��' INSURANCE BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Elect ' al Work$ Work to Start y`/ Inspection Date Requested: Rough/A//W Final Signed under the Penalties ofperiu r �� FIRM NAME r 2 c 17 f2� LIC. NO. Licensee 42A,-Y' Signature LIC. NO. Bus. Tel. No. Address C5??r_2 -&9d4::140.5 z77",,LL!/(.Q/LC Alt. Tel. No. OWNER'S INSURANCE WAI R: 1 am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owr Agent (Please check one) /�v(l1 � Telephone No. PERMIT FE $ � " 0 " (Signature of Owner or Agent) x•6565 N2 i v Date ........`- HOR7M - °!+ °;•�"° TOWN OF NORTH ANDOVER I. PERMIT FOR WIRING ,r �ss�cNusf� This certifies that ....:........... . ..........................`'�..... .............. has permission to perform...%- --''.............................................. wiring in the building of... 1 ,t-.1 71 -- r�.F � .................. at.......99- 3...... :; - ,�hlorFh Andover,Mass. ............. ....... Fee�%-��................ Lic.No. . ............................................................... ELECTRICAL INSPECTOR 08/04/9816.33 35.00 Rr WHITE:Applicant CANARY: Building Dept. PINK: reasurer The Commonwealth of Massachusetts Office us Only 7 ��- Department of Pubpc Safety Permit No._, 1/ BOARD OF FiRE PREVENTION REGULATIONS 527 CMR 12:00 occupancy s Fee Check 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR Ah work to be performed In-ccardence with the Massaehusons EleetnW code,527 CMA 1290/ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date_ City or Town of . '/r--/-) -The undersigned applies for a permit to perform the electrical work described below. To the Inspector of Wires: Location (Street & Number) �.3 �/�'/��j lE'y ne or Tenant /�/�l/FGtlll>D OO�l//�L06' NI �4�QP Owners Address_ o�(/�D �/%f/Q/p J�, S(//T !/U(f lfE/9/J/LV(_� i'i/ dl 0 Is this permit in conjunction with a building permit yes C3no & T7 Purpose of Building�,E�iQ��D�N 91 Utility Authorization No. (Ch�•;k Appropriate Box) Existing Service amps_ Volts Overhead ❑ Und rd ❑ g No. of Meters New Service Amps / Volts Overhead ❑ Und rd ❑ S No. of Meters Number of Feeders and Ampacity Location and Nat--,e of Proposed Electrical Work iQ/Ty P�/ ! No.of 112hting Outlets No. of Hot Tubs TOTAL INo. of Transformers jCVA No.of Lighting Fixtures Above In Swimming Pool rnd.❑ rnd❑ Generators INA No. of Aecaotacle Outlets No. of Oil Burners No. of Emergency fighting Battery Units No. of Switch Outlets No. of Gas Burners FiRE ALARMS No. of Zones No. of Ran es TOTAL No. of Detection and No. of Air Conditioners TONS Initiating Devices No. of Disposals HEAT TOTAL TOTAL No. of Sounding Devices __EEENo. of Pum s TONS KW No. of Self Contained No.of Dishwashers Space/Area Heatin KW Detection/Sounding Devices No. of Dryers Heating DevicesMunicipal Local ❑ Connection ❑Other No, of Water Heaters KW No. KW°f No. °f Low Voltage Signs Ballasts Wirin C No.of Hydro Massae Tubs No. of Motors Total HP OTHER: e 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 ❑ 1 haave submitted e valid proof of same to this office. YES ❑ NO ❑ It you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work $ (Expiration Date) Work to Start Inspection Date Requested: Rough Signed under the penalties of perjury: Final FIRM NAME , CO / LIC. NO. 74-&6 C Ucensee dm 4/ R ,[/4yje,Z Signature Address zyz 'Y'41eflo P7', &V17-101 LIC. NO 3 Bus. let. No.&43—M-1010 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Insurance coverage or Its substantial equivalent as required by Massachusetts General Laws, and that my signature on this application waives this requirement. Owner Agent (Please check one) \ . PEHMIT FEE $ (signature of Owner or Agent) Telephone No 1 ✓ �A so, �aF 04 \G2 O� .sem O 'S•SAO� A BS� 20.1x• �cs� N39 08 3e�E x,01 6F� `'4,�• ori o 2 f PLAN OF LAND A MANIC QV61NEMNO & /N SURWY CONSUL TAN7X INC NO. ANDOVFR, MA 97 7FNNEY VR££T- SU711r S - GEORGETOWN, MA 01833 DATE*- ATS. 12, 1998 SCALf 1" = 40 FT. JOB N0, 9712-09 ON THE BASIS OF MY KNOWLEDGE, THIS IS AN INSTRUMENT PLOT PLAN INFORMATION AND BELIEF, I CERTIFY JOHN S. SHOWING THE STRUCTURES TRU NUE EXISTING THAT THE INDICATED STRUCTURES No 31728 AND OBTAINING A B LDING PERMIT, FOR ARE LOCATED AS SHOWN, AND THAT OBTAINING A BUILDING PERMIT. 607 LINES HAVE HAVE NOT BEEN STAKED THE SETBACK DISTANCES SHOWN AS PART or AS SUCH THEAS PART OF THIS SETBACK DISTANCES THE HEREON WERE THOSE RECORDED AT REV. B. 1998 SHOWN ARE NOT TO BE USED BY THE THE SITE, CLIENT TO ESTABLISH LINES FOR 99 FENCES, SHRUBS, LANDSCAPING, ETC... Z9'd OV66ZS£86S 9NI833NIDN3'3IlNHllV Wd bb:b9 86-tT-H33 CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number 037 Date June 11, 1998 THIS CERTIFIES THAT THE BUILDING LOCATED ON 23 arldebezr in MAY BE OCCUPIED AS Single Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. ORT M M CERTIFICATE I SSUED TO Pinewnro p ADDRESS 200 ParkSt No. R&adiM MA `HUS Buit&4 Inspector 1� NORTti Town of Andover No.,? NIP 0 — * zt� dover, Mass., 8 19 9 * s f LAKE w '9A_COCMICNEWICK O 1. r e PP` (G BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ..............��/�. ( Q(�.�............... E. ........................................................ Foundation has permission to erect....................L.................. buildings on.........—.3.....f 4<,G1 �..�.6' .�t�y... �� Chimney tobe occupied as......................................... ..1..A)..G.kO................... ...... . �... . provided that the person accepting this permit shall in every respect conform to the ter�is of the application on file in 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. PLUMBING SPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ��/ PERMIT EXPIRES IN 6 MONTHS Gu ELECTRICAL P � UNLESS CONSTRUCTION STAR o .... ....... UILD G INSPECTOR Fin ' Occupancy Permit Required to Occupy Building GAS INSPECTOR 8j�.e Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. J I Smoke Det. PAGE 1 PF.Rlfrr xo. APPLICATION FOR PERMIT TO BUIL — ORTH ANDOVER, MASS. MAP i�0. LOT NO. ECORD OF OWNERSHIP (DATE (BOOK ;PAGE F1 ZONE I SUB DIV. LOT NO. _ Pu� PS[OF BUILDING S) LOCATION C 'OF STORIES SIZE OWNER'S NAME _ oc BASEMENT OR SLAB ^ OWNER'S ADDRESS L&D SIZE OF FLOOR TIMBERS 1STT_ 7,I r� 2ND C5 3RD ARCHITECT'S NAME SAA—�I� C;b v BUILDER'S NAME SPAN '.� � �p.� �� n ""'h - -- --" DIMENSIONS OF SILLS DISTANCE TO NEAREST BUILDI 101- /J DISTANCE FROM STREET �.('� { POSTS v — _ - GIRDERS DISTANCE FROM LOT LINES—SIDES '�' REAR S+ f THICKNESS AREA OF LOT FRONTAGE 1� HEIGHT OF FOUNDATION S� �Q OC J� SIZE OF FOOTING X IS BUILDING NEW « Q MATERIAL OF CHIMNEY �jJ��„`�. IS BUILDING ADDITION �� - IS BUILDING ON SOLID OR FILLED LAND IS BUILDING ALTERATION N O ' y� IS BUILDING CONNECTED TO TOWN WATER WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN SEWERS BOARD OF APPEALS ACTION. IF ANY '`=S s IS BUILDING CONNECTED TO NATURAL GAS LINE 4 � 3 PROPERTY INFORMATION INSTRUCTIONS LAND COST ' ` EST. BLDG. SEE BOTH SIDES ' - EST. BLDG. COST PER SQ. FT. r .a PAGE 1 FILL OUT SECTIONS I - 3 EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 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 Ft57��DR.l D WILDING INSPECTOR V SIGNATURE AGENT 6 6 y �� 14 OWNER TEL.# it FEE CONTR.TEL 1F- �me PERMIT GRANTED --- - - 19 - CONTR.LIC.# 0-S FEB I ! H.I.C.# SM PEW FEE tv DUE FRAME PERM vocation fNo. _ - Date z S] 40"T" TOWN OF NORTH ANDOVE c ?O. t. ° 9 Certificate of Occupancy $ -��►�'' ; Building/Frame Permit Fee $ � Foundation Permit Fee EIJ s�cMuse .. Other Per it Fee. f11$ �� . !Z-'5Z Sewer Connection Ze/ $ ZMAter Connection $ o Z'op i TOTAL $ tl i 1 it 'ng I ector Di . P blic Works i; PER-MIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. - MAP $-40. I LOT NO2 RECORD OF OWNERSHIP �DAT� BOtr., ZONE S- SUB DIV. LOT NO. i LOCATION 4 Ea kUrk PURPOSE OF BUILDING Aje S) , OWNER'S NAME NO. OF STORIES - SIZE OWNER'S ADDRESS �1 w� BASEMNT OR SLAB" acV ARCHITECT'S NAMESIZE OF FLOOR TIMBERS IST r� 2ND 3RD BUILDER'S NAME G1l SPA — DISTANCE TO NEAREST BUILDING Zen 10 DIMENSIONS OF SILLS DISTANCE FROM STREET ,i"l ^�' " POSTS DISTANCE FROM LOT LINES-SIDES REAR t r1''� GIRDERS Mf,-/�v(x AREA OF LOT ca FRONTAGE HEIGHT OF FOUNDATION f- THICKNESS l0 l� IS BUILDING NEW J SIZE OF FOOTING +/ X IS BUILDING ADDITION A/Q MATERIAL OF CHIMNEY IS BUILDING ALTERATIONNO 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 A IS BUILDING CONNECTED TO TOWN SEWER h� IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST,? PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS i - 12 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 . III ---- 4 A c UILDINO INSP[CTOh SIGNATURE Of OWNER OR AUTHORIZ AGENT 66y- Z q F E E OWNER TEL # 1 PERMIT GRANTEDCONTR.TEL.�-f c_ - ts 1 CONTR.LIC.# S� i I H.I.C.# /0 's 9 3 / ;y<. Sum BUILDING RECORD { 1 OCCUPANCY 12 SINGLE 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 8 INTERIOR FINISH CONCRETE B 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D —i PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL I1 FIN. B M'T' AREA _ 1/1 '/r 1/1 FIN. ATTIC AREA _ NO B M FIRE PLACES HEAD ROOM MODERN KITCHEN ✓ 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDNId'D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME I BRI N MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING i STONE ON FRAME _ SUPERIORPOOR _ ADEQUATE I NONE j 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 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 r 7 NO. OF ROOMS GAS OIL BiM`I n' _ ELECTRIC r NO HEATING 5 :;xti NORTH ovm Of over No...? 7 °o l LAKE A over, Mass., 19 g8 A_cOCNICHEW Ic K•i~''1• 0 E D S E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT....................................P/..tl�Za.-0( .I�..............., .c� ........................................................ Foundation has permission to erect....................(................... buildings on ....Zv—..3...... Rough p / g .�....1. ................pli.......................... Chimney be occupied as...............................................1.t ).G.k .....,............. provided that the person accepting this permit shall in eve ryrespect conform to the to the apcation on file in Final 4 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STAR ELECTRICAL INSPECTOR Rough ......................................... ....... .. ... ............. Service UILD G INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smolce Ter Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applicant on Building Permit(below) Address of Property for Permit(below) CO /IU cl Map and Parcel : Purpose of lication (check below) Phone N ber of Applicant: Single Family —Two Family t the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is[issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration,or reconstruction of a dwelling in existence as of the effective date of this by-law,provided that no additional residential unit is created. r41_The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning ylaw. This application is for dwelling units for low and/or moderate income families or individuals,where all of the conditions of 8.7.6.care met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section"senior"shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density (buildable lots),below the density, (buildable lots),permitted under zoning and feasible given the environmenral conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protection. adjThis application represents a tract of land existing and not held by a Developer in common ownership with an acent Parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply,whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. igna re o wner o orized who signed the Attached Building Permit Date This form must be attached to the B ilding Permit upon application for such permit. f , V i FORM U - VERIFICATION 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***************** i APPLICANT: n_ ' ' r U1� -' Phone LOCATION: Assessor's Map Number Parcel SubdivisionLots) Street St. Number �3 ******************** ***'-Official Use Only************************ RECOMMENDA IONS. F WN AGENTS: ' Date Approved Conservation Administratore I ry, Date Rejected Comments Date Approved ��onPlanner Date Rejected Comments ' Date Approved Food Inspector-Health Date Rejected I Date Approved Septic Inspector-Health Date Rejected Comments 1 ,C Public Works - sewer/water connections ! ?/ - driveway permit _ � 7� l Z7 .e£1411't.c Er of cf Iwo.�Cc Fire Department /r, Received by Building Inspector Date