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Location 3 7 k,�Its�
No. L;z Date G Z7 5 Z
�oR*M TOWN OF NORTH ANDOVER
t O't�•o ,•'�h.0
F " p Certificate of Occupancy $
Building/Frame Permit Fee $
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•n
b� o rr"�h
ass must. Foundation Permit Fee $
Other Permit Fee# ,1$
Sewer Connection Fee $
v ater Connection Fee $ -
09 c�6 � L $
Building Inspector
F CfCf Div. Public Works
PE&Ji1T NO
a, 2 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1
MAP 4-40: LOT NO. 2 RECORD OF OWNERSHIP DATE (BOOK !PAGE
ZONE I SUB DIV. LOT NO. 5�rr-- -
LOCATION 3� �/9-Fs J
PURPOSE OF BUILDING �^ yc
OWNER'S NAME NO. OF STORIES SIZE 1
OWNER'S ADDRESS 3,0-1 BASEMENT OR SLAB
r'rLG�c GZ
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME c ` SPAN
DISTANCE TO NEAREST BUILDING �- DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES-SIDES REAR "' '" 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
SEE BOTH SIDES �/ 3 PROPERTY INFORMATION
FR TEL� � ` LAND COST
CONTR.TEL --- •••�.��.. EST. BLDG. COST -3 ;?&-m O D
PAGE 1 FILL OUT SECTIONS 1 - 3 CONTR.LIC' EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12
EST. BLDG. COST PER ROOM
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
etc BOARD OF HEALTH
SIGNATURE OF OWNER ORSXlTTiiORIZED AGENT
FEE octA
PERMIT GRANTED PLANNING BOARD
19
�f � BOARD OF SELECTMEN
-U-- S 3 Z BUILDING INBP6
CTOR
� t
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY _r2FF
RIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY ICESLOT 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 1 2 13
CONCRETE BL K. PINE
BRICK OR STONE HARDW D
PIERS PLASTER
_ DRY WALL
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'T' AREA _
1/4 1/2 1/1 FIN. ATTIC AREA _
NO BMT FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDSB 1 2 3
DROP SIDING CONCRETE
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDY✓'D
ASBESTOS SIDING _ COMMCN
VERT. SIDING ASPH. TILE _ �7
STUCCO ON MASONRY 1 R..
STUCCO ON FRAME.
BRICK ON MASONRY ATTIC STRS. & FLOOR _
BRICK ON FRAME I �,r _. �.-.•.+i`• ��
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE I HIP BATH 13 FIX.) _
GAMBRELMANSARD TOILET RM. (2 FIX.)
FLAT I I 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 I 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
GAS
7 NO. OF ROOMS OIL
B'M'T2nd _ ELECTRIC
1st 13rd NO HEATING
FINAL
i ,f !' t A il AL PLANNING FINAL
.01
9; TAO T �f own of 15 ndover
/';�. .... ......
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----------
1A er, Mass.,XuAbf A& 199%p
CuRHEWICK
0
BOARD OF HEALTH
PERMIT T LD
THIS CERTIFIES THAT............. .. C.Wa. i8e x..............
71 BUILDING INSPECTOR
has permission to amft....1@ Wt.ft.. . buildi Rough
Chimney
to be occupied as...............". ..7s on i...... ............. ...b.w.�.r.�. a44iim Final
provided that the person accepting this permit shall in every respect conform to the terms of the application on rile 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 Voids this Permit.
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
Rough
(JNLESS CONSTRUC*TI RIART Service
Final
I
iU* ILDINGLDING1 PiROiGAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
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.
4d&&Wft 0-ft 6 Building Inspector I - I
"ORrH
OFFICES OF: . �� Town of
. a 120 Main Street
APPEALS
BU11 a-)ING : . .:; NORTH ANDOVER North Andover,
;,•�:i;::�:-•.e Mi isSF�(�I1ti5cits O 1845
r
C ONSE1IVA'I•tUN sS��" °` UlVltilON UI r, I
HEALTH
(61 7)685 477,E
PLANNING PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIREC-1.011
In accordance with the provisions of MGL c 4U S 54
Number "L-. a condition of Building
7 is that the drom Permit
disposed o[ in a properly liccnscd solid waste disposal facility s defined tby MGL cs work till,all bS
150A
The debris will be disposed of in:
(Location of Facil ty)
Z-0 N
u
Signature of Permit Applican
e
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
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