HomeMy WebLinkAboutMiscellaneous - 332 RALEIGH TAVERN LANE 4/30/2018 (3)Location ;",??
No.� a� � Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundaattio�n Permit Fee
bQ er berm 'Fee
Sewer Connection Fee
$ 7F� cv
3,
Water Connection Fee $
TOTAL $ 7P�
t®° Building Inspector
[7 i
Div. Public Works
PER1113 NO.
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
L/ PAGE 1
MAP KJO.
LOT NO.
2 RECORD OF OWNERSHIP 'DATE
BOOK 'PAGE
ZONE
SUB DIV. LOT NO.
�I
LOCATION yl C�h
/T
PURPOSE OF BUILDING
'CIjL
OWNER'S NAME
p
R Oh
NO. OF STORIES S E
OWNER'S ADDRESS �/�I C
�7
BASEMENT OR SLAB
ARCHITECT'S NAME
SIZE OF FLOOR TIMBERS IST 2ND
3RD
BUILDER'S NAME lO ^ L
DISTANCE TO NEAREST BUILDING
DISTANCE FROM STREET
bMENSIONS OF MLLS
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
d
SEE BOTH SIDES
PAGEtl FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
PERMIT GRANTED
19
6331
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST/ 1,0-h 1 dD
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
awlL /ICY insracrrvR
1
OCCUPANCY
.SINGLE FAMILY
STORIES
MULTI. FAMILY
PIPELESS FURNACE
OFFICES
APARTMENTS
FORCED HOT AIR FURN.
CONSTRUCTION
2 FOUNDATION
STEAM
8 INTERIOR FINISH
CONCRETE
—I
d
t 2
CONCRETE 8L K.
AIR CONDITIONING
PINE
_
RADIANT H'T'G
BRICK OR STONE
HARD-
7 NO. OF ROOMS
PIERS
OIL
PLASTER
B'M'T 2nd _
1st 1'3�rdj
ELECTRIC
11 NO HEATING
DRY WALL
_
3 BASEMENT
AREA FULL
'G '/p 1/
N_O B M
HEAD ROOM
4 WALLS
CLAPBOARDS
DROP SIDING
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
STUCCO ON MASONR
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
CONC. OR CINDER BL
STONE ON MASONRY
STONE ON FRAME
5 ROOF
F
FIN. B M AREA
FIN. ATTIC AREA
FIRE PLACES
MODERN KITCHEN
9 FLOORS
B t 2
CONCRETE _
EARTH
HARDIN D _
COMMON
ATTIC STRS. & FLOOR
WIRING
10 PLUMBING
BATH (3 FIX.)
TOILET RM. (2 FIX.)
WATER CLOSET
LAVATORY
KITCHEN SINK
NO PLUMBING
STALL SHOWER
MODERN FIXTURES
TILE FLOOR
BUILDING RECORD
12
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.
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
7 NO. OF ROOMS
GAS
OIL
B'M'T 2nd _
1st 1'3�rdj
ELECTRIC
11 NO HEATING
. &
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Location S (1-/ A, &1111
No. Date
"
TOWN OF NORTH ANDOVER
:at�ao ,a,ti°O
p
~ Certificate of Occupancy
$
',;Building/Frame
Permit Fee
$
SSA cHu,Et�
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee $
RECEIVED PAYMEW Connection Fee $
NAY cc TOTAL $
No. Andover Collector
Building Inspector
Div. Public Works
PERMIT NO. / APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. �h /� yv 6 J/ PAGE 1
MAP KVO.
LOT NO.
2 RECORD OF OWNERSHIP iDATE
BOOK PAGE
sZONE
I SUB DIV. LOT NO.
—
LOCATION 5 - IU 1 A��
/`
PURPOSE OF BUILDING ��r,���� �-L /j
OWNER'S NAME IJ1 N C� e����
NO. OF STORIES SIZE
OWNER'S ADDRESS S n�G'li ^r
I` {
BASEMENT OR SLAB
L
ARCHITECT'S NAME �•,IFQ /j
SIZE OF FLOOR TIMBE IST 2ND 3RD
BUILDER'S NAME NI/(.7•/ /' U� �/. C2 J_ I
000, � �
L/
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS"gf SILLS
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES — SIDES REAR
GIRDERS
AREA OF LOT FRONTAGE
H GHT OF FOUNDATION THICKNESS
IS BUILDING NEW
SIZE OF FOOTING X
/
IS BUILDING ADDITION rC ad C�,ty�I,(/I 1%�
4/► J 1+ '7V ef�-R/ i 1
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE YEIS
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
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED (A�NDA/'PPROVED BY BUILDING INSPECTOR
DATE FILED J/ / / / /(?"z
SIGNATURE OF OWNER OR KUTHO ify,D AGENT
I OWNER TEL p 62-00
F E E / Z S. 0 0 CONTR. TEL.
CONTR. UC. des;
PERMIT G A
2--
11 W R 11WR
I APR 2 11992 I �
L.v is !e DEPARTMENT
/ I
3 PROPERTY INFORMATION
LAND COST
EST. BLDG. COST# J {
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
BUILDING RECORD
Ji OCCUPANCY 12
'SINGLE FAMILY 11 STORIES
MULTI. FAMILY OFFICES
APARTMENTS
CONSTRUCTION
2 FOUNDATION
-
8 INTERIOR FINISH
CONCRETE
PINE
B
1
2
13
CONCRETE BL K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY V✓ALL
_
_
UNFIN.
3 BASEMENT
AREA FULL
'/4 1/1 3/1
FIN. B'M'TAREA
FIN. ATTIC AREA
_
NO BM'T
FIRE PLACES
_
HEAD ROOM
MODERN KITCHEN
4 WALLS
I 9 FLOORS
CLAPBOARDS
B
_
1
2 3
�_
_
—{I_
�—
DROP SIDING
WOOD SHINGLES
CONCRETE
EARTH
ASPHALT SIDING
ASBESTOS SIDING
_
HARDW D
COMMON
VERT. SIDING
ASPH. TILE
STUCCO ON MASONRY
_
STUCCO ON FRAME
BRICK ON MASONRY
BRICK ON FRAME
ATTIC STRS. & FLOOR _
CONC. OR CINDER BLK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR I I POOR _
ADEQUATE I NONE
5 ROOF
10 PLUMBING
GABLE
GAMBREL
FLAT
I HIP
MANSARD
SHED
BATH (3BATH FIXE
TOILET RM. (2 FIX.)
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
7 NO. OF ROOMS
GASOIL
B'M'T 2nd _
10 13rd
ELECTRIC
NO HEATING
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.
:.. FOR14 U
' TOWN OF NORTH ANDOVER
LOT RELEASE FOM
SUBDIVISION
ASSESSORS MAP
SUBDIVISION LOT(S)
PER�� 'ft
(ASSIGNED BY D.P.W.
STREET ti I Ajftw J-AA.4—
Ll
/-/ LPPLICANT �J�y�j SCS g2��N PHONE
,� 8�do Y6
//DATE OF APPLICATION
TOWN USE BELOW THIS LINE
PLANNING BOARD
TOWN PLANNER
CONSERVATION CO1,1MISSION
a
ti
CONSERVATION ADMIN.
r ;i
ARD OF HEALTH
DATE APPROVED
DATE REJECTED
DATE APPROVED �,(p
DATE REJECTED
DATE APPROVED'4P *7111
hE411ETIi SA TRRIANAi'E REJECTED _
/J&6fiofy). 4 Mrr
an*
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERMIT
SEWER/WATER CONNECTIONS
FIRE DEPT.
RECEIVED BY BUILDING INSPECTION
DATE
This form shall be signed by the agents of the Planning and Health Boards,
the Conservation Conunission prior to the issuance of any building permits
for the subject lot. This form shall not releive the applicant from the
compliance of any applicable Town requirement or Bylaw.
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