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HomeMy WebLinkAboutMiscellaneous - 440 BOSTON STREET 4/30/2018 440 BOSTON STREET 2101107.D-0003-0000.0 i 099-76 Date . //� . . . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING b4!' .This certifies that . . h✓.r.. . . has permission to perform .iv?u,/�-- P -oc(�C1�/sS . plumbing in the buildings of. at . . . . L�. .�/ ?7� ✓ J/n . . . . , , . ,North Andover, Mass. 'fy. Fee ��. . . . Lic. No. .���5 ' . . PLUMBING INSPECTOR Check# 76*&cj' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY U __IJP MA DATE � � ) PERMIT# 7 JOBSITE ADDRESS O p 57e�n� S� _ OWNER'S NAME "'J9 3 G Al POWNER ADDRESS N4 L� _ 1 TEL=_ FAX E TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL ® RESIDENTIAL)]. PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: I PLANS SUBMITTED: YES 0 N0LR FIXTURES-1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 _13_ 1_4 BATHTUB _ _( 3 ._ — .f!i CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM 1 .. _. DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM __ ------- DISHWASHER -..- DISHWASHER _ _ r "rfI, J 1 r DRINKING FOUNTAIN FOOD DISPOSER =1===== FLOOR/AREA DRAIN i _ 1 f l .---___ .__-_I _ = __ 1 _.__! _. _i ........ INTERCEPTOR(INTERIOR) KITCHEN SINK —I _ ._._.! � -____.! __.___.-.1 -._._._.._..! ..-______( __._-___.! -___.__! _-__._._; LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK _. 1 _...__. I _.----1 I _-----_. ( ._ I 1 _---.__f .._:___._f ___...__._l --X--__f _I TC.LET URINAL W4SHING MACHINE CONNECTION -_--_ r-_ _S I _ f ! 1 I 1 ! _r 1 WATER HEATER ALL TYPES WATER PIPING OTHER __._�_ i _-J _.... __f _w_I 1 _._ _I _I I _ J -f . ..__! I E ! I 1 INSURANCE COVERAGE: 11 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 4 NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW j LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND 0 OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER _I AGENT �0 SIGNATURE OF OWNER OR AGENT f hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with a Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME ._ JQ�/ r¢....L�IQ�/✓ .. ._, _.I LICENSE# _,>fA S_ - S GNATURE MPO+ JP DA CORPORATION D# PARTNERSH IP 0# !LLC E COMPANY NAME /2jgV lY� _A_ A/� ��_ ' ADDRESS / MA cTf CITY !M. L�"T ✓C``J _-..__....-._..-.._....-._1STATE �1�J�9 I ZIP 11 TEL FAX _ CELL��EMAIL The Commonwealth of Massachusetts - Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leafty Name(Business/Organization/Individual): ,: L 41e e If V, f Address: 36 /1 yew ez' -/ D IrIfL/ City/State/Zip: W 6Ttf-)coJ X1.1( Phone#: (� 7d' G17 112&- Are 2&Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2)<1 am a sole proprietor or partner- listed on the attached sheet. �• Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 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' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: . Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to-secure coverage as requiredunder 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 cern er the pains and penalties of perjury that the information provided above is true and correct. - Si ature: Date: (oc3 Phone#: Offccial 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#: Date........................................... 0 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ............................. .... . . ........................................................................ li has permission to perform wiring in the building of......VrI 6-S .................. ........................................................................... at >.....:.1...Y0......... ....-j ...... ......................Arffij Andover,Mass. Fee �o..........Lic. .......................N- EL CAL INSPECTOR Check# 11636 scll\ Commonwealth of Massachusetts Official Use Only Department of Fire Services PemutNo. BOARD OF FIRE PREVENTION REGULATIONS Occupv /07cy and Fee Checked � . j (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK J M All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: -6 IL1113 City or Town of: NORTH ANDOVER To the I sp ctor of Wires: rJ By this application the undersigned gives notice of his or her intention to perform the electrical work described below. l Location(Street&Number)_ yy0 &S7,rl SE OwnerorTenant f,90'1 ?/,r//4( ,fjoys Telephone No. Owner's Address .SgyrR Is this permit in conjunction with a building permit? Yes k�-- No ❑ (Check Appropriate Box) Purpose of Building 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: lel/l oc�w� oI�I . pts Completion of thefollowing table may be waived by the Inspector of Wires. �p No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets a No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 11- TTo--.oTEmergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners IFIRE ALARMS No. of Zones No.of Switches 4f No.of Gas Burners No.of Detection and 11 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers HeatPump NumberI Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices NoMunicipal El .of Dishwashers Space/Area Heating KW Local❑ Connection Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent a KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE R—BOND ❑ OTHER ❑ (Specify:) I certify, under the ains andpenalties ofperjury,that the information on this application is true and complete. FIRM NAME: . rZiQr,•, v LIC.NO.: t/0/3TC Licensee: �R rQ,.� l ti�(2�� Signature 4, LTC.NO.: Vo%3g,E (If applicable,enter "exempt"in the license number line.2 Bus.Tel.No.-99r– y"'11,4' Address: a -t-0MarQ eft i<cP 10)a,S7-V,,,. (V F( 038bS' Alt.Tel.No.: *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,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE.$ Signature Telephone No. The Commonwealth ofMassachusetts Department of IncZustrzcclAccid'ents Office of Investigations 600 Washington Street Boston,MA.02111 www.mass gov/clia • Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plmmbers Applicant Information Please Print Legibly Name(Business/Organi'zation/lndividual): 66 k t g n &rJCAA� Address: TG a r u C d2 City/State/Zip: cr r 57 q 63A6—Ph one,#: 91 T- — 3'- Are you an employer?Check the appropriate box: Type of project(required): 4. ❑ I am a general contractor and I g 1.❑ I am a employer with 6. New construction ompto ❑ yees(fulland/or part-time).* have hired the sub-contractors 7. F1 Remodeling 2.0 lam a sole proprietor orpartner- listed on the attached sheet. ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 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 ❑ p § 12. Roofre airs insurance .re uiredemployees.[No workers' required.] 13.❑Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showingtheir workers'compensation policy information. I Homeowners who submit this affidavit indicating they ire doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required Section 25A of MGL o.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as wellas 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 maybe forwarded to the Office of Investigations of the DIA.for insurance coverage verification. I d0 lleYeby CCYt�under the pains and penalties ofperjury that the information provided above is true and Correct - Simafore - Date Phone# 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.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - Contact Person: Phone#: i ' t; COMMONWEALTH EDF MASSACHUSETTS iLECTRICIANS :ASA F�EGSJOU JOUE ABOVE RNENSEYMAN .. TH _BRIAN M BOUCHER ��� 2.1S''AGE,,,, RU ATKINSTON NH 038.1;1 254D ;' ' OI38 E 07/31/1.3 8&&� 2 3 l� i I Location No. ye� ell Date NORTH TOWN OF NORTH ANDOVER Ott �•e i - A Certificate of Occupancy $ 4�0 O Building/Frame Permit Fee $ c) ��b'^••�'''t� Foundation Permit Fee $ s�cNusE _ Other Permit Fee $ Sewer Connection Fee $ connection Fee $ TOTAL Building inspector �s A ' 651-1 1 Div. Public Works PEa3u!r NO., APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. If yf`f/ fj/ ttt///, ! PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE ZONE I SUB DIV. LOT NO. �) LOCATION � PURPOSE OF BUILDING XZ ( �� rryl y JIrl1� t it OWNER'S NAME 1�NIC L7nQ/� j1,7 /g is [3L,) NO. OF STORIES '�._ SIZE �v OWNER'S ADDRESS fs�/� `fJ��®7 h' yLs;r BASEMENT OR SLAB ARCHITECT'S NAME 7• L�,n n SIZE OF FLOOR TIMBERS IST 2ND Y/� 3RD BUILDER'S NAME Tn,/1 M,AL•\�fh, SPAN la DISTANCE TO NEAREST BUILDING S 1 DIMENSIONS GOF SILLS 7' --- DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES�..�i V REAR 14 •• GIRDERS AREA OF LOT15 I FRONTAGE �. - HEIGHT OF FOUNDATION P 1 THICKNESS I IS BUILDING NEW .La SIZE OF FOOTING 4J % L IS BUILDING ADDITION�Y',�(^_ 0po,11'6L aND /- ')_ MATERIAL OF CHIMNEY IS BUILDING ALTERATION 7 /ydN,WIO fO 4),447W(•/. IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE LJAS IS BUILDING CONNECTED TO TOWN WATER h�D BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE No INSTRI S 3 PROPERTY INFORMATION 4efLAND COST SEE BOTH BIDES VVV EST. BLDG. COST t PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. j��, (� _f f 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 LED • t/ BOARD OF HEALTH SIGcNATURE OF OWNER OR AUTHORIZED AGENT FEE D PERMIT GRANT zlv�15 ��6 © OWNER TEL.# 66 /� �j�j�� PLANNING BOARD CONTR.TEL.# s`o2<-7�0 19 CONTR.LIC. BOARD OF SELECTMEN SEP 10 _ (J" BUILDING INSPECTOR .. ...... .. .... ✓Hoer'n6•tdG^rS4�'N,f.�yiN /Kbr�Y/lIASS'KC6YtaxZSxit3»':9#N'b[a<,. � •. COMMONWEALTH DEPARTMENT OF PUSUC SAFETY ag MA-SSACHUSETTsBOSTON,MA 02108 XP:s.7u.TION DA-f CAUTION E4 ltf i.?> E F' ,l .+._,r E >/ GAJ Ei, 41 'I .., tHi f E6 £ X e�n..�•bvr,<. yte'?.rii::fYr ,,,.vY,F/5f'G»"aro»x..w5-iitilwlkii4:i' r�.wp�u4w<eran. .e,.�<N-muaxaov.umrai,. ,tea � �.fr�.F` i? t:�?pZ-�sl C,✓>a,tl1F(>1'���' f� �.'#��C,Y;ito�:l�f'����i�'��,< S f.� a s s : . i l 1;I 1" I i � r j a I � � � 2 O 36 O(� _ � D � I oma•" rya ��F:--;C�/n/G g CM N CYR y pF No 1752�c0 � ciST�P 4 SU R'1EyO i i i y hh � o � o SOT M -:mor ; Dr►iEG�ir�/G'_�o iES vvi77 09, 01,'93 1;1:29 6 1 609 965 9806 TPvS JOIST 02 inn Page I of I *40;43:21 T 14 U S J 0 Is'r m a m i,. [11,A N (RAST sir-E1001) GN Project Name: IRA MALKIN 308 Page Title- N. ANDOVER,MA. ---------- US121ng1m 0.0 --'Building Code KER ---------- Type of Silo Distribution ----- ---------- Application; Deflection Criteria (K�) Member qoe................ JOIST Residential Floor (LDL} Ll 09f I TL Bit) Member Top Slope(inift)... @,lot Stress Level,,,,,,,,,,,,,,, itel, Span I L/432 L/240 Roof Slope(in/ft).... 9.000 Live Lo8d(psf)...... ...... 40,0 Overhang 21/39 2 L 12 4 Floor Decking................. 6 Dead Load(psf)... ......... 10,e Repetitive Member Use.,....... Y Partition load(pst)......... I:.e I Reinforced Overhangs,,,.,,,,,, N SPECIAL UAN: Live Load Stress Dead load WIAth Starting Point to End Add/Ropl I ^ONC(Plft Ho list 256 V- e.000 from Rt Add 5 P J 0 1 S`r @ 16 . 011 o /c 21- 0.0011 --------------------- ----------------- ------ S I I F A N A L Y S I S -._-----------------------------_...-.___ .-___-- IMPORTANT! --------------------------------IMPORTANT! 1fie analysis presented below Is output from software divgloped by Trus Joist KacMillan(IJK), Allowable product values shown are in accordance with current 13M mtter.1616 and ode accepted design valves, TJM Engineering has verified the analysis. The input load and dimensions have been provide by others and must be verified and approved for t4 specific application by the design professional for the project. The load conditions considered in thio design include Alternate member loading. Maximum Design Allowable Control Shear(lb) 689 561 ( 994 175% LEFT end Spal I under 100% stress ALTERNATE span load 0­ent(ft-lb) 2364 2364 ( 4656 197% MID Span I udder 100% stress ALTERNATE span load '1we Defl.(in) 6.361 e.50e L1598 KID Span I udder Live load criteria I %ta, Oefl.(in) 0.364 0.99e L1563 MID Span I under Total Load criteria Span 1 Overhang Rax Reaction Total(lb) 561 Live(lb) 480(im) I031(II61) If 4ssurtd Jfq, Length(in) 1 7 b 3,50 a°qd !­IWifl 42 sl Copyright tel 1993 by Trus Joist MacNlllan-, a limited ted par,�thershl p., dc, Tdlrpr I s.a,, regi stered trademark of Trus Joist N011 Lan TJS!ZingTM is a trademark of Trus Joist MacMillan, -- - -- -- --— Home improvement Contractor Registration MALKIN & SONS wa %a`l It OU,IIty warkmantshlp Builder's License No. OaoOf`f DA VCa01S,MASSACHUSETTS 01923 (!e!) 771.61W Fully Insured & License, LLI- mw� -- RESIDENTIAL CONTRACTING AGREEMENT Read this agreement and make sure you un0erstand It before signing it. This agreement has legal force and effect and binds those who sign it Notice: All home improvement contractors and subcontractors engaged in home improvement contracting must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contractor Registration,One Ashburton Place, Room 1301, Boston, MA 02108. This agreement is made on �" ' i between of l0 o D A,�//0 57L (date)wlwv`` 5 ��+ (contrecmr) C !! laddrgssL hereinafter called 'Contractor"and G_`T� �/� p of 1t T 0 L/W0 J/ jot hH&ve4 (Owner)671- S'pO hereinafter called"Owner'. (address) (phone number) 1. DETAILED DESCRIPTION OF WORK TO BE PERFORMED Contractor agrees to perform in a good and workmanlike manner all work detailed below. Such work consists of the followin ��`Rv r_r .4 19' X yo' &e6,,g,,O t�(O o/? i9D�i�`la�r S 1k-S BW c of DETAILED DESCRIPTION OF MATERIALS TO USE Materials to be used in performing the above described work consist of the following: as S ( 11.PRICE Contractor agrees to do all work described in Section I for the total price of iiia 7 �� Apo Pooxe rd 1-b./? llrLw o/ry� $ ?07 y00- o u 111. PAY ENT Payment will be made as follows: _ _9'° ($ �DOO• oo ) upon signing Contract; %($ upon completion of: FA"p w ,per d %(5 00•e O ) upon completion of: 8)rhv" $;',o%rV. (S ) upon completion of: JO 6 and the remaining g S^ %($ SOOO'O C3 ) upon verification of the work by Owner and Contractor as having been satisfactory completed, which verification shall take place promptly after completion. Payments due and unpaid under the contract documents shall bear interest from the date payment is due at the rate entered below. Fifteen (15%) percent Notice: No agreement for home improvement contracting work shall require a down payment(advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make, in advance,to order and/or otherwise obtain delivery of special order materials and equipment, whichever>amount la greater. IV. COMMENCEMENT AND COMPLETION OF WORK Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified here in writing. Contractor will begin the work on or about 4—F3� —9 3 in caused by circumstances beyond Contractor's control, the work will be completed by ld— _�3(date). Badate delay The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. 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: '�RrAidg !' L,WWd Q11-L19ZO80S Phone CATION: Assessor's Map p Number Parcel Subdivision Lot(s) Street LI qO 62MOH ST St. Number L/4'0 ************************Official Use Only************************ RECON+ 4ENDATIONS OF TOWN AGENTS: i Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspe�y}c-tor-Health Date Rejected itl�LC1/L/0 Date Approved f5P // Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector ,-y-`- T )' Date YV + ,.: ' SEP 101993 �0RTFf own of ;oriAndover 0 IX&I No.' 4.06 fl 4 Nor dower, Mass., i9A3�fEP coc_c.f:_",k A_ "BUILD '� BOARD OF HEALTH _ s- PERMIT TO Food/Kitchen Septic System THIS CERTIFIES THAT. .�a ... r/ .. 5 BUILDING INSPECTOR .............................. .... • Foundation has permission to erecta. #4$J*.d* . buildings on ....! !r,..�Q �. ..�.r..........0..... Rough to be occupied asl*fWiV. 0...A .0.04.....42.0. �..... .. � � Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file Final 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 TvION'TTHS Final UNLESS CONSTRUC, ION 9 T A4BUI , � ELECTRICAL INSPECTOR Rough Service &LDINlGeISPECTOR Final Ocatparicy Permit I?equlred t0 Occutj?y Building GAS INSPECTOR la in a Cons icuous Place on the Premises — Do Not Remove Rough Display Y � p Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT