Loading...
HomeMy WebLinkAboutMiscellaneous - 70 JOHNSON CIRCLE 4/30/2018 / 70 JOHNSON CIRCLE 210/037.D-0034-0000.0 i i I. i I I II I I i 3971 Date.................................. 3: at,�``..:°.•.�o� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ssACHU r This certifies that has permission to perform -�..... • -- =� � ................................................................................ wiring in the building of -{-r— at... ...... --�^-� .... .North,Andover,Mass. .... f" '.............i.....,....... G� JEL. Check #f Commonwealth of Massachusetts Official Use Only Permit No. 7` Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CM 12.00 (PLEASE PRINT IN INK OR TYP A'noti, INF RMATION) Date: l/J QA City or Town of: To the Inspector Wires: By this application the undersigne ives e f is or her inte tion to perform the electrical work described below. or-1 A Location(Street&Number) Owner or Tenant �/��� // / �n/ Telephone No. e Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Uzdgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion o the folloiWn table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ .o Emergency Lighting rnd. rnd. Baotte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o Detectiiid Initiating Devices No.of Ranges No.of Air Cond. TotalTons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: I I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection Heating Appliances Security Systems: No.of Dryers g pp Kms' No.of Devices or Equi alent No.of Water KW No.o No.of 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. 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 ❑ BOND ❑ OTHER ❑ (Specify:) W19- � (Expiration Date) Estimated Value of El trica Work: �� (When required by municipal policy.) Work to Start: 1;�Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the ains Wndpenalties of perjury,that the information on this application is true and complete. FIRM NAME: Security cos LIC.NO.: 1_u c Licensee: John S. Bassett Signature LIC.NO.: 1533C (Ifapplicable, enter"exempt"in the license number line.) Bus.Tel.No.. 603 594 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Li see 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 Signature Telephone No. PERMIT FEE: $ Location No. �� Date MaRT� TOWN OF NORTH ANDOVER f � 0 + � s + � ; , Certificate of Occupancy $ Building/Frame Permit Fee $ s BCH Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ^ 1532 3 ✓ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: r M 3 C2iao � - M SIGNATURE: Building Commissioner/I for of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Cl-11-a- t a Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Required Provide Required Provided RaPired Provided 2D V r, 1.5. Flood Zone Infomntion: 1.8 S 1 S tem: 1.7 Wa Supply M.G.LC.40. 34) �e�Po� ys Public Private p Zone outside Flood Zone Municipal On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT 2.1 Owner of Record S - ` A^— am P ' Address for Service: C� gna a U Telephone 2.2 Owner of Record: Name Print Address for Service: Z S,P-AL M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number W=�- l mess l 1� l" Expiration Daic_ Signature Telephone �. 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name — D M 14,0 01_ p Registration Number dres i 7 :z-0 [2-,e))4!�,7 -JExpiration Date Si nature Tele hone SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of t e building permit. Signed affidavit Attached Yes....... No.......❑ SECTION 5 Descri tion of Proposed Work check altapplicable) New Construction 0 Existing Building ❑ Repair(s) d Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: t SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed by permit applicant s $ 1. Building (a) Building Permit Fee x �v f Multiplier 2 Electrical b Estimated Total Cost of � O Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, �Q i.,��.� .�- ` e►..�i as Owner/Authorized Agent of subject property / � r ied-� H eb th e ` �.�.� 1 'l . to act on y matter�t-elative to work auththis/building permit applicatio . ' � t) W ature A Owner Dat ACTION 7b OWNER/AUTHORIZED AGENT DECLARATION ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Si a e of Owner/Agent Date L s MINE 11,111,111111,111'1 1-1-.111311M NO. OF STORIES Z. '� SIZE BASEMENT OR SLAB ND SIZE OF FLOOR TIMBERS 1 `��C l 2 SPAN c DEVIENSIONS OF SILLS — 1—11 M ENSIONS OF POSTS ` 17 LCL( u DEvIENSIONS OF GIRDERS x C S HEIGHT OF FOUNDATION " THICKNESS tO SIZE OF FOOTING X Z MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND - 1. IS BUILDING CONNECTED TO NATURAL GAS LINE i �J The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit at - - Please Print i Name: LvJ Location: t �,n z i i City Phone Gl�/ `�� am a homeowner performing all work myself. u �I am a sole proprietor and have do one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name Address ('be-L City: N Phone Insurance Co, v A"�Ot Poli �'� �/Vii✓�. l� `�. Company name: Address City: Phone#' Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties.of a fine up to$1,500.00 and/or one years'imp' ment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understa that a c th' t may be forwarded to the Office of Investigations of the DIA for coverage verification. !do he ify der sins a penalties of rjury th In rrnation provided above is true and correct Signature Date: Je, Print name Phone# f� 3 Official use only do not write in this area to be completed by city or town official' E] Building Dept ❑Check if immediate response is required Building Dept [] Licensing Board E] Selectman's Office Contact person: Phone#: F-1 Health Department Other FORM WORKMAN'S COMPENSATION North Andover BuildingDepartment artm ent p Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: Location Facil' r Signature of P i Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NORTH ®I" . ® E over CHC d o?• o70CIover, Mass., - 0 A DD o'L RATED H � BOARD OF HEALTH PERMIT T D )Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT....... n.. � /.A r CCOA; ............................................ rr Foundation has permission to erect...Z.Q '� ...... buildings an........ Gl �� ©. :".�4 .... ��....................... .............t. Rough to be occupied as �* Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application oh file in Final this office, and to the provisions of the Codes and By-Laws relatin to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. � 3 4/ PLUMBING INSPECTOR 3VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR Rough .............. .... ...................... Service... . .. .. . ......................... ......................... BUILDING 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 Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No.. SEE REVERSE SIDE smoke Det. Date. . . . ... .Z ",0 PT:!tio TOWN OF NORTH ANDOVER F PERMIT FOR PLUMBING 40 �SSAcwusE� f This certifies that . . . . . .� .� �' i . . . . . . . . . . . . • • • . . . . has permission to perform . . . . . plumbing in the buildings of . at. . . .7 0. . . . r.Q L,. . . C/. ,h. . . . .. North Andover, Mass. Fee. �3.r. Lic. No.. a 03.`� .. . . . . . . . . .� .��- -'? '?. . . . . . . P.�IMBING INSPECTOR Check # 5237 5� a 3 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS 7 f� Date ,� ( ` y Building Location 79 U'/!fiSae C�l�✓�/L _,r"� Permit# Owner Amount ,aTl I ����� New Renovation ❑ Replacement Plans Submitted Yes No ❑ FIXTURES ZU O w z w 3 x A4 rA CA z A a r > x O w O U a ra A SWTSW &1g1V1FNr is r HIM 21-D HIM 3nHDW 4M FIDCR 5M11" 6M ILOC1R 7M HDM SIH FIDCR (Print or type) // ` Check one: Certificate Installing Company Name /�j�` El Corp. Address / G ❑ Partner. 11 usmess Telephone irm/Co. Name of Licensed Plumber: M el,-- Insurance Coverage: Indicate th type f insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installation erform nder Permit Issued for this application will be in compliance with all pertinent provisions of the Ma., s tts St Plu ing o d apter 142 of the General Laws. By: Tigna re or Licenseaum er Typeo min L' ense Title City/Townis nse lNumDer Master ❑ Journeyman n APPROVED(OFFICE USE ONLY � r r Date. . . . /u- 6' z.. .. OF ,40RT a'9ti TOWN OF NORTH ANDOVER p 9 ' PERMIT FOR GAS INSTALLATION 9 j SACMUSE� li k. This certifies that . . . . . . !.. � !1 . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . , in the buildings of . . . . ��� f ate. .� . . . �� f� 6? �. �. . . .�f.�. ., North Andover, Mass. k Fee t. s Lic. No.. .Z. . . . .. ..'. . . . . GAS INSPECTOR Check# 7 4024 - y � MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS HTI'ING (Type or Print) Date . ! 0 Y NORTH ANDOVER,MASSACHUSETTS Building Locations -7 J ti�s� /c�caO_ Permit# `� y Amount$ , Owner's Name r�n New Renovation Replacement 0 Plans Submitted• F pOq y EW» O O O a c a ¢ SUB-BAS EM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR STH. FLOOR 6TH. FLOOR 7T.H FLOOR IST H. FLOOR (Print or type) one. Certificate Installing Company Name �Corp. Address Z4 in, ` ` O Partner. 1 a-- Business Telephone v 4,93 - ®'firm/Co. Name of Licensed Plumber or Gas Fitter ��C [ 6 INSURANCE COVERAGE Check one I have a current liability Insurance policy os it's substantial equivalent. Yes No If you have checked des,.pleaser indicate the type overage by checking the gppropriate box. Liability insurance.policy LL1I�.3,- Othertype ofindemnity rj Bond 0 Owner's Insurance Waiver: I am aware that the licence does not have the Inscugnce coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one. . Signature of Owner or Owner's Agent Owner 13 Agent ❑ i hereby certify that all of the details and information I have submitted(or entered)in above application ane trm and accurate to the best of my knowledge and that all plumbing work and installation performed under Permit Issued for this application will be in compliance with all pertinent provisions of the,Massachus taV G#s C//ode and Cha: 2 of the General Laws. Signature of Licensed Plumber Or Gas _fitter Titre Q Plumber 3 L City/Town 0 Gas Fitter License Number Master APPROVED(OFFICE USE ONLY) M,-JOumeyman Date. .�4). ... . . . .20. . .. . ... .. ,4ORTH o� �` TOWN OF NORTH ANDOVER � P r PERMIT FOR GAS INSTALLATION i h I ' �9SSR USE�1 This certifies that . . . . . - �. hasermission for gas installation----.4" nstallations:'4"! . .�--. . . . . I P ' . . . . . . . . . �. in the buildings of . . . . . . . . . . . . . . . . . . . . . . j at ' ' �+ t -:a. . . , North Andover, Mass. i Fee Lic. No. �/. . . . . . . 1. .�! . . . . . . . . . . GAS INSFECTO�� F Check# �/ �► 4021 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING Nor (Print or Type) AyLdo Uc�r Mass. Date-44-14`2 a Permit Building Location � f7SG t2 Owners Name M r�r� /e Type ofaO.cou ncy New O Renovation Replacement Plans Submitted: Yeses No u N tr 0 W N X z 1L 0 0 h U rt h X G 0 = O a 0 Y h W W a 0 U O 1- x 0 V C H < } z z 0 0: F" w z o W 6 o O z ►- < m 0 1- W W O e. = d < < h Y cc N C W WN W X < = rt � O fL W O W U J 1r W V h z J ►' X ;F, h Y H m X O i 0X X < W� O W 7 S < 2 < < W O y 3 0 J U c y o a • O 2 w O SUB-BSMT. BASEMENT 1ST FLOOR i I 2ND FLOOR 3RD FLOOR * 4TH FLOOR STH FLOOR R s STH FLOOR 7TH FLOOR STH FLOOR eck one: Certificate installing Company Name Corporation _ Address Q Partnership p Firm/Co. Business Telephone e Name of Ucensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes O No O K you have checked yet, please indicate the type coverage by checking the appropriate box. A liability Insurance policy O Other type of Indemnity O Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit appCheck one Nes this requirement. OWnerO AgentCl Signature of Omer or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit lssujad for this applicati will be in compliance with all pertinent provisions of the Massachusetts Slate Gas Code and Chapter 142 of the era ws TRGasfitt f Ucense! � umber nature o cen um r or rtter Title erasterLicense Number fa /Town ums rnan i. t• Location U �1 ©ijA)SO� IrG!I-, No. Date - �U NORTH TOWN OF NORTH ANDOVER F � � a • Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ 5 s Musa 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ .S 5� Check # _� 1 5 5 1 9 Z Building Inspector w TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR Dy�EMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: / M a� o � 3 �. G � SIGNATURE: Building Commissioner for of Buildings Date z SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 76 S cnJ ri (,C 1-E 3 Map Number Parcel N tuber 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R aired Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHM/AUTHORIZED AGENT M 2.1 Owner of Record L-i 0.r-A Yti A-(Z4o OJ 1 --70 cVJ C, R Cj-e Name(Print) Address for Service: y3 Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ G- b)reV7 N 2 �� Licensed Construction Supervisor: de O —7 �� � S`�` No _ R', License Number Ad ess / � G/� �0 �/ 0 p 3 Expiration Date / ici ignature t Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date zn Signature Telephone ®- SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ TAddition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: t Tc- C Z3& SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beUFFICIAL[TSE�ONLX Completed by permit applicant 1• G (a) Building Permit Fee r Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X (b) 4 Mechanical HVAC f� �- 5 Fire Protection �J 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. —Signature of Owner -�—r� Date SECTION 7b OWNER/AUTHORIZED AGENT D19CLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Siaturelof Owner/A entX Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 ST 2 3FD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING ;X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE North Andover Building Department Tel: 978-688-954 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of iri a properly licensed solid-waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant PA 14� Date NOTE: Demolition permit from tlje Town of North Andover must be obtained for this project through the Office of the Building Inspector ( The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 e' Workers'Compensation Insurance Affidavit i MINI Please Print Name: I//I Location: -70 --TOr4pSD Dy Ci ec i-r-. tv_ -7) _ City �6v Phones �� .�� L13 = am a homeowner performing all work myself. I..sz am a sole proprietor and have no one working in any capacity f am an employer providing workers'compensation for my employees working on this job. Compgny name: Address City: Phone - lasu arllce-91 poli#._ -emrry-nsme: Address GtY Phony #- lnsuranoe.Co. Pollcv Faihlr®w sectrrg coverage as maquire t under Section 25Aor MGL t52 can teed to t-ho on d criminal pens► ft ora tine up to$1,500.00 and/or one years'imprisonment as well as dvrl penalties in the form of a STOP WORK OC�iM and a rate of $100:00 a understand that a copy of this statement may be forwarded to the Oftice of investigations of the DA far � ) �Y against me. t coverage verification. I do hereby certify under pal and penalties of perjury that the kAYmaVm provided above is true ani!-correct Signature Date Print Official use only do not write in thisareato be completed by city or town ficial' Q Building Dept QGheck if immediate response is required Buildng Dept Q Licensing Board Q Selectman's ice Contact person. p��#. Q Health department O Other ?,'rt WORKMAN'S COMPENSATION I I o N gl Is i I � , I i 0 q I i NIGE�r 795 D le tre t i 1 I I t � Ct , s— S Cc I I i I I I I NORTH Town of 4 'Andover �, 0% No. - S-13C% o dover, Mass. COCMICKE WICK AERATED P?�L J S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........440.4...........//4 IeCd.�V ... ............................ Foundation .. .... ..... .. has permission to erect. . ..9.. ............... buildings on '70....TO Sa C Rough to be occupied as..... /t ......c.. ti......�'a. tit+�.�5 �!v sl v Chimney .................................................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in . 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. 3 9 /j q so- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR C Rough ..... ............................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. I,