HomeMy WebLinkAboutBuilding Permit # 3/17/2016 BUILDING PERMIT OoR,-H �
TO OF NORTH ANDOVER µ..°,
APPLICATION FOR PLAN EXAMINATION �
r'
Permit No# �' �� �� .� ����
Date Received ���P�AYEP dP�y
% � �acsaUS��
Date Issued: /
IMPORTANT: Applicant must con lete all items on this page
LOCATION
,.,) int
PROPERTYOWNER
Print 100 Year Structure yes
MAP PARCEL: ZONING DISTRICT: Historic District yes GO)
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
�tll 'I
DESCRIPTION OF WORK TO BE PERFORMED:
c . pry. a
Identification 'lease T � Fy
rint Clearly
y..er Phone: ` _..
OWNER: Name: i _ ( /
Address:
Contractor Name: Phone:
Email:
Address;
Supervisor's Construction License: Exp. Date
Home Improvement License Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1 p .00 OF THE
TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
) —
Total Project Cost: $4 ( FEE: $ ;
Check No.: % �( ceipt No.:
NOTE: Persons contracting Pith u egistere contracto Flo not have access to the guaranty fund
ni�07 /7K,
N®RTN 'A Aft AV&
I-�
- Ajtjtdt) vci-
® l
44�..K. h ver, ass, S 70 0 /s
COCNICHIMCK 1'
X1.95 RarE® ►`gR F
tl BOARD OF HEALTH
No m M IT �T� L Food/Kitchen
Septic System
THIS CERTIFIES THAT /.;/.�,�r: ...1.�'l�'t�¢;;fi ... .......................................... BUILDING INSPECTOR
.......... ............
C �C,<� C �j�G� Foundation
has permission to erect .......................... buildings on ........ .�..........�..............................................
C
Rough
to be occupied as ....... .....;..;.!L1($ 1'Ge �. ............y�:�� �/ <.G::Y.f........................................ Chimney
provided that the person accepting.this permit shall in every respect conform to the terms of the application Final
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 INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
MONTHS
PERMIT IR I 6 MONTHS ELECTRICAL INSPECTOR
LESS CONSTRUCTIO STARTS Rough
Service
............ ... ..y 1 ........................................
Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
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 Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
NORTH TOWN OF NORTH ANDOVER
°ftt"' ��° OFFICE OF
of., �.. OL
p BUILDING DEPARTMENT
a 1600 Osgood Street,Building 20, Suite 2035
o�RATtO <y North Andover, Massachusetts 01845
�SSRCHUS��
Gerald A. Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE: 7
JOB LOCATION:
umber v Str Address - Map/Lot
HOMEOWNER C-2 = G(i /
- � 7&�7
Name Home Phone Work Phone
PRESENT MAILING ADDRESS �--
A?L
City own tate Zip Code
The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two family
dwellings and to allow such homeowners to engage an individual for hire who does not possess a license, rop vided
that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be, a one-or two-family dwelling,attached or detached structures accessory to such use and/or farm structures.A
person who constructs more than one home in a two-year period shall not be considered a homeowner.(780 CMR
Section 110.R5.1.2)
The undersigned"homeowner"assumes responsibility for compliance with State Building Code and other applicable
codes,by-laws,rules and regulations.
The undersigned"homeowner"certifies that e derstands the Town of North Andover Building Department
minimum inspection procedures and requir ments nd that /she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 8.2015
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535