HomeMy WebLinkAboutBuilding Permit # 4/29/2016 OORT9
BUILDING PERMIT
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TOWN OF NORTH ANDOVER
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APPLICATION FOR PLAN EXAMINATION '
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Permit N®#� Date Received �RRTeo
Date Issued, / C US
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IMPORTANT: Applicant must complete all items on this page
LOCATION � � ,��
PROPERTY OWNER V Priv
�, rint Ioo.YearSttucture yes
MAP PARCELS� ZONING DISTRICT: Historic District yes no
Machine Shop Village yes. no .
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building One family
❑Addition ❑Two or more family ❑ Industrial
k4Alteration No. of units: ❑ Commercial
❑ Repair, replacement ElAssessory Bldg El Others:
aDemolition ❑ Other
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DESCRIPTION OF WORK TO BE PERFORMED:
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en fication- Please T pe or Print Clearly
OWNER: Name: Ph ne:
70
Address:
Contractor Name: �J � Phone:
Email:
Address: c.4A A AV
Supervisor's Construction License: ✓ Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER A)IZA Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF HE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
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Total Project Cost: $ FEE:
Check No.: / Receipt No.: - 0
NOTE: Persons contracting with Yfi egi9tered contractors do not have access to the guaranty fund
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No. gas
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rERMIT T Food/Kitchen
Septic System
THIS CERTIFIES THAT ® �� ' BUILDING INSPECTOR
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has permission to erect `- ®-��G r' �r Foundation
.......................... buildings on . ....:�.................................................................
to be occupied as e o`>G ® � ���„� �� �,��® ' —� �� _ Rough
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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
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
LESS CONSTRUCT TARTS Rough
Service
....... . .... .... . ... ..................................
BUILDING INSPECTOR Final
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 Approved by the Building Inspector. Burner
Street No.
Smoke Det.
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
1600 Osgood Street, Building 20, Suite 2035
North Andover,Massachusetts 01845
Gerald A. Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Pleaseprin
DATE:
JOB LOCATION:
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Number Street Address Map/Lot
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HOMEOWNER
Name Home Phone Work Phone
PRESENT MAILING ADDRESS Ll ;"
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City Town State 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,provided
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 I I O.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 he/she understands the Town of North Andover Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING
Revised 8.2015
Form Homeowners Exemption
BOARD OF AN" 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535