HomeMy WebLinkAboutBuilding Permit # 6/1/2016 �QRv�
BUILDING PERMIT
"TOWN OF NORTH ANDOVER m
APPLICATION FOR PLAN EXAMINATION
Permit No#: t Date Received--
Date
eceived Date lssued-- t I
t tT6�1RI VN Ap}�licant must coin' — -- P o— ---
— Mete all items on thi_ — --.
LOCATION > "
� �
PROPERTY OWNER M Punt
- Print 100 Year Structure yes 'no
MAP " PARCEL: " - ZONIN, DISTRICT:",_,,, __---.Historic District yes no
Machine Shop Village yes o
- — -- —..— — —------
TYPE OF IMPROVEMENT PROPOSED USE — —_.—
h
— — ResidentialNon-Residential
New Building kOne family
n Addition ❑Two or more family Cl Industrial
FAlteration No.of units: ❑Commercial
--..-------------...-------- - — -- —------ -----
7 Repair,replacement ❑Assessory Bldg [I Others:
❑Demolition 0 Other
SeptiI Well Ca Flood lain Wetlantls / , C7;Watershed Dis4nct
i/, �i ///iri
/ !:— //:i
DESCRIPTION F WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly ���- C�� d��
OWNER: Name: �,Z- y f Phone:
Address: ��oJ�AfS'' �5 �r V' Kl G1�'vr kWl
Contractor Name: Phone:
Email:
Address:
}f T.." 61 ,J i" 1 3
Supervisor's Construction Licens :t Exp. ate
Home Improvement License: v p. Date
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDINO PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project.Cost:$" 00(- FEE:$
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors no not have access to the guaranty fund
— —Signafur of geritLQscuner. * _ .._ S6liatur�of
Town of ,.,, ,Andover
leo. _
�1 _ W Iver, Mass, Z�
A ED
U
ff BOARD OF HEALTH
PE
Food/Kitchen
� RMIT TO ILU Septic System
THIS CERTIFIES THAT...../J./.-�2.�.../5/wz/e�............................................................................... Foundation BUILDING INSPECTOR
Gil J
has permission to erect..........................buildings ol.... ..........................................
Rough
....... ..............I......... Chimney
to be occupied as .............
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
UNLESS CONSTRUCTION STARTS Rough
�...... Service
......�i6iL6i G'INSPE'"C*'T0R" 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.
4 E TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
a e g 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
BUILDING PERMIT APPLICATION
Please print
DATE:�,k\,Q
JOB LOCATION: 100 k)\/l� lk
(�Nrumber Street Address 7 f Map/Lot
HOMEOWNER 4 M �Wt Q � {� t _
Naniel &e Phone Work Phone
PRESENT MAILING ADDRESS 3(CO W�fl�C3 C
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 ants 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 CNIR
Section I IO R51.2)
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 OFFICIAL
Revised&.2015
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 IIEALT11688-9540 PLANNING 688-9535
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dann norris batting• architect No.W27 rye
planning,design,architecture ; MAMEN.
one sandown road Mnss'
chester,new hampshire 03036
603- 887 a 0086