HomeMy WebLinkAboutBuilding Permit # 9/8/2016 = koRrh �
BUILDING PERMIT
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TOWN OF NORTH ANDOVER F
PPLICATION FOR PLAN EXAMINATION -
Permit NO: Date Received
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Date Issued: 9 sS�c►+US
IMPORTANT: Applicant must complete all items on this a e
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building X One family
❑ Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
11 Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
E + ti ill 1 1=1odplai 1❑�etl+ tds I Waershel ltti�i
Remodel Kitchen- return kitchen ceiling to ori final height. Relocate pantry opening.
Relocate sink, install dishwasher, new cabinets,counter tops with breakfast counter wall.
New recessed lights and relocate electrical and plumbing.
Identification Please Type or Print Clearly)
OWNER: Name: Lynne Rudnicki Phone: 978-771-5564
Address: 32 Marblehead Street North Andover, MA 41845
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ARCH ITECTIENGINEER Phone:
Address: I Reg. No.
FEE SCHEDULE:SULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ �` FEE: $ li
Check No.: Receipt NO.: 1_
NOTE: Persons contracting with unre ' tered contractors do not have access to the guaranty fund
S�gnatur of Agerftl3nlnegnature o contractor
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Town of 2 .. q ",t, Andover
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BOARD OF HEALTH
Food/Kitchen
PERMIT .T D Septic System
THIS CERTIFIES THAT BUILDING INSPECTOR
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has permission to erect .......................... buildings .... .... .. ..L ��,�.,.�..
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to be occupied as .. . ..6Q� " P.,(r..........................................................................
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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
UNLESS CONS TIJTRTS Rough
Service
...... ..... ...... ...... ..... Final
BUILDING I PBC OR
GAS INSPECTOR
Occupancy Permit Reegired to Occupy Baildrn Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Null To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
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11511
21910
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31'
ME
81311
g/m,
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3ft 6ft
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floor(j)pianner
TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
4
1600 Osgood Street Building 20, Suite 2-36
North Andover, Massachusetts 01845
CHt
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print
9/8/16
DATE:
JOB LOCATION:32 Marblehead St Map 8 Bleek-9-Let-0- ?JAtCf-A_
Number Street Address Map/Lot
HOMEOWNER Lynne Rudnicki 978-685-7506 (h) 978-771-5564 (c)
Name Home Phone Work Phone
PRE,SENT MAILING ADDRESS 32 Marblehead Street
North Andover MA 01845
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less
and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the
owner acts as supervisor). State Building (Code Section 148.3.5.1)
DEFINITION OF HOME-OWNER
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 structures, A person who constructs more that one home in a two-year period shall not be
considered a homeowner.
The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other
Applicable codes,by-laws,rules and regulations,
The undersigned"homeowner"certifies that he/she understands Town of North Andover Building Department
minimum inspection procedures and requirements and tha e/shewil amply with said procedures and
requirements.
HOMEOWNERS SIGNATU
APPROVAL OF BUILDING OFFICIAL
Revised 10.2005
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSFRVATION 688-9530 11FAI,TH 688.9540 PLANNING 698-9535
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Policy#or Self-ins.Zic.#: Expiration Date:
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Affach a copy ofthevorkers' cbmpez�atfoxs poijoy declarationpsge(shov,ingthe pa zcya� zbez and e aisora c aie).
Failure to secure caveraga as required un.derMOL a. 152, §25A xs a erimival Wolation puatshablo by a fine up to$1,500-0Q
and/or one-year im-pr5- onmaut,as weli a,ezvlpenahies in'le foxzn of a STOP WORK ORDM and a ane of up to$250_00 a
day against the violator.A,copy of•fis statement may be fozwarded to the Office ofInvestigatians OfthoDlA for xance
coverage verification_.
X rZo Hereby cer " user tl s�r2cl�eraadtie�of petjxFxy tlzret thezrtj o ncetior2p�a7sic ec a ora is hwe cid co,-2,0d.
Si att}xe: Date. r
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f.Eoard oiPCeaIt]ia 2.JQ diaagl3elaari nez7t 3.CityJTov.Clerk 4.Nlectrlcal ftspector 5.RlmnbiugInspector
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Co1¢tact Person: Phone#: