HomeMy WebLinkAboutBuilding Permit # 9/21/2016 t%ORT)l
BUILDING PERMIT 0�
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TOWN OF NORTH ANDOVER 0 . .....
APPLICATION FOR PLAN EXAMINATION
Permit No#: Date Received o
�L -nLl 7 ACH0
Date Issued:
IWORTANT: Applicant s on this page complete all iten'
�71 r I t
LOCATION P,
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PROPERTY OWNER
Print 100 Year Structure yes no
MAP PARCEL: ZONING DIS FRI CT:,-,----,—Historic District yes
Machine Shop Village yes
T —
POF IMPROVEMENT _TR_0150—SED USE
TYPE
Residential Non- Residential-----
C] New Building [1One family o Industrial
[I Addition El Two or more family Ll commercial
D Alteration No, ofunits:_----,-_,
ipair, replacement [I El Assessory Bldg Others:
[� emolition E Other
E]Wetlands A
b ptie- Well n
Floodplainh' 18 tict
d t
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V6
DESC,, IPTION OF WOR IK TO BE PERFORMED:
lAentificatio Please TypP
e or rint Clearly
Phone:
OWNER: Name. w /(., � .'I ----2L, I—I -
4
Address:
-Lo�
Contractor Name: Phone:,
Email:
Address:
Supervisor's Construction License: Exp. Date:
Home Improvement License: .-..-----Exp.
ARCH ITECT/ENGI NEER Phone:
Add Reg, No.
FEE SCHEDULE. BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F.
Total Project Cost: $ -----FEE:
Check No.: Receipt No.:
NOTE: Persons contractingivith unregi'ste 41(lontractors do not have access to the guaranty find
r—--------
TOWN OF NORTH ANDOVER
0 TICE OF
F
BUILDING DEPARTMENT
1600 Osgood Street,Building 20, Suite 2035
N oi-fli Andover,Massachusetts 01845
Gerald A. Brown Telephone(978)688-954.5
Inspector of Buildings, Fax (978)688-9542
ITOMEOWNER LICENSE EXEMPTION
BUIDING PERMITAPPLICATION
Please print
DXFE:
JOB LOCATION:
Number V S t r e 5Address Map/Lot
I]OMEOWNER
Name Home Phone Worl(Phone
PRESENT MAILIN-G ADDRESS
2
City Town State Llp Code
The cuiTent 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,prpyi
Acd
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 CNM
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 inspcction procedures and requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE— r -Z7
APPROVAL OF BUILDING OF, i
CIAE(�___
Revised 8.2015
Form Homeowners Exeniption
BOARD OF APPEALS 688-9541 CONSFRVKHON 638-9530 HFAIII-1 688-95,10 PLANNING 688-9535
.18 Caraamonvealt af'.71!lixss�chuseds
Department ofladustrialAceldents'
.1 Cajg"esV,S'Peet, Suite 100
— j 8ataa, 772 [ 02. 14 2017
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