HomeMy WebLinkAboutBuilding Permit # 2/27/2017 BUILDING PERMIT 0 "�or"
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
permit No#: l ! Date Received
SA,cµu��
Date Issued:
EMPORTANT:Applicant must complete all items on this page
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Print ;
PRO}?ERTY OVIINER . ti.
Print IN Year Structure yes no
x.
PARCEL :-: . ZONING'DISTRICT; Hrstoric'Dstnct yes no
Mab h6 Shop Village rho
-TYPE OF IMPROVEMENT PROPOSED USE
Reside
tial Non- Residential
❑ New Building ne family
❑Ad ' 'an ❑Two or more family ❑ Industrial
Iteration No. of units: ❑ Commercial
❑ Repair, replacement o Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
S t[c D Wel[ ❑ Floodplain ❑Wetlands C7 Wat&shee[ District,
DESCRIPTION OF WORK TO I3E PERF=ORMED'
Identification-- Please Type or Print Clearly
OWNER: Name: LrIL Phone: q7u_618 2 7
Address: C74 trra 9F
f .
rCNorrie?. /�..).9 : . . _ Pl ori.e :
Address-.
Supervisor's Consfructleri I-rcecise,
Exp. ` Dater
LH- me Irnprovembnt L1cense Exp:
ARCHITECT/ENGINEER Phone.-
Address:
hone:Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT, $92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F:
Total Project GOSt: $kwo FEE: $
Check No.: Receipt No,_ l
NOTE: Pe ns cont aeti with unregistered cont actoFs do not have:access to the guaranty fund
Si ;rtatire=o -."Agerit/Or�e
:W ,r` g Sr nattar of coiitra'ctor
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Town of Andover
�a IAN@ h ver, Mass, 7 0/ 7
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BOARD OF HEALTH
titRMIT T LD Food/Kitchen
Septic System
THIS CERTIFIES THAT .�,..C....... ........ . ......... ....... BUILDING INSPECTOR
has permission to erect .............. ........buildings on ........ .x......!SAr,r*!......;�.....,...... Foundation
.9;.V. ...... ! ® 'D.......... Rough
to be occupied as ........... , .......... 7/ l� 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. roo*v4suvj PLUMBING INSPECTOR
e/o Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIREST ELECTRICAL INSPECTOR.'
UNLESS T Tl T Rough
Service
............ .... . . ........... ........ Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy .Permit Required„to,Occupy Building Rough
Display in a Conspicuous Place on the Premises - ®o Not Remove Final
No Lathing or Ory Wall To Be ®one FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
of poRTM TOWN OF NORTH ANDOVER
�,.+ �•��`� �.`*.���
OFFICE OF
BUILDING DEPARTMENT
120 Main.Street
n
North Andover, Massachusetts 01845
� S�CHU
Donald Belanger Telephone(978)688-9545
Fax (978)688-9542
Inspector of Buildings
HOMEOWNER LICENSE EXEMPTION
Building Permit Application
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Please print
DATE: � -71261
JOB LOCATION: 7
Number Street Address Map/Lot
IIOMF.,aWNER le . 6.� 7
Name Home Phone Work,Phone
PRESENT MAILING AI7DI2ESS �" lem
--
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 sup—grv-visor.
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 110.85.1.2)
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 SIGNAL'URE __.___---------._-----------.-------_. _..--
APPROVAL OF BUILDING OFFICIAL
Revised 9/16
Form homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVA,rION 688-9530 HEA.I.'I..t_I 688-9540 PLANNING 688-9535
The commonwealth of.lflassachasetts
.Department ofi idustrialAceldeMS
I Congress Street,�S`u to Z 00
_ooston VA.02-
114-2017
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do 7ze eb certify under`thepuirzs cr�z�plllftf ies ofperjury that tTxe inforraaafioix�ravideci aiiaveN true ani carred
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