The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #79-15 - 338 SALEM STREET 7/23/2014Permit No#: Date Issued: BUILDING PERMITo` "° DT "qti TOWN OF NORTH ANDOVER F� y ` 0°, APPLICATION FOR PLAN EXAMINATION �:ILIj Date Received 7eA�a�rep PP.45/ ,LOCATrION? _ PROPERTY WR ONE ,MAP 51 (.9- PARC AI 34TANT: Applicant must complete all items on this page r /Print. Pnnt 100 Year Structure yes, C"\ NING DIS= �RI:CT:__Historic District yes ves ` TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0 =Septic El Well ❑ Flo'otlpla n Wetlands , ❑Watershed District D Water/Sewer:d DESCRIP ION OF WORK TO BE PE ORMED: 0Vy 0 1'F' Vl 111LLL '"A A.7 OWNER: Name: Ire --\ Phone: %J- Address:`�3 C't'l S�— A1014'e IJ-Aeade- Contractor Nam 0;:- 'Phone:_— Supervisor's Constructio.n,;Lic-ense: r — _ Exp. Date:- --- --$ Hoine'irnbrovement License:' Exn_ *Date: x ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT.$12.00RER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ (�01 FEE: $ Check No.: Receipt No.:_9 T NOTE: Persons contract* with unre istered contractors do not have access to the guaranty fund 5ignaturerofAgent/Ov►/ Signature :of coWacto _,... _ s r a Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS i Signature. Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: Com Zoning Decision/receipt submitted yes Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Locatea .364 usgooa street FIRE DEPARITMENT i.remp Dumpster.on siteyes _ 'no, —_ Locatedi dt 124,Main Street Fire'Departmentsignature/date Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup Call Email } Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 Permit No#: Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 4 Date Received IMPORTANT: Applicant must complete all items on this page LOCATION nt ..PROPERTY OWNER. - Print . 100>Year Structure yes no. MAP _ PARCEL:_. __._ . ZONING' DISTRICT: __ _ Historic pstrict yes no: M;;Mina Slinn` ViINna uas inn TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family 0 Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑'Floodplain, ElWetlands . ❑ Watershed Distnet` El Water/Sewer DESCRIPTION OF.WORK TO BE PERFORMED: OWNER: Name: Address.-��L SGS �'► r G - Please Type or Print Clearly nr� 60CL 0 l OM Poop 45 Phonegi�'S�3J^ ARCHITECT/ENGINEER Phone: Address: 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 contracti(lg w,4h unregistepfd contractors do not have access to the guaranty fund nature of .contractor il Iwz 'e w y Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ _T_Y_P_E_OES.EMRA.GE—DJSPOSA.L_ Public Sewer ❑ Tanning/Massage/Body Art ❑ Sw"mning Pools ❑ well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS / �/ I P e,-j, j CONSERVATION Reviewed COMMENTS HEALTH COMMENTS Reviewed on nature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con nection/Sianature & Date Drivewav Permit DPW Town Engineer: Signature: Located 384 Osgood Street :;FIRE DEPARTMENT = Temp Bumpster: on site yes no _ Located at 124 Main ,Street .Fire'Department signature/date 'COMMENTS - Location. No. Date 441( TOWN OF NORTH ANDOVER Certificate of Occupancy $$ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ " Check # v 27807 Building Inspector APPRAISAL REPORT OF 338 SALEM STREET NORTH ANDOVER, MA 01845-3108 PREPARED FOR SOLIDIFI PROSPECT MORTGAGE LLC 15301 VENTURA BLVD. SUITE D300 SHERMAN OAKS CA., 91403 AS OF 06/09/2014 PREPARED BY THE CRAIG COMPANIES P.0 BOX 1212 LYNNFIELD, MA 01940 THE CRAIG COMPANIES SUBJECT PHOTO ADDENDUM File No. 16743 Cas N Borrower LARRY JOHANSEN e 0. REF #81362819 Property Address 338 SALEM STREET City NORTH ANDOVER County ESSEX State MA Zip Code 01845-3108 Lender/Client PROSPECT MORTGAGE LLC Address 15301 VENTURA BLVD. SUITE D300 SHERMAN OAKS CA. 91403 FRONT OF SUBJECT PROPERTY 338 SALEM STREET NORTH ANDOVER, MA 01845-3108 REAR OF SUBJECT PROPERTY STREET SCENE UAL) version 9/2011 Produced by ClickFORMS Software 800-622-8727 Page 8 of 28 THE CRAIG COMPANIES PLAT MAP File No. 16743 Case No. REF #81362819 LARRY JOHANSEN address. 338 SALEM STREET RTH ANDOVER County ESSEX State MA Zip Code 01845-3108 ent PROSPECT MORTGAGE LLC Address 15301 VENTURA BLVD. SUITE D300, SHERMAN OAKS CA. 91403 UAD Version 912011 Produced by ClickFORMS Software 800-622-8727 Page 17 of 28 MLS LISTING File No. 16743 Case No. REF #81362819 it LARRY JOHANSEN ( Address 338 SALEM STREET RTH ANDOVER County ESSEX State MA Zip Code 01845-3108 „ lient PROSPECT MORTGAGE LLC Address 15301 VENTURA BLVD. SUITE D300 SHERMAN OAKS CA., 91403 SLR£ r mom^'. Nmd d.;E:vr,`i: sth §3�tf$1-�Itt� "fYf: . party App,".al a�'m 0``K3s fxwv °a C ot": a For-uut�m ..... ................ {to t evti Ax- Lo'.xv 0,8.4 tib• -*e ,. a;t�: No rfta-> €.e;$ �Lx: AS'F.A =/t.M Fels Wmhar, t3ryr.r sq.% 1966 rrnmi,+,ti .+r S;VA 46914 - - (Pa!rres Gansatlr; Q*v� Whitt t4r if SI{:+:-rltw,�. ,r"z.+'tr7^a.T tiff-xidPaat etartxaai a�'m 0``K3s fxwv °a C ot": a For-uut�m ..... ................ {to t evti ,..,......... .. ,. ,..........................,.,.....,...,. 5,4.v,r"H,ELtlez .,...,,,. Arn.1 ,ff; ". q, !,'3a#1%p—e-"' ~tr rtaatsag- Wmhar, t3ryr.r /1>S'dwo : } ?"011 f' .r'IVIN" "oppfnp. �s":van';- y t4r if SI{:+:-rltw,�. nsatatt.. Sr;YaetO§ etartxaai v-; TeN put -Yn:'4i" $ talt.i +CnitipR t'89tf«� 1-.:l::Ft �r�tti� r}rMY.joa •li:tr9wwa Ea dna. Diming moot sn.A?siln.,rkT C •l tt ,... '2 22.1' flawing . rW�:,r yiny3 3";rmwoofl E r ?`Y 3? •?''4 rtay2 rr' Staragt+. hawl r fl.-ing> Hot water lt:metdrwt,. 0'#s. ?tartlnaoil 4 k a'o Naiaarat £aq 3lir11 1. : 4��arxFs' Ctm2rnf ia&ut3R1 .n_.n4Y• .h t$ « �^ x7aat i:'2aa±sxq- it: i&?!: Ctr9ttiP2Wtf Harttrood -sn3:,-,vY•9: i+4vic x,,t'A:p3tttLI1°i'atztpktst;5ktifag?ws: Far€°43a1.c a'a;ix:±r3gp • vi >a 5. po-'*4 sv.)'.O W-ItWl 0tyf'rvo .. water i hiir"es':F", mo Tis ;,y;;r.>• f;',;{ ..;: age [ir n+prP sp scx;? Want Ar atrrn Haar Rirm' gffrrurq ar itlantt Ane Imr, gnq'e aluiog and faaY#tq rbro ns, r lal.rcrvanpnt. w€nam�gz.lsafltas 2aA tttibr r1s'nt W, olayrtlahg, ha3'atwoA ti,:or,� anc3it tiir s 5trr btarmam wgll it:- vrry awn to ir'f'ti.r.=gtr:crx 00'0 op (` i< rets€ woY t 6 vlt t.. Ymu°€S Fra sa r'rcgxdt+D tl3,turcr:+.tzfavrtiy hnekyara'with ipme"Aia€garitrms• a#' qe heauiSru€oa .r: etrthrr ifY}I)A nT UM0. ifilm. t F,Mui,p hrrok op W (awo Ft!4Naf.,,,Fa%T 651}InatC.S'AYttiFT#sta. 1R. Irttnr::;eairsi. 1934,ra:°{ z`a��3 a. a r�,;'?1' $„i7 k.'1t1rd� -�M, Yzm rr .r=tt R3 S a MstlSDti37 F..1tTfiaSS a.roT%34D ? , �°:: D;.y.• 5491 t`a ::=.: t-41 tiraanq. uFiri� r�srtt+:t E� vc�' Cszrnty aT S�arvna nxf9 AnpieU7sa :%terr2� � rg i>�e+a,€ta• 1!€'�"°. ixftix3t+za fttght tc55eit r.'n 'S r7ia tsz�r : 4r�,+; �rf2iD't $c z i, z-;� :1y-..?;. 5uD-hp¢igtii,' tewleam"hi"I P#Sal x r N?Aqvr. C.itf 051 omco f';r:t^ d 7,9 ° ?r 3Y'.^' Cast illi ia!l'e:r. :�7 �.� »y ...1_ LO t ! T11:':.'J."':. r+4dY3 fIF 'S ft")" t5^ rik # 1R�E•.Yi r FON u, b.N' -- {ls".vitk ;a � fi,'; V';Art [ka&0 ! € :c: iarf x C Mmtsstan rn ha:set4 cn salua ry>ir.; sainv:' mer snrs. s.a ad.) vrgrt gut }r -i t f. ll: rd pti°y app+'as:J, t :- ...: Fti 3Mk_!Y 3��inrtgr�w� i3i�j i1-:rgJ3tF tt,tix,, a r, t%zataat4 Z•iptir tyS :.� (_; w .. [7!hrlsnk ffi hc-Frd ;? ac:€ trJ7k2 sfJ:t.�4tra �a tsr'c ar rrrw r✓ x2a $YMm 5 ra•-r dnyovice, nrn:it Rr3 HtS F. LUEt it 1- qqf 3C SVI'9IIit tt ,b bST,: 3i r'r': ._I_ -errs e 3,jr•:;r t•,x!e-FttleQ -s.r x, 'tl:+-,za 'yf; r.; ji1 t��3rt �.k t. ,. -: d 'fttrs✓'MPi,ig i+t�'«T, BtTSpuA1 t':;i :rs; tam t"- .. - a :>? ri ,srati UAD Version 9/2011 Produced by ClickFORMS Software 800-622-8727 Page 22 of 28 �e 4--o or9e e4 and move fr f j dc-. - d 4 r .: East: �c :.., d R 1 Y 4 ! �.. 90 i To iv A. r ,.r Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H. I. C. And C. S. L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 Yke.Cor monwearth offfassachusetts Department 0fJfid,!Swg1-Ace1d&iS Office oflnvesiigafeons 660 Washington. Street -Boston, MA 02111 www.Masygovld'ia Wo rl ex$' Compensation bsu>rance Affidadt: BunciersiContradores/Eleet-ricxanstTI*bex$ Tame (]3usiness/Organizationll (RV dual): -Address: City/Staiel p: ✓ / ✓-c�, M �l �—Phona 0: Ara your an. employer? Cheek the appropriate box: Type of project (required): 1. ❑ I am a employer with - 4• ❑ I am a general contractor and I g. ❑ New cOnstructioli f employees (full. andlor pact time).* have hiredthe sub -contractors 2. El am a sole proprietor or partner listed on the attached sheet: T 7• El Remodeling ship and`7ravenaemployees These sub -contractors have 8. ❑ Demolition workers' comp. insurance, 9, Building addition working forme in any capacity. ❑ g [No workers' comp. jnsurance 5. ❑ We are a corporation and its 10 ❑ Electrical repairs or additions xeciuired.� officers have exercised. their 3. Z am a homeowner doing all work right of exemption. per MGL 11..❑ Plumbing repairs or additions Myself [No workers' comp. c,152, §I(4), andwehaveno 12,❑ Roofrepairs insurancerevired.1 i employees. [No workers' 1311 Other comm insurance required.] Anyapplicantthatchecksbox Zmustalsofilloutthesectionbelowshowingtheirworkers'compensationpolicyinton ation. ? -Homeowners who submit ibis affidavit indlcatingfitey Re doing Aworlg and then hire outside contractors must submit a now affidavit indicating such. xCoiftactors that cheektbis box must attached as additional sheet showing the name of the sub, -contractors andtheirworkers' camp, policy information. I Man emp%yep that is•p�ovicli tg worrkers, compensation insuranee foprrzy er�loyees Bet'ow is iiiepoliey nrtdjoix life in, formation. . Insurance Company Policy #1: or Seii ins. LiG. ExpixationDate: l'ob Site Address: City#Slate/Zip: Attach a copy of the workers' coxnpensation-polzcy declaration. page (showing•the policy nmuber and expixatioa crate). yajime, to secure coverage.as xequiredunder Section 25A- of MOL o.152 can lead to the imposition of erblinalpenaliies of a due up to $1,500.00 and/or one-year impxisonYnent, as wallas civil penalises in the _form. of a STOP WORD ORDER. and a fnie of -up to $250.00 a day againstthe violator: Be advised that a copy ofthis statementmaybe, forwardedto the Office of investigations of the DTA. for 1suxan ce coverage Verification. X do laer y cert." Fder fi; 1, nd venaltie�s o f verPry that the ire• fopmation pYovirlec7l above is true and correct. Official use oJily. Do not write in this area, to lie Completed by City or toren offieial. T Permialcense Czty or own. Issuing A-nthority (circle one): 1, Board of)E(ealih 2.BuildingJmepartment 3. CitylTown Clerk 4. Electrical Inspector 5. Numbing Inspector 6. Other Information an Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuaait to this statute, an ern, kee is defined as ",.,every person in the service of another under any contract of hire,• express or hapR4 oral oxwritten!, Au employe is defined as "an individual, partnership, association, corporation ox othexlegal entity, ax anyiwo oxmox ofthe ioxegoirigengaged inajointenfeaprise,andzucludingthelegalrepxesentatvesofa•deceasedemplQ ex,,orfbe e receiver ontnisfeeofranindividual,partnership, association or other legal entity, employingemployees, lToweverthe owner of a dwelling househavingnotmore than three, apartments and who resides iberolu, or the occupantofthe dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because, of such employment be deemed to be an employes." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance ox renewal of a license orpermit is operate a business or to constrilet bi ldi ags in the commonwealth for arty applicant who has not pro dirced.acceptable evidence of compliance with the insurance coverage required:' Additionally; It GL chapfez 152, §25CM states"N'eziherthe c ommonwealth nor any of its political mb61'sions shall enter into any contract for the performance ofpublie workuntil acceptable evidence of compliance with the insurance requirements of this chapter have beenpresentedta fhb contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(.-), addresses) andphonenumber(s) along with. their certifzcate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) With no employees other than, the members oxpartners, arenotrequfredto canyworkers' compensation insurance. MULLC orLLP doeshave employees,apoiicyisxequired. Be advisedthattlzisafndavitmaybesubmitcedfoilteDepaztmentofrndustria7 Accidents fox confirmation of hisurance coverage. Also be suxe to sign and date the affidavit. ';':'Ile affidavit should be xetumedto the city or town thatthe application for theperri t or license is being requested, notthe Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation.policy, please call the Department at the number .listed below Self-insured companies should enter their self insurance license number on the appropriate kine. City or Town Officials Pleasebe,mrethattheaf0davitiscompleteandpriatedlegibly; The Department has provided a space attho, bottom ofthe affidavitfoxyouto fill out in the event the Office ofInvestigationshas to contactyouregardingthe applicant. Please be -sure to fdl inthe permit/lzcense number whichwill bowed as a reference number. 7n addition, an appIzcant tliatmust submitmultiple pannit/Rcense applications tit any givenyear, need only submit one affidavit indicating current Policy Mormafion (ifnecess;W) and under "ibb Site Address" the applicant shouldwxite "all locafions in (city ox towar):' A copy ol'flie affidavit that has bean officially stamped or marked by tha city or town may ba provided to the applicant as pzoofthat a valid affidavit -id on file £or fature permits or licenses. A new affidavit must be filled out each Year. More a home owner or citizen Is obtaining a license ox pemlit not xelafed to any business or commercial venture (i.e. a dog license orpermit to burn leaves eta.) said person is NOTxegcixed to complete this aftxdavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do nothesitde to give us a call. The Depattment's address, telephone avid fax number: ` no Ct?7. Ox W.Ct ajtjj ofM?S�ac,�?USet�� Dgpa umt dludwfxlal AccNoW3 office o:JrTAV"QgAtCO,4,% �Q0 wakmiatm Sweet TO, RM -2&4900 W 406 ox 1-877,M�5 � Revised 5-26-05 Fax # 617"727-7749 WWW-Maagaldla TOWN OF NORTE[ ANDOVER _ OMCE OF _ JBUffiDING DEMT NT 1600 Dsgood Street Building 20, -Suite 2-36 • • NorthAndovex, Massachusetts 01845 Gerald A. Brown Telephone (978) 688-9$45 Inspector ofBuildings -Fax (978) 6&8 9542 HOMEOWNER.•LTCENSE EXENiPTON BT7 D G PFWMT ALPLZCA'ION • Pleasepnni , DATE: JOB LOCATION; UUNMOWNER•� 34 /e/ -N Number StreetAddress Map)Z of Work Phone -'RESENT MAILING ADDRESS -37 o C I t,i Tod I R. A ¢4- O( a ?,p Code The current exemption for "homeowners" Was extended to '60, allow su:h homed. r include owner-occdpied dwellings to Uvo units Or less and uers to engage ail Mvidual•for hire who does notpossess a li acts as supervisor). State3uildkg (Code Section 108.3.5.1) cense, provided that the owner DEFINITION OFHOMEOWNER Persons) who Awns a parcel ofland on which he/she resides or intends to reside, on which there is, or is intended to b'e, a one or two family structures. A person who consiracts more that.one home in a two yearperiod shall not be considered a 110MCDwner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules andxegulations. The undersigned "homeowner" certr,Res that he/she understands the Town of North Andover Building Department minimum. inspection. procedures and requirements and that be/she will comply With,said procedures and requirements, HOMEOWNERS SIGNATURE APPROVAL OF BU LDMC, OFFICIAL " Revised 7.2009 Form Homeowners Exemption 'BOARD OFAPPEALS 6$$-9S4ICOI�SEr : R'4ATION 68$-9550 HEALTH 689-9540 PLA . NNWG 6$9-9535 E f 3 0 EEO JOv LLJ = LL 0 DZ m N O O LL E O N fl_ N (n H z z m C 7 O LL OA 7 O Q' ? _ L U O LL 0. H z 4 to 7 O wLL (0 C O H z Q U W W MU 7 O �' N (n f0 O LL W CL Ln z Q �M 7 O �' — ILL z LUO CLW W W0 iy v ` CO N N N D -Y O In _ O cc _ Cc O V a L am cc= cl)a cD cn t..7 L y WO P ca N QQ = Op ` : q: O tir► V i �+ Vl CL M A L m > Cc_ = d y d O •� O O y .a 0 c C Q to O m y z - ` N = o t •y 3 )J: c o0 L Q Q 4) ® V �+ _ I cl $ (n � : =o c x CL 4) LijH 0 y O V m Com® w _ -0 -- o o 2 w`Mcno v v LU L v 0.- v aCL L a) �i '~ _ N y -= o H s . CL o V 0 W m z U) z v J m d 0 O O O Z N tm W Q •E m m C 0 CD L 0 a �a 0 _ V J cc 0 'A4'+) W U U) c H 0 Cf) 0 � Z W 0 � Z., � w X LLI �w Z O CO o� W J CL Z d 0 O O O Z N tm W Q •E m m C 0 CD L 0 a �a 0 _ V J cc 0 'A4'+) W U U) c H ko �I Z Jp W LL 0 Q m Y \ O LL E N T U N N Ix a Z z m C O _0 O LL L O W C .0 U _ C LL cc O u a Z Z co J d L O -. OC C' LL O uoc a Z W W t to_ O m UW v N C LL F - a Z Q i p C LL Z oC W a W LL m O z N N Y N L I n O O O a.+ _ • •� i �= CLcc a� O: D Q * c c E v o E " r � L CL O �v C -4-: C C tN`0 V 7E �U _ Q W to J O 1 L m > ccc O d f/1 Oen N 'a O O O > ��a r_ t O o O 0) 1 Mno o a) d OO w .y 3 im )l' .O F- �•L m��• m ® 0 �..r L 0 f $ cm m a) i-- o L c d (0--o Q. d O (A 2 m N N LL •� lA C O L •E •0 a 0 O LU L 0 W.- 0 ._O w im, -0 o `�= c v I�1 H t o+CLo0 mo > Z m CD Z Cl) w X LU G LU M O U O CO W Z Z C.> v Z ; w 0 0L L C O Q ai Q r J O Z N c ao� Per�jove. ��, 4-- P�ytf,j 9! ----------- C-orie-c,-V scivoroe� ao� Per�jove. ��, 4-- P�ytf,j 9!