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Home My WebLink AboutBuilding Permit #449-17 - 44 MOUNT VERNON STREET 11/20/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: ' IMPORTANT: Applicant must complete all items on this page LOCATION' 3_ %.7 ✓�'1 t �'—J �/ ,r �� ~ Print. PROPERTY QINNERs- ,S�fl N 7t- Print G Qle Print' 100 Year Old St6ucture yes 'no; MAP tNO _ _y. fFARCEL: _ _ _ ZONING DISTRICT: .... _.._.__ Historic District yes no Machine Shop Village. ye Frio i _ TYPE OF IMPROVEMENT PROPOSED USE Residen ' I Non- Residential ❑ New Building ne family ❑Acloit4on ❑Two or more family ❑ Industrial teration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ElSeptie 01W_ll ;. .'❑.Floodplain; 0 Wet dst ❑ Water$hed�strict• - _ 11 1W DESCRIPTI N O WOF TO BE PERFORMED: Identification Please Type or Print Clearly) _ OWNER: Name: /vt zJ N nPhone: Address: �� % CONTRACTOR `Name: _ Phone:. P. Add r;,ess - --=- - - �. Supervisor's Construction License. __ - Exp. Date:- Home Improvement Lite nse.__n �� __.._ v_= _ Exp.. Date-,_ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ tS� �� S&b 0 FEE: $ Check No.: T� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature}ofQA ent/Ownerf65,'' refof�confractort°` Plans Submitted L171"" Plans Waived [TP Certified Plot Plan Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE_OF-SEWERAGEDiSROSAL 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 DATE REJECTED DATE.APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on 196 Si nature COMMENTS ""10 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Tow;! >En&eer: Signature: Located 384 Osgood Street FIRE DEPARTKL-N'T- =-Temp Dumps er an site .yes no Located at 124;Mair Fire Depar tme►jt signatiarelclate �1: �, 1� :� ,,:• :, ;,. t, ,,. ,� ,< . ..� COK4M.ENTS _ _ . 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 I NOTES and DATA— (For de artment use 5 �(c, �6 ) r— i ® Notified for pickup - Date E `- { E i Doc.Building Permit Revised 2010 r Building Department -,`rhe fol!-awing 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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And I auUc_Ca1Gw.Iations (If Applicable) ❑ mpliance Report (If Applicable) ❑ r Engineered products NOTE: All dumpster=perm=tsre�quitre�ign 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 apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Bui?ding Permit Revised 2012 I Location No. Date lJ • - TOWN OF NORTH ANDOVER •� Certificate of Occupancy $IfBuilding/Frame Permit Fee Foundation Permit Fee $ . Other Permit Fee $ TOTAL $ Check# 27122 Building Inspector NORTH Town of tAndover No. Iq - h ," ver; Mass, I � cocN�cHew�ca �1. �as GATED PPP��y U BOARD OF HEALTH Food/Kitchen PERMI LD/► Septic System G� THIS CERTIFIES THAT ..........E4..............�...................................................................................... BUILDING INSPECTOR ' Foundation has permission to erect .......................... buildings on ..... .�....... .......��L.LIf. 1....�................ Rough ..... .. .... ........ ............................................................... Chimney to be occupied as ........V&a........... provided that the person accepting this permit hall 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 MONT S ELECTRICAL INSPECTOR UNLESS CONSTRUCgo T RTS Rough Service ........... .......................................................... Final BUILDING INSPECTOR 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. SEE REVERSE SIDE i Pictometry Online Page 1 of 1 All k uln 13 11 oj ��7h .,.✓ i � A��i1 � .tiF , r F� I F, a' s � ids m�6 rte. AV— Print Date: 01/21/2014 Image Date:04/01/2012 Level:Neighborhood http://pol.pictometry.com/en-us/app/print.php?title=&date_fmt=m/d/Y&year=2012&month=04&day=01&level=N&type=Ob&... 1/21/2014 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 89000.00 m $ - $ 96.00 Plumbing Fee $ 12.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 12.00 Total fees collected $ 220.00 f 44 Mount Vernon Street 449-14 on 11/21/2013 Convert Porch to a 3 Season Porch FR. � 4NK S. GILE� �.�;. � ; .� ATE.NO JEMBER 13 013 ► : ,=��- REVISIONS: ;:CERTIFIED PLOT ' ;, v� ): OF.M a Q P�- S � ONSUL �,., �.;!�.�._ ; PLAN.:OF.LAND` .. F t a AND_ROAD — BRIGHTWOOD :LOCATION : ---- a : ". AVE. s LL ( 73 AERN STET LAWRE44-46 M s 1713 SCALE: 1"=20' _ NE; NIA 01 S41 OUNT VERNON STREET Q, NORTH ANDOVE 01" 20' ( Tel. 978-975-2059 R; MA. 01845 j 40 ( : . SITE: X n, ":: ,. 1 ,. MOBLAND VIEW v�SUR1 PREPARED F — FrankGiles ---- -- ----- " coancast.net T RN !. OVEMBI � 201 i L CLIFFORD EDMUND SUMMIT- STREET � wENTWoR� MAP 67 LOT 58. AVE. MAP 67 LOT 59 MAP 67 LOT 60 . NSF NSF: I,®ALTS MCCL'INTOCK APPERTI } 39 UPLAND STREET 43 UPLAND STREET 49 UP OL?,ND STREET NTS 3: l . `ZONIlVG DISTRICT R4 . I 139.00. CLIFFORD EDMUND , 44-46 MOUNT VERNON STREET i i' GBM SCALE wNORTH MAP 67 BLK. 49 LOT L 845 MAP DEED BOOK 5 989`, PAGE 236 67 EXISTNG PORCHL SEE PLAN#123 L PROPOSED ROOF OT 49-L i . AREA-160 S..F �. 18.3 - 12,640 S.F.s.f. va MAP 67 _1L@ , f LOT 50. co ,.LjL° MAP 67 ' L .2.STORY DUPLEX < , M LOT 48. 1 N\F _ L 18:8' LL`L MOOD F. %. oo NSF : -' D WII-INNS;MARILYNIVIARILYN E. 36 MOUNT VERNON, ll STREET ISE.,#44=4b 37=39 FURBER STREET d 42' 54:1' 1 i - THE OFFSETS SHOWN`ARE FOR THE USE OF THE BUILDING:INSPECTOR, E N: ONLY AND SUCH USE IS FOR THE DETERMINATION NATION OF ZONING . M CONFORMITY OR NON-CONFORMITYWHEN CONSTRUCTED. ' I DECLARE,THAT THIS PLAN AND SURVEY WAS DONEIN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL STANDARDS FOR THE PRACTICE OF - 1 LAND SURVEYING IN THE COMMONWEALTH:OF.MASSACHUSETTS. . 1.2.20, THE LOCATIONOF THE BUILDING AS.SHOWN HEREON EITHER WAS IN COMPLIANCE WITH THE LOCAL ZONING BY LAW IN.EFFECT WHEN CONSTRUCTED(WITH RESPECT TO SETBACK MOT�lrT �+ REQUIREMENTS ONLY) ORIS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS ! U T vER�T ON s�ET G.L. TITLE VII BUILDING CHAPTER 40 E . A SECTION 7. LEXAR:IEDMUND'CLIFFORMPLAN.DRG.PLAN.DRG _ {a��Y,rn ka sya TO"OF NORM ANDOVER }°- •- °� OFFICE OF Td BUILDINGDEPARTMENT o� .1600 0sgood Street Building 20,-Suite 2-3 6 yqs c+tusNorth Andover,Massachusetts 01845 Gerald A.Brown Inspector of Buildings Telephone(978)68$-945 HOMEOWNER'LICENSE EXEIv1PTION - Fax (978)688-9542 ""DING PENT APPLICATION i Please Print DATE: JOB LOCATION: '71�' S Number Street Address Ma �OMEOR NER /t': j /N-1q�P , of GJ-'/Name. Home Phone Work Phone PRESENT MAILING ADDRESS �� / 5—g . State zzip Cod.. The current exemption,for"homeowners"was extended to to allow su;b homeo;d - � � b include owner-occupied dwellings to UVO units-or less and ue�s to en 1e,an individual•for hire who does notpossess a license,provided that the Domer acts as supervisor). Safe Building (Code Section 708.3.5.7) DEFINITION OFROMEOWNER Persons)who gwus a parcel of land on which he/she resides or intends to reside, be,a one or two faintly structures. A pars on which there is,oris intended to considered a homeowner. on who constructs more that.one home in a two-yearperiod shall not be The undersigned"homedwner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and-regulations. The undersigned"homeownez"cerifies 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 i APPROVAL OF BUMDING OFFICIAL Revised 7.2009 Form Homeowners Exemption I • '130ARD OF APPEALS 688-9541CO]�3ER�r T ` • ATION 688-9530 HEALTH 688-9540 PLATINMG 688-9535 The Commonwealth of Massachusetts07 - - Department of IndustriglAccidents Office of Investigations 600 Washington Street Boston,MA.02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Buil.ders/Cont°actors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name(Business/Organization/lndividual): MC-1 t`,D l i Address: /-/v V � � ` —TGA /- City/State/Zip: o u ' � bene#: f 6�l—D S—:? Are you an employer?Check the appropriate box: Type of project(required): general contractor and I ` 1.❑ I am a employer with 4. ❑ I am a g 6. E]Now construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ T am a sole proprietor or partner- fisted on the attached sheet. �• F1 Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workerscomp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.F1 Electrical repairs or additions required.] officers have exercised their 3. I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions mys elf.[No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance .re uiredemployees.[No workers' required.] 13.❑Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showingtheir workers'compensation policy information. t-Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one=year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi rider the pains and p lit s of perju that the information provided above is true and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express orimplied,oral or written.,, An employeiis defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the 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 employer." MGL chapter 152,§25C(6)also states that"every state or Ideal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the 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(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retained to the city or town that the application for the permit or license is being requested,not the 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 line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Comx4onwaith of MassachvsPtts Department of JAdusidal Accidents Office of I1westigat>!ons 604 Washington.Street Boston,,MA,02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax#617-727-7749 WW-Mass.govfdza `-1 1MD'j AF V4MO'k 1. Y f 1 �» f i ' 1 �r et I t 1 1�Li y � 041 ver I 1 i i { `�`l 'Movwf. y eroa n 'S trecT S Locations No. f 01-3 Date .� F NORTH TOWN OF NORTH ANDOVER �ti _ O0 -------� A Certificate of Occupancy $ �- : Building/Frame Buildin /Frame Permit Fee �ss�eMusEt� Foundation mfr it Fee $ Other F iMfKit'F et� $ d °u Sewer Connection Fee $ e Water Connection fee $ TOTAL $ Building Inspector ^� 7269 Div. Public Works PE9111T NO. /0 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. AGE 1 MAP 4d0. LOT NO 12 RECORD OF OWNERSHIP IDATE BOOK PAGE ZONE SUB DIV. LOT NO. I LOCATION ,/ �d� e e A ,p PURPOSE OF BUILDING 1��X 1a OWNER'S NAME l�' /)lJ; y •/T /ych NO. OF STORIES / CSIIZZEE. OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME 7 T T SIZE OF FLOOR TIMBERS 1ST J f 2ND 3RD BUILDER'S NAME SPAN –�—�� DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET ,61 �X.� '" POSTS DISTANCE FROM LOT LINES – SIDES _�fR/ REAR � 10, X GIRDERS AREA OF LOT/J �� C(J FRONTAGE L/® / HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING .1b /° gg Jf r e Few IS BUILDING ADDITION MATERIAL OF CHIMNEY 7 IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 1y IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY y IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT.AT, i l EST. BLDG. COST PER ROOM 9-4 PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE "ED BOARD OF HEALTH SIGNATURE OF OWNER OR A HORIZ AGENT F E E O OWNER TEL.# PLANNING BOARD PERMIT GRANTED CONTR. TEC.# o? t9 L CONTR. LIC.# BOARD OF SELECTMEN . �� BUILDING INSPECTOR I AA I BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S IEs THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 I 2 13 _ CONCRETE BL'K. PINE _ BRICK OR STONE HARDW D —_ — — PIERS PLASTER DRY WALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M'T AREA '/, 1/1 '/, FIN. ATTIC AREA _ NO 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN — I 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH ASPHALT SIDING HARDVJ D _ ASBESTOS SIDING _ COM&AGN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY ST TUCKCCO ON FRAME BRION MASONRY ATTIC STRS. 8 FLOOR _ ' BRICK ON FRAME I - CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR — ADEQUATE NONE 5 ROOF 10 PLUMBING -� GABLE HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) — FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN, TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS . '7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE C _ JOB LOCATION_ y D Number Street Address Section of town HOLIEOWNE.R �� L � '� / A��-z, Name Home Phone Work Phone PRESENT MAILING ADDRESSy�f,�I- G��'Ca� �'7� /lam �n��✓P�' City/Town State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six 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 109 . 1 . 1 ) DEFIi1ITI0N OF HOMEOWNER : Person( s ) who owns a parcel of land on which he resides •r intends to reside , on which there is , or is intended to be , a one to six family dwell- ing , attached or detached structures accessory to such use acid/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed under the building permit . (Section 109 . 1 . 1 ) �� ' ante with she bil it for compliance' �- ned Homeowner assume., responsibility The unde_ s�g State Building Code and other applicable codes , by-laws , rules and regulations . _ The undersigned "homeowner" certifies that he/she understands the Town oL ;worth Andover Building Department minimum inspection procedures and recuirements and that he/she will comply with said procedures and e�UIr ements . AP? ,O`Y.�.L OF BUT LDI:IG OF.ZCIAL `Ion_ . Three fam- dwellings 35 . 000 cubic Feet , or Larger , will be _ c^il__ c^ �O ccmo ',with State Building Code Sect-on 127 . 0 , Construe - -on Cc-_ .rot E � i i I Cd 6 - _ rn PUT .� W1L LAND X --- NOTE: This plan prepared j d—•- VOZ-7N Aticcv,6for- mortgage e, AV.OSS, purposes only. Daa= -V000kGE/yjBEet ZZ, /983 �drV., �Z. NOTE : I certify that the Z dj offsets to this existing ScOI*I A! feet to on inch `'3' foundation are. in compliance with the Zoning QST SURVEY ASSOCIATES, INC. Laws of'" the Town' of North Pknws - Engineers - Surveyors Andover. Old Nashua Road, Amherst, N. N. 5-3-84 NOTE : See Plan No . 123 . • NOTE : I certify th this existing lot is not located within the FIA Flood Hazard 1 Boundary Area. \ 12-28-83 •i CHARLES R CD TIEDEMANNI f J�. No. 2G103 Z7 o �EC1ST Q. 1s_` /p�rAl LAK�.C�Y KS Z , .� % CA � 1 Z8•a— n�� ,` I v 4Z,v a_ l%Paar�: ii 21.85 AORTH ® Of Andover 0 No. L A E Ori dowe19 r, Mass., /�'1 I� .� COC MIC new ICK ADRATED P?�'�4%,�5 .7 BOARD OF HEALTH :a' Food/Kitchen Septic System r BUILDING INSPECTOR . f THIS CERTIFIES THAT..........&O.O.00r..... ... ; 4 .. Foundation has permission to erect....j#.4C �...... buildings on ..4.V f. 1. .....e. .. !.... Rough F to be occupied as..... ....Arled. .404ce.4r.............................................................. Chimney 4 provided that the person accepting this permit shall in every respect conform to the terms of the application on file in .Final ,= 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ........ .:..... .. ... ...... ....<....:....... ........ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT