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HomeMy WebLinkAboutMiscellaneous - 21 BELMONT STREET 4/30/2018N O`Or, 0D m zi e-' FORTE[ ANDOVER BUILDING DEPARTMENT 1600 Osgood Street North Andover 'I`& 978-688-9545 Fax: 978-588-9542 .BUSINESS FORT FOR TOWN CLERK DATE: NAw. G cv, ADDRESS; 9 L rte,. 0 n, d ZONINGDISTBIEOT: TYPE- OF BUSINESS. V" t K � (yG �-- C -i e, BUILDING LAYOUT PROVIDED: YES NO AVAILABLEPAR.EsING SPAMS: ZONING BY LAS- USAGE: YES ' NO EURDING INSPECTOR. SIGNA'TUPX BUSINESS FORM POP-MWN CLERK 2.49 Home Occupation (1989132) An accessory use conducted within a dwelling by a. resident who resides in the dwelling as his principal, :. address, which is clearly secondary to the use. of the -building for living purposes. Home occupations shall 'incIiide, "but "not 'limited to the following uses; personal services such as furnished by an artist or instructor, but not occupation involved with motor vehicle repairs, beauty parlors, animal kennels, or the conduct of retail business, or the manufactu nig o�goods, which impacts the residential nature of the neighborhood 4. For use of a dwelling in any residential district or multi -family district for a home occupation, the following conditions shall apply. a. Not more than a total of three, (3) people may be employed in the home occupation, one of whom shall be the owner of thd home occupation and residing in said dwelling., b. The use is carried on strictly within the principal building; c. There shall be no exterior alterations, accessory buildings, or display which are not customary with residential buildings; - d. Not more than twenty- five (25) percent of the existing gross floor area of ;the dwelling unit. so used, not to exceed one thousand (1000) square feet, is devoted to 'such use. In connection -with such use, there is to be kept no stock in trade, commodities or products which occupy space beyond these limits; e. There will be no display of goods or wares. visible from the street; f The building or premises occupied shall not be, rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other way become objectionable or detrimental to any residential use within the neighborhood; g.. Any such building shall include no features of design_ not customary in buildings for residential use. §ignature zi Date North Andover MIMAP December 3, 2014 ,Ol)8�O�OOf72 32 MAY T 018.0-0 34MAY ST 0118?0-0004' f53 MrAY:ST &0 foo olsx'aoa%i GB Ol(8t0�0005 99 . 18 X38 MAS' ST' 1,80001 0015: '0181. :0-006 so A1�8?Q?O.OQ9J X52 MAY ST 0180-00�'� BELMONT ST ; X58 MAY $T ;018�01001�7 Ol'�8� 0.0(ff WJ4 64 MAY ST ,0181000188 _. tonts�a�000� � O1r8�0°0019� * — 27B MONTjS�T* y 2r7 LM < NT ST 018�0�0020 ,BE 29IBELM0�7 ST Slee 01-002 �p��< X96 BE��M`ONT STS �01'80002d qd .fie, 5Q p018''0�-0026' _ ¢35'BELMON1T�SiT �9�8 BELMONT�S� ,00 ,01)8x.00025 < 01810-0024' X018?0-003.0, 0180 L 81 0023 E MO;i!IjTS�T — Rail Line - -- Wetlands Zoning - - Interstates - 0 Exempt Lands _ I 0 Busine B Busine s 1 District s 2 District - - - ' Horizontal Datum: MA Slateplane Coordinate System, Datum NAD83, — SR - - - 0 Busine 1 Busine s 3 Distnct - - s 4 District - 14ORTh Meters Data Sources: The data for this map was produced by Merrimack Valley Planning Commission (MVPC) using data provided by the Town of --- Roads � r Easements Gene 0 Planne - 13 Corrido Business District - OR ct C -�ti Commercial Dev. 1 : ?-'� r��e O� � Development Dist - North Andover. Additional data provided by the Executive Office of Environmental Affairs/MassG15. The information depicted on this map is Q MVPC Boundary Q Municipal Boundary - Zoning Overlay - 0 Corrido 0 Corrido Industn 3 G Development D st O R Development Dist - h 9 I 1 Distnct - for Tannin purposes on It may not be adequate for legal bounds planning p y g boundary definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR Adult Enlenainment Q Downtown Overlay District Q Historic Dislricl - � Et Industn - 0 Industn13 0 Industn 12 Dlstriq « # _ • t , o District - * o d ♦ I S District - 1y r<•<.+ SUITABILITY OF THESE DATA, THE TOWN OF NORTH ANDOVER DOES NOT ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF ® Water Protection G• Reside ce 1 District - . 'f7.9 o'��tlu ♦N'S.(�J THIS INFORMATION ❑ Parcels. 0 Residei {m Pa lde ce 2 District Sg^�NUgQ ce 3 District - 0 Hydrographic Featuresde 1" = 50 ftde +Ede ce 4 Distnct -5Distnct — Streams ce 6 Distnct ... `.,,,age esidential District - - Location a Vh Off+ Nod Date �� 5 MORToy TOWN OF NORTH ANDOVER Certificate of Occupancy $ y �.-- . Building/Frame Permit Fee $ �'�b'••"''t�' Foundation Permit Fee $ Sswc"us t Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ —' TOTAL $ a S� Building Inspector 12 5/98 10.10 25.00 RAI;: Div. Public Works Location 1 't -� - _ L� Nth. Date ! /v�517C3` TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee Water Connection Fee TOTAL r r.1R05/98 10:10 25,00 tf t Building Inspector Div. Public Works Q tom. � z U � z 4 Z_ C Ci d Z C l ti N a w _ N LU � F a J u O C3 - w G r� j QQ cu z � C - z vi Z Cz M LU N V) 1 Z iu •� w Fm.. T �. •— N J F- X ¢ V Q z Z < 'Q ^- Z ',' :�, — — — - ?, a, w T a - C z � F:+ z z — Q w ¢ w N Q u \ C a 3 w C S LU o o z s N C w = y C w rM. Z Z mm � ^ N ^ t= Z C wLU M V� n Z 0u ZZ ZZ ZZ }t Z u U z ti yc z z Z_ 2 O O G ¢L _L � Z C � � ►r w QVIJ Q, w 0 < z z 1� "J z LU w w x - > Z ',.u, w m mn s z zuz. Z Ln r W W61 A J Z N Z z z z z 1 2 �l Z z z Z Z Z C Z Z < 2 t - u. C' n z LU 0. 6uU �' U ( u 9 0] Q w w z z w a U t tom. z U � z 4 Z_ C Ci d Z C l ti x L a w _ N LU � F a J u O C3 - � 4 1 Z C Z C x L z c; Z w G r� j QQ C - z vi Z Cz M LU N V) 1 Z iu •� w Fm.. T �. •— ` J — ¢ V Q z Z < 'Q ^- Z ',' :�, — — — - ?, a, w T a - W.; s. �C c r- o ox m c p O N •—Q C 40 p F x cA da V � W. a cx U z Q w° L o°G c U c x w a n°' coW w c� w :L o c7 w occ °�° 0° ro ii w w w w v rte Z -b cn o cn ;9 R' O C) O Z 0 D CO) y co COCL C O :..3 m CL y 0 V 7 . CO) c 0 cc CO2 w L O v co CL H C O p� C Oco C m m E= s ev a 3� �o co 0 Q O C. C. 4 4-0 3 c 1CIO0 Z w CL C C u c r- o m c p O N •—Q C 40 p ac me :L o occ m a o _ •- ts c E '�O m o� 3 N ' C � fl CO L C N C y W 0+ N CD r �L cv CLCJ L: ,Ay O m t = O O> Qf p c = N a a== m O m � N p Z 0 Cp. O cm C N ~ �+p+ p ~ m W c N m wp•. � Z p •ca �L _ J- C!.= .r ac *E d CS,N Z a Qo Q CA m� p� S /N 0 m .p.. �= � � CL*- R' O C) O Z 0 D CO) y co COCL C O :..3 m CL y 0 V 7 . CO) c 0 cc CO2 w L O v co CL H C O p� C Oco C m m E= s ev a 3� �o co 0 Q O C. C. 4 4-0 3 c 1CIO0 Z w CL C C u / , w _...._-.._... .5, t License or registration valid for individual. f use only before expiration date. If found return to: One Ashburton Place Rm 1301 Boston Ma. 02108 I Restricted To: 00 00 - 35,000 cf enclosed space (MGL C.112 S.60L-) 1A - Masonry only 1G - 1 & 2 family Homes Failure to possess.a current edition;of the Massachusetts State Building Code is cause for revocation of this license. �I rr HOME IMPROVEMENT CONTRACTOR W� Registration 111848 Type — DBA Expiration 02/04/99 STONE CONSTRUCTION &i IAM H. STONE 04 CLARK ROAD ADMINISTRATOR TEWKSBURY MA 01876 TENKSBURY, MA 01816 DEPARTMENT OF PUBLIC SAFETY CONSTRAJOR SUPERVISOR LICENSE Birthdate: Nuaber Expires! A 7 06/11/1952 GS 123 6/102000 e 00 TENKSBURY, MA 01816 iN PER -Al Wo.. �V APPLICATION FOR PERMIT TO, BUILD --NORTH ANDOVER, MASS. PAGE 1 MAP K -4O. Q i a . LOT NO. I .2 RECORD OF OWNERSHIP IDATE BOOK -'PAGE ZONE SUB DIV. LOT NO. 1 LOCATION P II/gPOS� OF UILDING(L) N�rJ .-�NIOl yOd OWNER'S NAMEA&gr �� /_ 0. Y L'S HiQ S1tT�O ES SIZE OWNER'S ADDRESS -1.v Z3 .L �QKL L7 T BASEMENT ORS ARCHITECT'S NAME _ SIZE OF FLOO IMBERS IST 2ND 3RD BUILDER'S NAME �T I L � SPA DISTANCE TO NEAREST` BUILDING DIME IONS OF SIL '� POST DISTANCE FROM STREET I DISTANCE FROM LOT LINES - SIDES EAR GIRDER _ t AREA OF LOT FR NTAGE HEIGHT OFF UNDATION THICKNESS IS BUILDING NEW iZE OFrFOOTI X IS BUILDING ADDITION M TER7AL OF CH NEY IS BUILDING ALTERATION CAI &-I, L dolV TCO 1 BUILDING ON SON O 1D OR ILLED LAND WILL BUILDING CONFORM TOR QUIREMENTS O G G BUILDING CONNEC TO TOWN WATER ::1 .• BOARD OF APPEALS ACTION. IFA Y IS BUILDING CONNE ED TO TOWN SEWER IS BUILDING CON ECTED TO NATURAL GAS LINE IN I RUCTI NS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED %\112 -AL SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED 9k4le1_ Ir KIP` 1 2 `- 3 PROPERTY INFORMATION LAND COST EST. BLDG. COSS IS 26 .Of EST. BLDG. COST PEft SQ. FT. - EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OUILDING INSPECTOR OWNERTEL.N 360—G83— 11 V7 CONTR. LIC. # 0 Z 1 > lyaa H.I.C. � 11160 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES 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. I fe 'V'%c. ^14%i r,W�v i7 GOV S -A a OCcti F- jf l _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH d t 2 I3 PINE CONCRETE CONCRETE BL'K. BRICK OR STONE —{ HARDW D PIERS PLASTER DRY WALL UNFIN. 3 -- _"BASEMENT AREA FULL '14 1/1 '/, FIN. 8'M'TAREA FIN. ATTIC AREA _ N_O B M'T FIRE PLACES _ _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRY STUCCO ON FRAME B 1 2 3 _ _ CONCRETE EARTH HARD\'J'D COMMON ASPH. TILE BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BILK. WIRING STONE ON MASONRY STONE ON FRAME- ' - SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF, 10 PLUMBING GABLE GAMBREL I HIP MANSARD BATH 13 FIX.) 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_ 1 sf I 3rd ELECTRIC NO HEATING I fe 'V'%c. ^14%i r,W�v i7 GOV S -A a OCcti F- jf l a � I 1 14 Y 0 4. 0 m" W F- O_ N X a � f N W W Z e Z 0 p m i a W L 0 0 Z W m �' g o I N L z ca 0" H F� X W d � s Z iA 0 Q Z F � 0 Z O 0 J UI 0 K M O Z N F YI N a W ID f Ir 0 0 4 4 0 W N m Z 6 N O _z O J Nm h N W C W< :EW ZZ 0 N K U W Z O J F: N m O 0 W ] < h z 0 rc IL I 0 9 O z J O W J J ZL K 0 O J 0 N z O a Z O J ] m' N T A O N 40 :EN N � Q1� s W C i 1 9 M :QQr1 K 'Pbcr r T O O (\[�, ~ W < O O Z Z Z < 4W O 0Ix W iz � 0 u 6 ` L O rn m r W< Y� W W p (L Z U z z C 6< u a 0 W V F J oc cc a z 0 O z° 0 O 7 `' Z N 3 O O W m Q 3 o 0 o v Ci C1 S J WI 7 0 K M O Z N F YI N a W ID f Ir 0 0 4 4 0 W N m Z 6 N O _z O J Nm h N W C W< :EW ZZ 0 N K U W Z O J F: N m O 0 W ] < h z 0 rc IL I 0 9 O z J O W J J ZL K 0 O J 0 N z O a Z O J ] m' N T W A O 40 :EN � Q1� s , I i 1 9 M :QQr1 K 'Pbcr r T O ~ W WW O W a 4W L W iz � 0 u 6 ` L O It LW O Y� L t 3 W 3 m< a' a. F. & u �' m m g Jm C 6< u a W W W V F J oc cc a z 0 O z° 0 O 7 `' Z M 3 m W m Q 3 o 0 o v Ci C1 S W A O Z z K Z O ~ W O W a 4. L U O z O J 7 m m z J_ h < ooK U J ] W L W O rc Zzo._. N Z W O Z ° 0 J o ] M W h J ] 0 W W V IA °� O WN Z f m C > M N p d Z lx 0 O < 7 u z Z m ° O O N z C W W I J_ Z O O J J.. W fi A to W O W 4 LL U W. Z J ] m N F F X U m LL W W U < L W -< L O U YI A O H z K O ~ W W a 4. L 4 r-1 0 rij rij co d. E< 4D aiw O CD cm I- ' ♦.. a c� h � � m %i c ' �+ SCJ m O 'Em m o � acsco e ct� ® � :... .o C c �a a�z m mor �meZ o CIS o cm CL QQ� 04-3 0 v/ Z c z C/) CJ z O W C i. ® C G . C +� O E CD a C.2 ® C y O I � C � O N w `n� V o U w • � cv V d. E< 4D aiw O CD cm I- ' ♦.. a c� h � � m %i c ' �+ SCJ m O 'Em m o � acsco e ct� ® � :... .o C c �a a�z m mor �meZ o CIS o cm CL QQ� 04-3 0 v/ Z c z C/) CJ z O W C i. C G . C +� L E CD •�1 C.2 ® C y O I � C � O N w .0 �= C �CL�m� • � cv d. E< 4D aiw O CD cm I- ' ♦.. a c� h � � m %i c ' �+ SCJ m O 'Em m o � acsco e ct� ® � :... .o C c �a a�z m mor �meZ o CIS o cm CL QQ� 04-3 0 v/ Z c z C/) CJ z O W C .Cc C +� L E CD C.2 ® ca m C3 cm Co o '� y a. m O i w .0 �= C �CL�m� co C3 E CD L _0 V Z CD CL CO2 0 C C cm. CO3 co h m � cc CO L- 0 CD H = CL co �� 0O rCc 0 CK Q. fi cmcc co C .� O = ccC ca 'p G3 c Z c v h cc C c CL H C 0 ON r-4 D J O c� w o � x O y a 04 C O U ' V V RCCU Jgw v -- ._ C u g -aa • CD C Cdo � 0 w° vii w° C2 U w a°' w w d w rA cn vii D J ., M-10 CD O CD •. L _O v Z CD CL O CO) � C ///I � C C* Q Amy d O E m m 3.a di O C OL o- C a Co •— 'D O CL O .0 Z s CD V ca O C C cc a y o c� o � O y ' C O ' V V RCCU C Ea �: CD • CD C � 0 _ w C. GO . O m y W � So ca co =m o � 'fl j[/ = C y C y O ,t. CO m av m oa C 32 a c z 0 0 ca H O V Z O ca ' CO CL C Q o y 0, •O 2 :mso3 N O. V3 LUO ev = m C v .y „�„ r=... •� H M �E az�C v ;;$ y Z o0 . V! a =..0O- J r m a= o =aM�� ., M-10 CD O CD •. L _O v Z CD CL O CO) � C ///I � C C* Q Amy d O E m m 3.a di O C OL o- C a Co •— 'D O CL O .0 Z s CD V ca O C C cc a y Location a;� hi' timaiJ No. r Date NORTH TOWN OF NORTH ANDOVER f � 0 • ow p �o Certificate of Occupancy $ cNusEBuilding/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee 64e) $ 2S-,00 TOTAL $ I OD Check # I `Z. ! 0 56'6 A I Cu Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: �` C Building Commissioner/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2-02 ae- z /y ON/ 6 /, 1.2 Assessors Map and Parcel Number: Map Number Parcel Number AhI D U V e R Al 4 S S 1.3 Zoning Information: Zoning Disttid Proposed Use 1.4 Property Dimensions: � t7 Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided ReqWred Provided 1.7 taster Sap�ty M.G.L.C.40. 34) Public ; Private ❑ zone 1•S. Flood Zone Information: Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal @� On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHINAUTHORIZED AGENT 2.1 Owner of Record go 6 PRT `�. C /� RR Name (Print) ©/ J a /� L My N % s i �y ✓-I �? �nyP� i'�if� Address for Service: Signa ��/ Telephone q ,) c , G c ` J D o 0 2.2 Owner of Recor -�V o N) a C-. Ci� Name Print A a 01 I z a 0 e LA4o r7 -r s`�; �.�4�� overt Address for Service: M Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address ,f Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Tele hone M M X ic z O Q m O z M 90 ic 0 r M r r a® z G) SECTION 4 - WORKERS COMPENSATION (NLG.L. C 152 § 25c(6) I Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildine permit Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: i4 5T/911 SSX 9 CLeO 1 SF.CTTON 6 - FSTTMATR12 CONCTRTTCTTnN CnQTC I Item Estimated Cost (Dollar) to be3FFl< � F Com leted b permit applicant v� 92 e 1. Building, (a) Building Permit Fee O O O Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) �- 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work. authorized by this building permit application. / G A-Aer Si ratUe of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1,_ As Owner/Authorized Agent of subject property Hereby declare that the statements and information on.the foregoing application are true and accurate, to the best of my knowledge and belief C4&201/ Print Narne Signature' of Owner/ t Date 1 NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TUvIBERS IS 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DEMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY IS BUTI DING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL, GAS LINE. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT_obpt PHONE%S- LOCATION: Assessor's Map Number PARCEL 05 SUBDIVISION LOT (S) R '.J STREET bP L Ann j ST. NUMBER *****************************************OFFICIAL USE ONLY*********************************** RECO MENDATIONS OF TOWN AGENTS: ADZ CONSERVATION ADMINIST ATOR . DATE APPROVED DATE REJECTED COMM TOWN PLANNER COMME FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO Revised 9\97 jm TE Please print DATE 6 — Li C) JOB LOCATION "HOMEOWNER Number A Name PRESENT MAILING ADDRESS City Town HOMEOWNER LICENSE EXEMPTION .1k) -� ) ` Street Address CIgA1-�0/1 Home Phone ✓ti UL— State 18 ,;� S' Map / lot ��- Gffff-/Y�l Work F Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual1br hire who does. not possess a license, provided that the owner acts as supervisor. '(State Budding Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: 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 ac- cessory to such use and/or farm sb udiues_ A person who constructs more the one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements_ HOMEOWNER'S SIGNATURE 7--"' . APPROVAL OF BUILDING OFFICIAL :o s Town of North Andover ' Building Department 27 Charles Street . North Andover, MA. 01845 D. Robert Nicetta .Building Commissioner (978) 688-9545 (978) 688-9542 Fax Please print DATE 6 — Li C) JOB LOCATION "HOMEOWNER Number A Name PRESENT MAILING ADDRESS City Town HOMEOWNER LICENSE EXEMPTION .1k) -� ) ` Street Address CIgA1-�0/1 Home Phone ✓ti UL— State 18 ,;� S' Map / lot ��- Gffff-/Y�l Work F Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual1br hire who does. not possess a license, provided that the owner acts as supervisor. '(State Budding Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: 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 ac- cessory to such use and/or farm sb udiues_ A person who constructs more the one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements_ HOMEOWNER'S SIGNATURE 7--"' . APPROVAL OF BUILDING OFFICIAL :o s C/) m m m U) VJ 0 CO) 10 0 CD O CZ �co O o p IC CL Q c� CD Cl CO) .p O 'C3 C7 C O C CO) Er Cl) co O CD CD CO) CD y I s +� 06 3 r� bC7 :3w cn UQ :5 cm ff O 01 O Z '�rl ac 5.0 0 o ti .� o Z NmaR ._ 3, m s cn �L Zo O a. ? m o m c n� O 0V V O N O --qYx / � � 2. O m N O m • O O ?r ' F4 O Z�•n 5� CD vir CD CD c � c C, m 3 N 7 N N `Q cr C W � a N 1;m :� `V" • A V CD: N O N co ^L m w O n • j0�' O � :b O '� It Q ?m: CD 3 o m% m ns r-- CD CA O C O o_. 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