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PERMIT FOR GAS INSTALLATION
SACHUS
This certifies that .... ............... . ......
has permission for gas installatio . . . . ..
in the buildings ..................
a.A.e ......... North Andover, Mass.
Fee./-51�� Lic. . ..............
Check 4 ���z GAS INSPECTOR
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MASSACHUSETTS-1UNIFORM APPUCA
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FORPEMW TO 00 GASFITTING
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2C�, Permit
Ownees Name-
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ReplacerrmtiC� pWu Submitted. yes[3 N07Cj
Installing Company Name-
Business T
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Name of Licensed Plumber or Gas Fitter,
'INSURANCE COVERAGE.'
I have a c14 flablifty,irmirancepdicy-or Its substartial, equivalett,which -meets the requirements of zMGL!Ch,.;142..
Yes No C1
you have -cheelmdaM&pWan*Wicdi�&*4yM.=vmge-by dackirig the-appwpdat��box
A liablifty Insurance: poky X OUW-tW-,CCM&'mnity 12- Bond El
OVYNER'S INSURANCE WAPM,.,, I am- aware1hat the licensee 4oes -not:have - Ow Irmurance coverage required by
Chapter 142 of the -Ma2L General-1aws. and V*..my signature -on Vft �permit -application waives this requirement.
Check one:
Signature ot-OWPAUWADWV�4 Agent-- OwnerO Agent,0
I hereby cer* that all of the details and information I have submitted (or entered) in above application we true and accurate. to. the best of my
knftfledge and that AN Plumbing Work And ifMIAllatimPerformed under the permit issuW for this application will be in compliance with. all
pertinent Provisions of the Massachuseft State Gas Code and Chapter 142 of the 1!70 Laws.
License:
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Business T
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Name of Licensed Plumber or Gas Fitter,
'INSURANCE COVERAGE.'
I have a c14 flablifty,irmirancepdicy-or Its substartial, equivalett,which -meets the requirements of zMGL!Ch,.;142..
Yes No C1
you have -cheelmdaM&pWan*Wicdi�&*4yM.=vmge-by dackirig the-appwpdat��box
A liablifty Insurance: poky X OUW-tW-,CCM&'mnity 12- Bond El
OVYNER'S INSURANCE WAPM,.,, I am- aware1hat the licensee 4oes -not:have - Ow Irmurance coverage required by
Chapter 142 of the -Ma2L General-1aws. and V*..my signature -on Vft �permit -application waives this requirement.
Check one:
Signature ot-OWPAUWADWV�4 Agent-- OwnerO Agent,0
I hereby cer* that all of the details and information I have submitted (or entered) in above application we true and accurate. to. the best of my
knftfledge and that AN Plumbing Work And ifMIAllatimPerformed under the permit issuW for this application will be in compliance with. all
pertinent Provisions of the Massachuseft State Gas Code and Chapter 142 of the 1!70 Laws.
License:
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TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
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This certi es that . .. ..... ...... ....
has permission to perform .......
plumbinginthe uilding-of..0-'l-.'?):'& .........
at ................. North Andover, Mass.
F e e L i c. N o. . ..............................
PLUMBING INSPECTOR
Check # 7,11�7 �z
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MASSACHUSE.1 I UNIFORM A
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Bufting I oca ion
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FLICATION FOR PERMIT TO DO PLUMBING
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FIXTURES
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Aftew,--�(4LI - (Z'
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A NWO Of UCSnSed PlumbW '—"� L -Lev% �
PRIM AckLat'rN
DOURMCE-COVERAM
I have a cment liability policy or its =AntaMW equivalent which m a apt the requirernents of MGL Ch. 142.
Yes A No C3
If you have dwftW Yes, Please indicate the type coverage by checklng the appropnate bar
A liability mmmknce policy -g 011w type of kxmmnity . 13 Bond 0
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OWNEWS INSUPANCE WAWM I am aware #m me licensee don not have tft SUrance
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DOURMCE-COVERAM
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Yes A No C3
If you have dwftW Yes, Please indicate the type coverage by checklng the appropnate bar
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Zoning Bylaw Review Form
Town Of North Andover Building Department
27 Charles St. North Andover, MA. 01845
Phone 978-688-9545 Fax 978-688-9642
Street:
L/
Requil!15 -s//&2>
DateA
Please be advised that'after review Of 'yoUrApprication"AfidPlAfis yd6r Apolitation is
APPROVED / DENIED for the following Zoning Bylaw reasons:
Kernedy for the above is checked below.
Item # Special Permits Planning Board. Item # Variance
Site Plan Review S�e—cial Permit c V
Access other than Fron �tano . ... . . ...... Setback 6ariance
r-luinage =cepiion Lot special Permit
Common Driv�vvay Special Permit
Lot Area Varia -e
Permit
Height ariance
Variance for Sign
Continuing Care Retirement Special Permit—
ja4tRendent Elderly Housing Special Permit
Special Permits Zoning Board
Special Permit Non-ConfoTmiMn2�e
Large lz state Condo S Decial Permit
ZBA
Earth RemoVa Special Permit ZBA
Planned Development District Special.Permit
Planned Resident
ial Special Permit
Special Permit Use not Listed but Similar
R-6 Density Special Permi
Special Perm' for.Rign
Other
Watershed Special Permit
Su I Additi )nal Information
i -'3 ) e-� 4 to
0 A) C 0 k-9 014 #' PA I Ut 1":�td, .14
The above review and attached explanation of such Is based on the plans, request for or Information submitted. No definitive —
review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant
serve to provide definitive answers to the above reasons for this action. Any inaccuracies, misleading information, or other
subsequent. changes to the information submitted by. the applicant shall be grounds for this review to be voided at the discretion
of the Building Department. The attached document titled "Plan Review, Narrative" shall be attached hereto and incorporated
herein by reference. The building department will retain all plans and documentation for the above file.
c2 —
5;tdin Department Official Signature
Application Received Application Denied
Denial Sent: If Faxed Phone Number/Date:
COW- . I
Plan Review Narrative
The following narrative is provided to further explain the reasons for the action on the property
indicated on the reverse side:
Referred in!
Hea6
7V M
r 4!' gug "A. M, O"d,
M1,11 7
�17
ON I'M -M,
.............................. . . . . . . . . . r, SO! "M
AO P -e e- Y4
Police oning Board
Conservation Department of Public Works
Planning Historical Commission
Other BUILDINO DE-ff-
604111-1-lAued ZI
X
Referred in!
Hea6
Police oning Board
Conservation Department of Public Works
Planning Historical Commission
Other BUILDINO DE-ff-
7-; -D.J� ... TN---*-v%f%^^
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1 HEREBY CIRIVY To T" TIMC JKSUROR JMD
TO ME Z"K 7MT WX DFILL[Ho IS LOCIT
THE LOT AS SHONY AJVD TMT 17 DoIrS 'ED jW
COMPORIf
Rsumma"--" ZOMW ARCULATrOMS
WITH THE
NJC.rBACrS PROM STRUVS k LOT LrNCS._
1 FURTHER CIRTLPY TMF rM DVILUAro IS A . rol.
LOCATED N TMR FLOOD HAZARD AREA AS
suo pw ON 17 PAMM i
SVEPHAY-
DATE
THIS PLAN
BOUNDARY HOT FOR
Boum&Rr womarjom
TAKEN FROM EVSMo jacoRm.
/9 ?If -14
PLOT PLAN
IN
DRAWN jnR
1 MERNMACK RX1911VEERING ISERMES
Gil PAM STREET
ANDOVER, MASSACHUSE27S 01810
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUC-F REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMT NUMBER: DATE ISSUED:
SIGNATURE:
Building Comrrtissioner/12N�Extor of Buildings Date
SECTION I- SITE I-NFORKATION I
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
2.1 Ow f Record
n /I
11.0V
Name (Print)
7-)
A<
Z6, -S 1
Address for Service:
Iq I& P,4?,
2.2 Owner of Record:
Name Print
Address for Service:
Signature Telephone
Map Number
Parcel Number
1.3 Zoning Information:
1.4 Property Dimensions:
1-f
Expiration Date
0%, C)
Lo 0
Zoning Dikrict Proposed Use
Company Name
Lot Area (sf)
Fr-tage (ft)
1.6 BURDING SETBACKS Lft)
Expiration Date
Front Yard
Side Yard
Rear Yard
Required Provide
Required Provided
Required Provided
L3
1.7 Wt. �;.G.L.C.40. 54)
1.5. Flood Zone Information:
1.8 S�� Disposal System:
;71�y
Public Private 0
zone Outside Flood Zone 0
municipal On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT
2.1 Ow f Record
n /I
11.0V
Name (Print)
7-)
A<
Z6, -S 1
Address for Service:
Signatuie lelephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature Telephone
Not Applicable fr
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable 0
Company Name
Registration Number
Address
Expiration Date
Signature Telephone
I SECTION 4 - WORKERS COMPENSATION (XG.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 building permit.
Signed affidavit Attached Yes ....... 0 No ....... 0
SECTION 5 Description o Proposed Work (check applicable)
New Construction 11
Existing Building V
Repair(s) 0
Alterations(s)
Addition 0
Accessory Bldg. 0
Demolition 0
Other 0 Specify
Brief Depscs'ption of Proposed Work:
SECTION 6 - ESTLVIATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed b ermil appl ant
ic
CIA
I . Building
(a) Building Permit Fee
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)
fo, r-) SZ�T 1
Check Number
SECTION 7a OWNER AUTHORIZATION'TO BE COMPLETED WHEN
OWN ENT OR CONTRACTOR APPLIES FOR BUI]LDING PERMIT
1, V as Owner/Authorized Agent of subject property.
Hereby authorize to ac Qn
My behalf, in all e ative orized by this building permit application.
Signatitr&;rOLA,iiedrll>�� Date
SECTION 7b 9M�NER/AUTHORIZE"GENT DECLARATION
1, Z/�O� 0 as Owner/Authorized Agent of subject
property If
Hereby declare that the statern information on foregoing application are true and accurate, to the best of my knowledge
and belief ttt; '�')
Print Nai��
Ag— ke—
of Owner oent Date
Mature
now=.— i—MEMIMEM
NO. OF STORIES J�N6 SIZE
BASENENT OR SLAB fJV-r
SIZE OF FLOOR TUvMERS 'X16 2 N5 -ZY10 3 RD
SPAN
DMENSIONS OF SIILS
DINENSIONS OF POSTS 92
DU\4ENSIONS OF GIRDERS 9;' 1-1
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING U W 1�/q ow X
MATERIAL OF CHRvJNEY C�m U
IS BUILDD�G ON SOLID OR FILLED LAND
IS BMDING CONNECTED TO NATURAL GAS LM Q
m i HERsyr unrin ro nm rmLr jvsuRoR Am
M rRr AUK Mr 'a
M J)WZUMG IS LOCAM Off
WE LOT AS SHOW AMD rMr 17 j)ORS
WITH THE ZOMNi; UcompoRjf
r
,ULA ffojVS
Jwa4RDl'vo szrjucjm PJwm Mars & Lor Lrmzs.m
" 1 PURTHRR CRRTIPY Mr MIS DMUVr, jS yor
LOCATED 'W MR F&DEML FLOOD HAZARD AMU AS
SHOWN ON Pf PAMM
67 -
.A�
00
S. DA TE
THIS PZ" )I' Nor FOR
nxv)%Wj�E�s'rs
BOUNDARY w
N. Bomar xFoRwvjj)m
TA"M FROM MUSTWO RZCDRM.
SW ev
PLOT PLAJV
IN
1\
DRA WV Fi)R
1 MEWMACXRNClVE.EWvjg SERVICES
86 PARK STREET
ANDOVER, MASSACHUSETTS 01810
Q. Robert Nicetta
Building Commissioner
(978) 688-9545
":(978) 688-9542 Fax
Town of North Andover
Building Department
27 Charles Street
North Andover, MA. 01845
HOMEOWNER UCENSE EXEMPTION
Please pri '
DATE �IVZM
3 qc,
JOB LOCATION 2-4
Number
"HOMEOWNER
Nam4
PRE
,JINT MIAILING ADDRESS
City Town
Street Address
Home Phone
State
40, ON
* 04
Map / lot
Work Phone
The current exemption for "homeowners" was extended to include owner-<=upied dwellings
of two 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 108.3.5. 1)
DEFINITION OF HCMEWOWNER:
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 structures. A person who constructs more than 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 "hcmeowner"certifies that he/she understands the Town of ��A�dovjer_
Building Department minimum inspection procedures and requirementsafmffiat he/she will
comply with said procedures and requirements.
HOMEOWNER's SIGNATURE
APPROVAL OF BUILDING OFFICIAL
e
Town of North Andover
Building Department
27 Charles Street
North Andover, Massachusetts 0 1845
(978) 688-9545 Fax(978)688 -9542
DEBRIS DISPOSAL FORM
ttORT
,,_I D
0
'? ?.kV
ACHU
In accordance with the provisions of MGL c 40 s 54, and. a condition of
Building permit # the debris resulting from the work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL c 11, s156a.
The deWs will be dRvosed of in /at:
FA
Facility location
Signature
Date
NOTE- A demolition permit from the Town of North Andover must be obtained for thifs
project through the Office of the Building Inspector,
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Zoning Bylaw Review Form
Town Of North Andover Building Department
27 Charles St. North Andover, MA. 01845
Phone 978-688-9546 Fax 978-688-9542
Street: 3
Is U
Map/Lot: / /1-1
_551UU81d
Applicant p- V
0- so
Request:
Lot Area
Date:
F- VC150 Low auvised thist aner review Gr your Application4nd Plans Ydijr Apolkatibri is
APPROVED / DENIED for the following Zoning Bylaw reasons:
Zoning
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Item
Notes
_551UU81d
Item
Notes
A
Lot Area
q1JMH
F
Frontage
I
Lot area Insufficient
I
Frontage Insufficient
2
Lot Area Preexisting
Ll e-
2
Trontage compiies
3
4
Lot Area Complies
Insufficient Informa—tion,
3
Preexisting frontage
Insufficient Information
Lj eS
B
Use
5
No access over Frontage
I
Allowed
e- S
G
Contiguous Building Area
2
Not Allowed
I
Insufficient Area
3
Use Preexisting
2
Complies
4
5
Special Permit Required
Insufficient Information
3
4
Preexisting CBA.
Insufficient Information
C
Setback
H
Building Height
I
All setbacks comply
1
Height Exceeds Maximum
2
3
4
Front Insufficient
Left Side Insufficient
Right Side Insufficient
2
–i—
4
Complies
-Preexisting Height
Insufficient Information
5
Rear Insufficient
I
I Building Coverage
6
Preexisting setback(s)
Li e-
1
1 Coverage exceeds maximum
7
D
1
Insufficient information
Watershed
Not in Watershed
2
3
4
Co erage Complies
Coverage Preexisting
Insufficient Information
Lfe
2
In Watershed
j
Sign
3
Lot prior to 10/24/94
Sign not allowed
4
5
Zone to be Determined
Insufficient Information
3
Sign Complies
Insufficient Information
E
Historic District
K
Parking
I
1—
In District review required
I
.
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Plan Review Narrative
The follom(ing narrative is provided to further explain the reasons for the action on the property
indicated on the reverse side:
Location c>2 to 3 fy� A �,S A, u --- —
N 6. Date -C� to -00
TOWN OF NORTH ANDOVER
0.
Certificate of Occupancy $
Building/Frame Permit Fee $ W,
CHU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 10
141.01 9 J Building Inspector
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TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
'g�
WELDING PERM[IT NUMBER: DATE ISSUED:
SIGNATURE:
/V (CaA--
Building Commissionerfl!!4=to' of Buildings Date
SECTION 1- SITE INFORMATION
1. 1 Property Address:
A
1.2 Asssessors Map and Parcel Number:
zx�' , /OY2
Map—Number frarcel Number
1.3 Zoning Information:
Zoning Di�-r ict Proposed Use
1.4 Property Dimensions:
Lot Area (so Frontage (ft)
1.6 BUIELDING SETBACKS (ft)
Front Yard
Side Yard
Rear Yard
Required Provide
Required Provided
red Provided
1.7 Water Supply M.G.L.C.40.1 54) 1.5. Flood Zone Information:
Public 0 Private 0 Zone Outside Flood Zone 0
1.8 Sewerage Dispo sat System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSEUP/AUTHORIZED AGENT
2.1 Owner of Record
I DAVI 5'
Name (Print)
CO)S41 726 60joj
Address for Service
Signature
Telephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature
Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor-
Licensed Construction Supervisor:
313 ")rce-576-
Address I D�;4�
'"an'
Sigiia—ture
5+1 H%&U1 lbw -
6in 2 373-2-d?z-
Telephone
Not Applicable El
c (0- S(
License Number
Expiratioti Date
3.2 Registered Home Improvement Contractor
Not Applicable 0
Company Name
Registration Number
Address
Expiration Date
Signature
Telephone
0
z
M
go
0
on
M
G)
I SECTION 4 - WORKERS COMPENSATION (MLG.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 building permit.
Signed affidavit Attached Yes ....... 0 No ....... 0
SECTION 5 Description o Proposed Work applicable
New Construction 11
Existing Building X
Repair(s)
Alterations(s) [I
Addition 11
Accessory Bldg. 0
Demolition 11
Other 0 Specify
Brief Description of Proposed Work:
RemovQ VROGT'...
Remoae-1 Llc�c?n 41 44A 8 1,00pi S.
SECTION 6 - ESTIM[ATED CONSTRUCTION
COSTS
Item
Estimated Cost (Dollar) to be
Completed bypermit applicant
�'OFFVC—IAL'U�E
1. Building
Cg
(a) Building Permit Fee
Multiplier
2 Electrical
13 C.)
(b) Estimated Total Cost of
Construction
3 Plumbing
/0 Go
Building Permit fee (a) x (b)
4 Mechanical (HVAC)
5 Fire Protection
a;z
Total � 1+2+3+4+5) —7777R�770c)
Check Number
.6
SECTION 7a OWNER AUTHORIZATIbN TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner/Authorized Agent of subject property
Hereby authorize�--��atir� Di, to act on
My behalf II matters relative to work authorized by this building permit application.
�igi�ature`of Owner Date
SECTION7b 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
Print Name
Signature of 0 e /A ent Date
1011111,1111131 111111 1 119,111111�ioiiimli
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR ITVIBERS 191, 2 ND 3 RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHEVINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
1�wl
v
a
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
vr' Number: CS
065128
Birthdate: 04/01/1971
Expires: 04/01/2002 Tr. no: 18582
Restricted To: 00
SHAWN R DUFRESNE
33 WORCESTER ST
HAVERHILL,, MA 01832 Administrator
I
Town of North Andover tAORTH
0
Building Department 0
27 Charles Street
North Andover, Massachusetts 0 1845
(978) 688-9545 Fax (978) 688-9542
44T*0 A
AcHUS
DEBRIS DISPOSAL FORM
In accordance with the provisions of MGL c 40 s 54, and. a condition of
Building permit # the debris resulting fi7om the work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL c 11, s I 50a.
The debris will be disposed of in /at:
Facility location
0 C7
§—gna"'ture of A icant
)z,7
Date
NOTE: A demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
Please print
DATE � J� 6 /00
JOB LOCATION �63_
Number
"HOMEOWNER
Name
PRESENT MAILING ADDRESS____
J� ef
C -1 tYTo w n
HOMEOWNER UCENSE EXEMPTION
/I ve,
Street Address
7
Home Phone
40r(�t4qar ;9 C
State
loq"a
/ lot
Work Phone
Zip Code
The current exemption for "homeowners" was extended to include owner-<=upied dwellings
of two 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 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 structures. A person who constructs more than one home in a
two-year period shall not be considered a homeowner.
The undersigned "homeowner' assumes I responsibility for compliance with the State Building Code and other
Applicable codes, by-4aws,. rules and regulabons,
The undersigned "homeowner' certifies that heishe understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures ai
HOMEOWNER's SIGNATURE
I
APPROVAL OF BUILDING OFFIC
Town of North Andover
Building Department
27 Charles Street
North Andover, MA. 01845
D. Robert Nicetta
Building Commissioner
(978) 688-9545
688-9542 Fax
Please print
DATE � J� 6 /00
JOB LOCATION �63_
Number
"HOMEOWNER
Name
PRESENT MAILING ADDRESS____
J� ef
C -1 tYTo w n
HOMEOWNER UCENSE EXEMPTION
/I ve,
Street Address
7
Home Phone
40r(�t4qar ;9 C
State
loq"a
/ lot
Work Phone
Zip Code
The current exemption for "homeowners" was extended to include owner-<=upied dwellings
of two 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 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 structures. A person who constructs more than one home in a
two-year period shall not be considered a homeowner.
The undersigned "homeowner' assumes I responsibility for compliance with the State Building Code and other
Applicable codes, by-4aws,. rules and regulabons,
The undersigned "homeowner' certifies that heishe understands the Town of No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures ai
HOMEOWNER's SIGNATURE
I
APPROVAL OF BUILDING OFFIC
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