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Date
TOWN OF NORTH ANDOVER
' p Certificate of Occupancy $
Building/Frame Permit Fee $
CHUSE` Q ,,, FF4odation Permit Fee $
Other Permit Fee $
Oewer Connection Fee $
Nov Z ^\9q, Connection Fee $
�6 \40 \TOTAL $
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Building Inspector
Div. Public Works
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Town of North Andover
BUILDING DEPARTMENT
Homeowner License Exemption
(Please print)
DATE o- 1- ,L
JOB LOCATION 9 - V) SECONp S7- R.ES I n6NGF , 4
Number Street Address Section of town
„HOMEOWNER" 3,04t,y> -j A&P-g6we 6H 9+S5- 975 -K-;
Name Home Phone Work Phone
PRESENT MAILING ADDRESS q5, SEcoNp S�'.
q0 Vn,* Avno vc-(L AAA-
City/Town
A-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)
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 to six family dwell-
ing, 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. 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)
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
North Andover Building Department minimum inspection procedures and
requirements and that he/she will comply with said procedures and
requirements.
HOMEOWNER'S SIGNATURE.
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35,000 cubic feet, or larger, will be
required to comply with State Building Code Section 127.0, Construction
Control.
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