HomeMy WebLinkAbout20191001 Micellaneous - Miscellaneous - 68 HIGHLAND VIEW AVENUE 9/25/2019 %10
PLANNING DEPARTMENT
Building Conservation Health Planning Stevens Estate Zoning
Certification of Payment of Municipal Taxes, Fees, Assessments, Betterments and
Other Municipal Charges
The Town of North Andover General Bylaw Chapter 129-1, provides that any application for a
permit or license may be denied, suspended or revoked if the applicant or holder thereof has
failed or refused to pay any taxes, fees, assessments, betterments or other municipal charges
assessed to the applicant or holder to any business, corporation or trust in which that individual
has an interest. By signing this application, the applicant represents that he or she has paid all
such taxes and fees.
I //?P/r _ �SV' %✓ , certify under the penalties of perjury that to the
best of my knowledg4 and belief, I have not nor has any corporation, trust or any other
commercial entity in which I have a financial interest neglected or refused to pay any municipal
taxes, fees, assessments, betterments or any other municipal charge including amounts
assessed under the provisions of section twenty-one D, or am not applying for a license or
permit with respect to any activity, event or other matter which is the subject of such license or
permit and which activity, event or matter is carried out or exercised or is to be carried out or
exercised on or about real estate whose owner or any business,corporation or trust in which
that individual has an interest has neglected or refused to pay any local taxes, fees,
assessments, betterments or any other municipal charge.
Signed under oath: -
Name
Address
Does the Property Owner own any additional property in North Andover? (YIN).
If yes, please fist the property address of any additional property.
Property Address:
North Andover Tax Collector Signature C-
ame
Date