HomeMy WebLinkAboutBuilding Permit # 11/2/2015 TH
IUILDING PER IToth°DT-o 46
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No##: Date Received
�SSaC US�R�y
Date Issued: ll
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: ���� ,(u�1 Phone:
Address: 1i
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ARCHITECT/ENGINEER Phone:
Address:
Reg. No.
FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER S.F.
Total Project Cost: $ FEE: $ �'
Check No.: 1114 Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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�S�gnafiur„„e„ofi�Agent/O,wner, , .�f� ,� ,,, Sign--- of,,cantractor
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ADR^TED I'P��'��
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BOARD OF HEALTH
Food/Kitchen
PERMIT I LU/ Septic System
THIS CERTIFIES THAT .. '. "! ��.... ..... G:�! .i. �C1: .................................................... BUILDING INSPECTOR
............... ....
Foundation
has permission to erect buildings on . ... .?..�. :.�:. ;� .............................G,
.... . Rough
t0 be occupied as ....... .. .. �::: 7 .�✓.��..f./��.. !.s✓"'.:.: '. .../.
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provided that the person accepting this permit shall in every res ect 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. ougn
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
LESS CONSTRU CTI 'ST RTS ough
Service
............... ... .......�..J......................
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.
NORTH TOWN OF NORTH ANDOVER
6 0 OFFICE OF
° } A BUILDING DEPARTMENT
a 1600 Osgood Street,Building 20, Suite 2035
�'"�R;T;o�•a`c5 North Andover, Massachusetts 01845
�SSACHUS
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE: �Wle(l-vo
JOB LOCATION: i�i
Number Street Address Map/Lot
HOMEOWNER gjla 88)1
Name Home Phone Work Phone
PRESENT MAILING ADDRESS
City Town State Zip CON,
The current exemption for"homeowners"was extended to include owner occupied dwellings of one or two family
dwellings and to allow such homeowners to engage an individual for hire who does not possess a license,provided
that the owner acts as supervisor.
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-or two-family dwelling,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. (780 CMR
Section I IO.R5.1.2)
The undersigned"homeowner"assumes responsibility for compliance with 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.
HOMEOWNERS SIGNATURE V.6VVIV
APPROVAL OF BUILDING OFFICIAL
Revised 8.2015
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535