HomeMy WebLinkAboutBuilding Permit # 12/11/2015 OORTH
BUILDING PERMIT -D
TOWN OF NORTH ANDOVER 0
APPLICATION FOR PLAN EXAMINATION
Permit No#: 2z>11 Date Received ATED
�7;) C
Date Issued: IMPORTANT: Applicant must complete all items on this page
LOCATION 4 3 uz� C C
PROPERTY.OWNER C
Print I L
Print 100 Year Structure yes no
MAP PARCEL: 10 '7 ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
0 New Building Ane family [I industrial
El Addition Li Two or more family [i Commercial
RAlteration No. of units: [I Others:
LI-Repair, replacement El Assessory Bldg
El Demolition [I Other
_DESCRIPTION OF WOR6C TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name Phone:
Address: q .3
Contractor Name: Phone:
Email:
Address:-
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
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: $ 2- 4 C� FEE: $ 3 iD C> 1
Check No.: � ? '/ 7 Receipt No.:
tiwith to the guarantyfund
NOTE: Persons contrac *n-a unregistered contractors do not have access
---------- ------
d f r-nntractor
NORTi-�
own ot Andover
0 �-`jn
O LANE ♦er ^'
' SS' ✓/
COCNICHE WICK
7,95 RATED
U BOARD OF HEALTH
F ,ERMIT T Low Food/Kitchen
Septic System
THIS CERTIFIES THAT ........
/ ................................... BUILDING INSPECTOR
.®. �'• �.. ..L1
...'� '.�cJ
r ? S � Ge Foundation
has permission to erect .......................... buildings on .................4?.....� 1.. ....................................
G ����� Rough
C.v�
to be occupied as ........................x............................................................................................................... Chimney
provided that the person accepting this permit shall in every respect 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. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIONSTARTS Rough
.............. Service
............
BUILDING INSPECTOR Final
GAS INSPECTOR
Occupancy Permit Required t® 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 Approvedthe Building Inspector. Burner
Street No.
Smoke Det.
of NORTF{q TOWN OF NORTH ANDOVER
,t"° `"•do OFFICE OF
° A BUILDING DEPARTMENT
a 1600 Osgood Street,Building 20, Suite 2035
North Andover,Massachusetts 01845
^c►+u5
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE:
JOB LOCATION: `t `�—
Number Street Address Map/Lot
HOMEOWNER
Name Home Phone Work Phone
PRESENT MAILING ADDRESS q3
City Town State Zip Code
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, ron vided
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 110.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 requ' is and that he/she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 8.2015
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535