HomeMy WebLinkAboutBuilding Permit #051 - 768 Waverley Road 7/28/2006 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION o`�'�oT"gtio
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Permit NO: �� 1 Date Received
Date Issued:
SAC HUS����
IMPORTANT: Applicant must complete all items on this page
LOCATION fa-
Print
PROPERTY OWNER Ccm. /kiJDaQZg2 LL<2
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MAP NO.: Z`7 PARCEL: (4o ZONING DISTRICTN�1(---v�,
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
❑New Building ❑One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units:
❑Repair, replacement ❑Assessory Bldg ❑ Commercial
emolition
❑Moving(relocation) I ❑Other ❑ Others:
❑Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
!: .G®UM ori
Identification Please Type or Print Clearly)
OWNER: Name: �� � a� ( (_ Phone:C-
Address: �� �1 cS�1�U Z.a _�g Tzk a"Rbnj z4,,(.i
CONTRACTOR Name: 'r�. 4 oa-A Phone:5g,P, 3%3.-' 39�4
Address: 2S Atn 7C1r ,1 c.t Sf SL--C�on.�� ,GIC _77`7
Supervisor's Construction License: Exp. Date: -7, 1 to
Y
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone: (:,I 2- cl-z,
Address Zf'o 4Mcr7, ��- k�A Reg. No.
R
FEE SCHEDULE.BULDING PERMIT.$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost :$ Co,<=>p o x =FEE:$
Check No.: Receipt No.:
Page W4 4
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TYPE OF SEWARGE DISPOSAL
Tanning/Massage/Body Art ❑ Swimming Pools ❑
Public Sewer ❑
Well 11Tobacco Sales ❑ Food Packaging/Sales 11
Permanent D er on S'
Private(septic tank,etc. ElElectric Meter location to
project
NOTE: Persons contracting with u ter ontractors do not have access t e fund
Signature of Agent/Owner J Signature of contract
Plans Submitted ❑ PI s Wa' ed ❑ Certified Plot Plan ❑ amped Plans ❑
TH OL ING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF-U FORM
DATE REJECTED DATE APPROVED
PLANNING& DEVELOPMENT ❑ ❑
[]Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
i
DATE REJECTED DATE APPROVED j
HEALTH ❑ ❑
COMMENTS
,Zoning Board of Appeals:Variance,Petition No:
Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water&Sewer connection/Si- nature Date Driveway Permit
Temp Dumpster on site yes no Fire Department signature/date
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required Provided Required Provides Required Provided
DIM
ENSION
Number of Stories: Total square feet of floor area,based on Exterior dimensions.
Total land area,sq.ft.:
NOTES and DATA— For department use)
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Page 3 of 4
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Created JMC.Jan.2006
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be
obtained.
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
Addition Or Decks
❑ Building Permit Application
❑ Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
❑ Mass check Energy Compliance Report
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the
Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds.
One copy and proof of recording must be submitted with the building application
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Nop 4 of 4
Location
No. Date
�aRT� TOWN OF NORTH ANDOVER
.
;�s"••°•E�� Building/Frame Permit Fee $ —
MUS
Foundation Permit Fee $
Other Permit Fee $ ;—
TOTAL $
Check # /
Building Inspector
NORTH
TOANM 0 t
19Andover
No.
0 4�
SS.
LA 011- dower, Ma
SS.,
K
Ids RATED
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.............. C4. .........AJA...44 id .....4.4 ..................................... Foundation
Jill 44WJ!
...... ....
has permission to erect...... .... buildings on .......74-t..Ifliol .....
.................... Rough
Chimney
to be occupied as................. W.......
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provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final
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
PERMIT EXPIRES IN 6 MONTHS Final
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIO0-JTARDT,.S- Rough
10
...L ... Service
BUILDING "T�R
TSP Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
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.
SEE REVERSE SIDE Smoke Det.
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JUL-19-2006 12:09 BELL ATLANTIC 978 662 0401 P.01
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JUL 27 2006 14:04 FR ENGINEERING 978 725 1036 TO 916038954922 P.03
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Antex Pest Control Co., LLC
4 Sunrise Terrace
Plaistow, NH 03865
603-382-1776 a 978-372-9929
DATE I TIME ❑REGULAR ❑INSIDE
IN I❑ONE-TIME ❑OUTSIDE
NAM 4V! OUT ❑RESIDENTIAL❑CM&OICIAL
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CITY, E
STATE,
ZIP Z.
jV'Pest Control ❑ Inspection
❑ Tites ❑ Pretreatment
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C EMICALS USED AMOUNT % EPA UMBER
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DESCRIPTION 1 REMA S AMOUNT ,
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TAX '
License °• '�Ry TOTAL
Customer Signature
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SERVICE REPORT N0 0302
Prod 7051-CROWN GRAPHICS•1.80D-2524011
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P.O. Box 154, Fremont, NH 03044-0154
Tel. 603.895.4900 Fax 603.895.4922
Demolition & Environmental ***Inspections &Consulting ***Licensed & Insured
June 21, 2006
Graydon McCormick
72 Turnpike Street
North Andover, MA 01845
Re: Abutters Notification
To Whom it May Concern:
Please be advised that we will be demolishing the homes located at the following
addresses:
1. 768 Waverly Road North Andover, MA
2. 782 Waverly Road North-Andover, MA
3. 792 Waverly Road North Andover, MA
4. 802 Waverly Road North Andover, MA
5. 814 Waverly Road North Andover, MA
6. 21 Turnpike Street North Andover, MA
7. 29 Turnpike Street North Andover, MA
8. 35 Turnpike Street North Andover, MA
9. 41 Turnpike Street North Andover, MA
10.47 Turnpike Street North Andover, MA
We will mobilize on or about July 15, 2006 to begin demolition.
Mita M. Danl
President, Danley Demolition Inc.
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NORTH ANDOVER BUILDING DEPARTMENT
Tel: 978-688-9545
DEBRIS DISPOSAL FORM
In accordance with the provision of MGL c 40 S 54, a condition of Building Permit
at: —76�-W 0�/t, is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
c 11, S 150 A.
Also, note Permits"are required under Fire Prevention laws"Chapter 148 Section
10A.
The debris will be disposed of in:
(Location of Fac'
CA ImAl
Signature of ertnit Applic
Fire. Department Sign off:
Dumpster Permit
Date
May 23 06 09:03a Ins Offices 6036353815 P. 1
DATE(nwwDlYYrn
AODM- CERTIFICATE OF LIABILITY INSURANCE o5I23f2oo� j
PRODUCER THIS{MMMATE IS MSUED AS A MATTER OF MI OMTlON
Leo Rush InsuranRd ONLY AM CONFM NO RMn UPON TK CERTIFVATE
Rd HOLDER. THIS CERTIFICATE DOES NOT AMEND, WEND OR
25 Old Lawreace ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pelham, NK 03076
603-635-2539 INSURERS AFFORDING COVERAGE MAIC#
I NS DRIED Danley Denb6lition, Inc INSURER A: BoarliAgton1hYrnraaae a
INSLIRETR 8 Progressive
P O Box 154 jajRmc: ver Undskcwrlters
Fremont, RH 03044 INSURER D.Arch Insurance
603-895-4900 MLWaR E:U010AY Insuranceat.%ng
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMM ABODE FOR THE POLICY PERIOD INDICATED.NOTYRDWANDIN G
ANY REOUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MTN RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUMCT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POUCIES.AGORECATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLApt!/S�S.Y
ita POLICY NUMBER S1AlE UA LIMITS
GENERAL LIABRJTY EACH OCCLRRENCE 5 1,500,000
NAL GENERAL LWBILTTYPOe SES(-Eu goamm S +
CLAIMSMADE MOCCUR MEOEXP{Argonepei l S EXCluded
A HGL0009127 03/29/2006 03/29/2007
PERSOW1i.aA0VLWl$t1' S 1,000'Off
GENIAL A sGGREGATE S + +
GEITL AGGREGATE U IT APPLIES PER PRODUCTS-COMPIOP AGG S + r
POLcy M 2R M LOC
AUTOMOBILE LIABILITY COME
StN(X E t1r97 S 1,000,000
ANYAUTO
ALL OWNED AUTOS v
BODILYWWRY S
SCHEDULED AUTOS C PSI
8 14REDAUTOS 034498870 03/30/2006 03/30/2007 —
WON•OWNAUTOS f -dide"9 i
ED
PROPERTY
�DAMAGE S
GARAGEUABLITY AUTO ONLY•EAA{CIDENT S
ANYAUTO EAACC S
OTHER THAN
AUTOONI Y: AGO S
EXC2?5SMUBRELLA LIABILITY EACH 00CURRENCE $ 2,UOU,Ow
OCCUR ❑ctiASaBMADE AGGREGATE S`2r r
142343 04/07/2006 03/29/2007 S
R DEDUCTIBLE
S
RemNnoN 510,000
S
WORKERSCOMPENSATIONAND XTORY
EMPLOYEWLIABIiITY WOM3814B422 20/17/2005 10/17/2006 EL EACHACCIDENT s 100,
C mFMOaEMM oMXCGI�
- i
e�dese� E.L.DtBEASE-EA EAPLO 100,000
SPECNL t»ww E.L.DISEASE-POLICY UMR 13 r
OTHERas per scaedule
D Equipment Floater 606DIN03719 31123/2005 11/13/2006 on file
DESCRIPTION OF OPERATIONS I LOCATIONS I VE HICLE$I EXCLUSIONS ADDED BY ENDORSEMENTt SPEgAL PROVISIONS
Da'bleoLYTYOW CONTRACToR
Walgreens, Vaverly Street & Route 114, No Andover, MA
Additional insureds but only with respect to work done by insured:
D F Pray Inc, Rice Worth Andover LI.0 and Mark Investments Inc
CERTIFICATE HOLDER
SNOLII.D ANY OF THE ABOVE DESCRSED POLKXS BE CANCELLED BEFORE THE EXPeRA
D F Pray Inc DATE T1EREOF.THE ISSUING I MAMR VML ENDEAVOR TO IAAIL30 DAYS WF ITU N
25 Anthony Street NOTICE TO THE CERTIFICATE HOLDER NAMED TDTHE LEFT.BUT FAILURE TO DO SO SHALL
Seekonk, Z% 02771 IMPOSE NO 0BUGATLON OR LIABILITY OF ANY 00 UPON THE INSURER,ITS AGENTS OR
REPREsmix nes.
895-4922 +„�„� „
II �
ACORD26(?tI0 MS) CACORD CORPORATION 1988
07/26/2006 09:05 FAX 15083363384 QFPRAII-FAM-2 001/002
BOARD OF BUIILLD 0 R/EGULA111OS
License: CONSTRUCTION SUPERVISOR
Number. CS 064841
Birthdate:07/011196"0
1c:yi ; Expires:0710112006 Tr-no; 1837.0
Restricted: 00
RONALD H LAPRISE
312 SMEN ST /
FALL RIVER, MA 02724 11�;4-
CommissienCr -
11 144
` BOARD OF BUiLCING R2GULATIONS -
License: CONSTRUCTION SUPERVISOR
Number. CS 064615
BirthdaW' 04117i'G55
Expires:04!1712007 Tr.no: 12135
Restricted: 00
VINCENT K VILLELLA
181 RESERVOIR AVE
-WANSEA, MA 02777
Con:rds'io�l�'
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