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HomeMy WebLinkAboutMiscellaneous - 117 Waverly Road 1 t� /� Location o? d � No. S.� � Date MORTM TOWN OF NORTH ANDOVER F?,• • OA * ; , Certificate of Occupancy $ . o, ' • / J�CMUS� Building/Frame Permit Fee $ �U Foundation Permit Fee $ Other Permit Fee $ TOTAL $ i Check # /51711 52 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: LC � Buildin Commissioner/Inspector of Buildings Date SECTION i-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: wawly Q8 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R 'red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT MI 2.1 Owner of Record `1 63 I I Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Nage Print Address for Service: Signature Tele hone (� SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construcjtion S,ve(` sor: Not Applicable ❑ayt Licensed Construction Su rvisor: t/ � at �� ® I License NumberMn Address ? '1 0 6� Expiration Date Signature Telephone m 3.2 K-kistered Home I proveine4t Contractor Not Applicable ❑ Ate, Company Mine Registration Number Address Q ' Q �, 7-74r ` Expiration Date Signature Tel hone P � SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: q '` 2,q m aY "� u yfeP dawn CSECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be CIA" O�,y Com ted by permit applicant :-;- 1. Building Ip w (a) Building Permit Fee V.V Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection / 6 Total 1+2+3+4+5 Q4 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I> as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I> `iy as Owner/Authorized Agent of subject '� property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent, Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 01.106/2004 09:27 19793276517 WI#_I_M PAGE _._01 >« CERTIFICATE OF LIABILITY J URACE =----- CATE[bTMEDDtYYYY! itti#TER4V I #N$,1b iGl AGENCV,iNI' 97&976-4344 OWLY A1�7I�F*��ht€ERS�O�RtGH S�UPt�t� OF IN T E CERTIFICATE 622 522 CHICKERING ROAD tlOI.f lm THI$ CERTWICATE DOEA NOT AIN P-No, EXTEND O NORTI-IANDOVER,MA 01845 ALTER THE COVUAG& AfFOR_ P9 @Y t-H �ttt rrlE d�. i INSURERS AFFORDING htAlC!E DA rCWTRACTIS�:G,INC. ��a :A#t�ELIA pFs,OTECTfot — — — { OAVID GULEZ3,4' pis R !d©I�F9L ;&E}EC3�lAfIllj 428 PLEASANT STRP�T st+aft:c:ARSELI A ROT `T t�N NORTH AN 7OV R,MA 0184 Irastr E Eeo AIS IMSUI�AN �` { THE PCtO IE$Ma T.TERM O L iQON BELOW HAVE SEEM ISSUED TO YI�E tkSURE�v I�R#ED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REtdU1RER3EryT.TERM OR CONbETION OF ANY CONTRACT OR OTHER DOCUMENT V017tE IRE-SPECT T9 WHf(!9 THIS Iv€RTEFIrr MAY®E ISSUED OR PERTAIN.THE 1NSURP,NGE AFf>aR1?ED By tN8 Rel+>EE5 DE$vR18SC!?E. RJR IS SU9JEGTTb ALL THE T€RM& (i( POLICI€j2:*,G(kPU;AT€LIMITb SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, EXCLUSIONS AMD CONDITIONS OF BUCK ROLtCYNUIkIBEIf Pi}tI�Y"EfFEC k9�`E Q'F N: ? 411�!ABltiTY i I LL4t A X EQ6t6TERCIALGENERALLlAmurY ;SStD I3a49 :EtDC7:UP.RENCf ' 1,000,000 { - --. I�T1t3€72pp3 $ t?77t3`?12004 a � 3T —� 100,0pC i - ! eats MAGE ' X GCevR I S_ — 1 j M€4EXP(Artq�irepatsWli F �5a�t1� f.. po:ICY 1 -imPIROi IOC i PRGGDlIt TS>COIdFIppAc S �z i AI}TOMQHtLgZ348AJTV _ ANY AUTO 1901516920611212003 S!''CLS LIMIT i 0611212003 W1212004 Ee au�n{i _ I ALL OVMGDALrT00s ! L�nAtlr�s ; e it,T _ 1 ,. kNfRCDAUTOs - j Citi i RtiIT�S I NJUR* a P_R0PC- ?Y DAMAGE i E I.G_ARAGELIABILtTY AtEtO.ONLY>£AAZCIL ntT !gr� j q7}i THAN SAnGt;I__._.-. ._... —. __... f 'AUT {3NtY. aLsG S i ExcES$f{ImaREI.LRLiAtiILtTY s - ! I O X_:0MR L II2SYDziE 46DM399 'IZtifl M3 1211Q 4 !AT3C;Rf t?taTE s 3 1,OCLO,GiII3 ' _ WORKM �-... .. .. .. - Ni [� t N Arra 03131,12 -_ - T ' E.L.EACnACt IDENT _100,000 ? q ;,M"PROPS..ETOKIFAP.TNEatEXECUTIVE ...� .. s { FtCER.4tEMBER E7 CIULFS7 EL'DLCEASE t EA EMPI Qyr:e £ It tlpstsd�edn3r_r E,L,prAA9GtPGl1(..'YLIMIT S— -a-500000 i sFE�1A „ALD?�k IONsl;aaw t OTHER 4 � 215SQ"TIONOFOPERATIONS ILOCATIONS VEHiCLLSIfttLLiSf MA0—Svt:Noq WAWrSPECIAL PROVISIONS I CERTIFICATE MOLDER CANCEL LATCpT3 _ ...- :'.,..._.. _...:-. � 8}tQUL2iA{iYQFS#EEA.EIQYEYd!&CRI&�..fiPQtJGlr688LANCELLEbBFAQI�E`NGEXFIRhtfO?'t . '.f. b.4T€TT44Pi T.''SE I$SUtMQ ttiStERER LYfll ENIIEAVOR TO MAIL v+i� DAYS WRiTTEk NOTICE TT!TMECEKnW_tTB KOtMR NA#ED TO TWE LEFT.RM FAILURE TO AO SO SMLL } th0lbiE tit?OIBL$40164 CSR LIABILITY bT ANY ICING UPON THE INSUkkk ITS Adkmit bR • R€�RESENTATEV _ AtiTtftittiCEG EEt � - -- ACORD 25(2t4ollo8) .; 'ACORD CORPORATION 1488 J Olt Of uo d�p-e� 6 P 1 � Vt si 1 00 514e P) iko Idle �lcl�� �ail dog / �� �>O,Y? 141 � a D.G.CO TRAC JL Ili]G, INC Kitchens, Baths, Additions, Home repairs, Finished basements, Decks, Excavation work David Gulezian President 428 Pleasant Street, North Andover, Ma. 01845 OFFICE: (978) 689-4797 HOME: (978) 683-0397 FAX: (978) 686-6337 MA Lic.#001821 INSURED Home Imp.# 120199 Woodridge Homes Attention: Gary Build a deck on grade the width of the patio door by 4' Off this deck build a ramp to grade f A permit is required by the town of No. Andover by a licensed contractor, (which I am). We will need to dig footings down 4' below grade, have the town inspect the footing hole then pour the concrete. Then we can build the deck and ramp. $ 1,880.00 Price does not include painting or landscaping. D.G.C®NTRACTING, INC. Kitchens Baths Additions Home repairs Finished basements Decks Excavation work David Gulezian President 428 Pleasant Street, North Andover, Ma. 01845 OFFICE: (978) 689-4797 HOME: (978) 683-0397 FAX: (978) 686-6337 MA Lic.#001821 INSURED Home Imp.# 120199 Woodridge Homes Attention: Gary Gibson front entrance Build a pressure treated deck on the existing concrete platform. This deck will be raised and flat, so that wheelchairs have a place to land and open the door. Build a ramp going down the front walk. The pitch will not exceed on inch per foot. $ 2,150.00 Ni ,AORTH ® of T �O _�+- LAK , lover, Mass., 4 COCMICKEWICK S.e A0RATEO AP�,��� S u BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... ..`�...r.. .�.�..D.G..L...........?'u ..fix.. ............................................ Foundation has permission to erect. .� W.p... buildings on ....... . w�.V�.�L......................... . Rough p 9 � ................ .. Y � � : to be occupied as.......RAr.I..Y&.. * A A ... /�II„G Chimney .............................................................................. 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-liws relating to the Ins pec ion, Alteration and Construction of Buildings in the Town of North Andover. Q 3 f7 y O own, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS T c T �g- T T c ELECTRICAL INSPECTOR UNLESS V LESS CO V S 1 R CTION ST TS Rough ..� Service ........../M. . ... ........................... ..... .:... BUILDING INSPECTOR 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.