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HomeMy WebLinkAboutMiscellaneous - 6 Woodberry (2) / 6 WOODBERRY 210/038.0-0134-0000.0 ` l Location v _ j No. Date I TOWN OF NORTH ANDOVER O: • GR Certificate of Occupancy $ E<� Building/Frame Permit Fee $ ���'• '� .1 CHUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ P S^ Check # .� x i 1 5340 3 4 0 � Building Inspec(oe "Y v 4 t TOWN OF NORTH ANDOVER BUILDING ]DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING MUM BUILDING PERMIT NUMBER: DATE ISSUED: Z.-6 SIGNATURE: Building Commissioner/I tor-of Buildin Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1:2 Assessors Map and Parcel Number. Ze Map Number Parcel Number At Vy�L-7'!�l � 1� 01/ L'�L 1.3 Zoning Information: 1.4 Property Dimaisions Zonin District Use Lot Aria Fronto ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Reqdred Provided Rapj&W Provided 1.7water SupplyUGLCAO. s4) I.S. FloodZonoIufom mow IS SawerWDisp ASystem Public ❑ Private 0 zone Outside od FloZone 0 Mrnicipal 0 On Sine.Drsp J System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2:1 Owncr of Record Nam (Print) Address for Service: Si tore Telephone .2-2 6wner of Record: Name Print Address for Service: Sifaature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed +wConstruction Supervisor: / Not Applicable. 0 � Licensed Construction Supervisor: 6/ License Number 7 "35 Z- 26','/ Expiration Date afore Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Pte`16 of i Ia. G t'9 K C 7`O w y A(4 , �r(4 t l V�U Registration Number Ad ress �V� (j J,.6 �60 Z Expiration Date Si ature Telephone i SECTION 4-WORKERS COMPENSATION(AILG.L C 152 § 25c(6) ! j 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.......V No.......0 i SECTION 5 Description of Proposed Work(check an applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify., ,, , Brief Description of Proposed Work: -7'z, 10Ccieli C 4b ,`Aur -15 , I/ Zig O1-( "14 �?eTif 15 ej, 40 1- 40 7. CK, 4/cou e. r1p -S/ggg- �s it &-e� t-4 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed by applicant 1. Building (a) Building Permit Fee -4/1, Oavv0 Multiplier 2 Electrical (b) 'Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical AC 5 Fire Protection do 6 TotalJ1+2+3+4+5)1+2+3+4+5. /./1. 0o 0-0 U Check Nuinber SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property He y authorize to act on My half,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, aster/Authorized Agent of subject pro Here declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief c) i Print ame M/f CL 02 Si a of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRABERS 1 Sr 2ND 3 SPAN DRVMNSIONS OF SILLS DD.4ENSIONS OF POSTS DRvIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i BOARD OFR ✓tl�ua� a License: BUILDING REGULATIONS ` CONSTRUCTION SUPE i Number: CS SUPERVISOR j Birthdate: 11/02/1942 08147 i EXPlres: 11/0212 003 Tr-no: 8931 t i JOHNRestricted: 00 t 10 TTI MOULTONRST _ GEORGETOWN MA 01833 �Ad nistrator i t Board of Building Rte{ bona Standards HOME tMFROVEtNENT CON T FUlC?OR �.. Registration: 108505 Expiration. 8119/C2 Type:--PRIVATE CCRFFORATiON MORE-,`T!&SOr4,INC., john Moretti 10 Moulton SVPO Eox 119 _ Georgetown,PAA 01833 " Administrator iThe Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit { i Please Print i Name: t<i Location: PQ:910k UU Li L '70-'U ,i,er 4c- city `�u y . /�� 01P.33 Phone 3.x z---Zaq( am a homeowner performing all work myself. �i am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address City: Phone 4P Insurance Co. Policy# Company name: Address City: Phone#• Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penallies.of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against rne. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify ndepr the pains and penalties of perjury Chet the information provided above is true and correct Signature "� l�G Date_ 6'14 i Print name Svc �i A. /�'�a .�: �� Phone* l� Official use only do not write in this area to be completed by city or town official' E] Building Dept ❑Check if immediate response is required Building Dept E] licensing Board p Selectman's Office Contact person: Phone A. r-� Health Department n Other FORM WORKMAN'S COMPENSATION 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 Number is that the debris resulting from this work shall be disposed of in a properly licensed solid.waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: l Q } 4 (Location o acility) Signat re of Permit Applicant ��0 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector NU rc 1 ry Town of over No. _ _ - � / oZ �O LA o dower, Mass., ' COCHICKEWICK S RA 7 E D H BOARD OF HEALTH PE IT T Food/Kitchen Septic System AJ. BUILDING INSPECTOR THISCERTIFIES THAT. ... ................................................................................................. ......................... •• +••••••••••• Foundation ftv has permission to erec buildings on.. .... ............................... ...... ........... Rough to be occupied as.... ................................................................ .......I............................. 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-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 CONSTRUCTION &WS Rough Service • 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. I Location �o G-'ao�i3c�Yz No. SS3 Date I paRTH TOWN OF NORTH ANDOVER ,t`,o I•i+W. � F Certificate of Occupancy $ Building/Frame Permit Fee $ ,ss'ACMUSEt� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector ru 12/23/93 09;46 15.00 RAIL' v- 6 8 21 Div. Public Works Location No. Date „oRTly TOWN OF NORTH ANDOVER +i p Certificate of Occupancy $ Building/Frame Permit Fee $ CMU sEth Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ !I Building Inspector 12123:c 05;47 15.0: i AID Div. Public Works Pr9RAIIT NO. 3 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. /PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE I SUB DIV. LOT NO. LOCATION , e PURPOSE OF BUILDIN f �.®� ��y L,ofiwoCd �1 OWNER'S NAME wle U,q AA/ NO. OF STORIES SIZE OWNER'S ADDRESS / AE .� s BASEMENT OR SLAB -- ARCHITECT'S NAME (n ��9 SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME )y// ,v,��0 N G�yi f� SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. C08442//5-C,-j:> PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COOT PER*Q. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS .� PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE ILED BOARD OF NEALTN SIGNATURE 6FOWNER OR AUTHORIZED AGENT FEE !S OWNER TEL.k 6 -26�y PLANNING BOARD PERMIT GRANTED G2 j4- CONTR.TEL.k 3 19 CONTR. L!C.## D�CoG Ys- BOARD OF ORLECTMEN ���' BUILDING INSPZCTOR s BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BLK. PINE BRICK OR STONE HARDWD PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 I AREA FULL FIN. B'M'TAREA _ v, FIN. ATTIC AREA _ NO 8 M'T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS 8 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDVl'D ASBESTOS SIDING COMMOM/dCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER ELK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR ADEQUATE ADEQUATE NONE 5 ROOF 10 PLUMBING i GABLE HIP BATH (3 FIX.) `41 GAMBREL MANSARD TOILET RM. (2 FIX.) AT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR14 - TILE DADO 16 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING r r NORTly Town ofZ` � L 1 93 o ort over, Mass., Cz, 3 X953 IASCOCMICMEWICK ORATED / t BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............ ! I ! !!.� M!1..... ...:..................................................... Foundation has permission to ems.... .......... buildings on ... ...... .hftme. ..... . i Rough to be occupied asA.& ....A ( � f � ..... �....dAft......9.o0 .. 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-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 t Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTITS ELECTRICAL INSPECTOR Rough ..... .....&........... INEService . Final Occupancy Permit Required to Occupy Building GAS INSPECTOR la in a Cons icuous Place on the Premises — Do Not Remove Rough Display Y � P Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT \�I ,, � °T.l��oomneo�unevld o�✓6laawdu I� i HOME IMPROVEMENT CONTRACTOR Registration 102658 Type - DBA , Expiration 07/02/94 Mike Antoon Construction Michael J. Antoon 14 Bearse Ave ADMINISTRATOR Methuen MA 01844 e, COMMONWEALTH - OF I DEPARTMENT OF PUBLIC SAFETY MASSACHUSETTS ONE ASHBORTON PLACE BOSTON,MA 02108 04219 L I C E N S E EXPIRATION DATE C CONSTR. SUPERVISOR o r: RESTR C?ONS 9 4 EFFECTIVE DATE NONE LIC-N0. ; 06/30/1993 026645 j o MTCHAEL J ANTOCN SS q 023-38-4086 14 3EiRSS AVS o m METHUEN MA 01844 PHOTO(BLASTING OPR ONLY) Z FE 00.00 m NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: - STAMPED-OR-SIGNATURE OF THE COMMISSIONER DOB: -, 11/25/1957 '- THIS DOCUMENT MUST BE l� CARRIED ON THE PERSONOF _ THE HOLDER WHEN EN" F NSEE OTHER MB`PRINT GAGED IN THIS OCCUPATION. COMMISSIONER a I,