Loading...
HomeMy WebLinkAboutBuilding Permit # 6/16/2016 BUIL DING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAWNATION Date Received Permit NO: Date lSSUeW2"1LiP/_40 IMPORTANT. licant must colani)Iete all items hiLp:a p L0CAT"lQN__` 0 xwl PROPERry OWKR�/ 110%oo; P t ZONINGNSTR G Historic District yes' no MAP NO:,,. PARCEL: __—Machine Shop Village yap s.- -fY—PLr OF IMPROVEMENT PROPOSED USE ­ Residential Non.- Residential-- i New BUilding eA.One family _j Addition Two or more-family F1 Industrial _,_�Alteration No. of units: _—F-1 Commercial (o Repair-, replacement Assessory Bldg 1-1 Others- _1 Demolition Other - Septic, f-1 Well Floodolailn [-"I Wetlands T 1-1 Watershed Distkt Water/Sewer Identification PleaseType or Pi-int Cleat'ly) d OWNER: Narne* C (6) AG A') Phone: L s1 Addres: I G L ! 0 0 4- D Otoi\A") CONTRACTOR Narne: Phone: k,:�_ Addr'em/ a� Ste,,upervisorM's,Constrtj(,,�tion'Lic,6hst,4, Exp,. Cite: Ile 154. Date: ARCI Address:---­-, FEESCHEDULESU1.01 PERMIT:$12.00 �..��,__,_ TR$1000.00 OF THE TOTAL ESTIMATED COS TBASED ON$125.00 PER SA FEE: Total Project Cost: 4; Check No.: Re(,­.eipt No.,___ J NOTE- persomv copphw s ere,1 do not have aceass to the gy,#7� nq,fiund c"i t Signature of Agerd/Own a.J3 Ina ure o,f contract w. �1--- tj®RTH \A Town of ndover 1 70061 i !t� ver, SS, � ®A04 AArEo /'P��t� S U ® BOARD OF HEALTH PERMIT LmD Food/Kitchen Septic System THIS CERTIFIES THAT ... ... ....... . .. . ...... ....... .. ... .. ..At Af of. . .. .. .... BUILDING INSPECTOR has permission to erect......... g ..... Foundation ................. buildings on ...Is A99W .. ........ . . .. .. ..... 9* A Rough tobe occupied as ... ... .... ... .. .......... ..... ........ ...... ... ... .... .......... Chimney provided that the person accepting this permit shall In every respect conform to the t ms of the app (cation 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 EXPIRESPERMIT ELECTRICAL INSPECTOR . .. Rough Service .. .... ........ Final I TO GAS INSPECTOR Occupancy Permit Required to Occupy Bu Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing r Dry Wall To e Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Plans Submitted El Plans Waived El Certified Plot Plan ❑ Stamped Plans El TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Ail ❑ Swimming Pools F1 Well ❑ Tobacco Sales ❑ Food Packaging/Sales -1 Private(septic tank,etc, El Permanent Dumpster on Site Ll THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF ® U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT F1 El COMENTS M'E"REjEU`I'ED" A I UVED CONSERVATION F1 El COMMENTS DATE REJECTED DATE APPROVED HEALTH F1 ❑ COMMENTS Zoning Board of Appeals:Variance, Petition No: —Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Drivewav Permit Located at 384 Osgood Street _0" rnp"burn"p's er,omzft F1 T�'Fire Department natu.W.-date COMMENTS:- s i I 4 I S -VO j ' � frA I i � , j r.9. t z i t I 4. sP i _y tl� F O P tlm 8 a ' .a 2 � S I 1 i ,„,..._..w.. ... , �.._.....� _.._ .war w� � I pit � s IJ 7-.1—l", -_ a 0 t�nf � yy t The Commonwealth of Massachusetts a Department of Fire Services Office of the State Fire Marshal P.0.Box 1025 State Road,Stow,MA 01775 Permit NoDate: (City of Town) (If Applicable) Dig Safe Number In accordance with the provisions of M.G.L. Chapter 10as provided in section 5 2 7 CMR 34 This Permit is granted to: Start Date Full name of person,Firm or Corporation Permission to locate dumpster for construction/renovation/demolition of structure Comments: dumpster be 25 ' from structure or covered with tarp or plywood Restrictions: at end o f workday at (Give location by street and noor describe in suc manner as to provied adequate identification of location) Fee Paid S -,5-0, 06 , This P� will expire ( ignature of offical granting pe Offical granting permit (Title) TWIA P;=PMIT MI 1AT IIP r-r) ICPICI Inn ICI V Pr)CTI=n I IPnKI TWF= PP9MICIFC 7 f CHRIS-8 OP ID: KW DATE(MM/DOIYVYY) CERTIFICATELIABILITY I 06/14/2096 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTNAME: Fitts Insurance Agency Fitts Insurance Agency,Inc. PHONE FAX 2 Willow Street,Suite 102 AIC No EYt:508-620-6200 AIC No):508-489-0227 Southborough,RAA 01745-1020 E-MAIL info@fitfsinsurance.com Fitts Insurance Agency ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Commerce Insurance Company 234754 INSURED Chris Arena INSURERB: Arena Construction 939 Forest Street INSURER C: Franklin,RAA 02038 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL R POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MMIDD MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,00 CLAIMS-MADE ®OCCUR YP7258 08/01/2095 08/0912096 DAMAGE RENTED PREMISES TO occurrence 5 100,00 X Business Owners MED EXP(Anyone person) 5 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,00 X POLICY PRO- ❑ JEGT LOC PRODUCTS-COMPIOPAGG $ 2,000,00 OTHER: 5 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ '.. DED RETENTION$ $ '.. WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABYIN ILITY STATUTE ER ANY PROPRIETOR/PARTNERIEXECUTIVEE.L.EACH ACCIDENT 5 OFFICER/MEMBER EXCLUDED? ❑N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE 5 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 5 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) '.... Contractor CERTIFICATE HOLDER CANCELLATION TOWNN03 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept 1600 Osgood St. AUTHORIZED REPRESENTATIVE North Andover,MA 01845-2909 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ARENA-1 OP ID: SH CERTIDATE(MMfDDIYYYY) FILIABILITY ' 06/14/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Robert A.Fair Jewell Insurance Agency,Inc. _NAMEPHONE FAX 1101 Worcester Road Afc No Ext:508-879-1310 AIC No: 508-872-2764 Framingham MA 01701 E-MAIL Robert A. Fair ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:Continental Casualty Company 20443 INSURED Christopher Arena d/b/a INSURERB: Arena Construction INSURER C: 139 Forest Street Franklin,MA 02038 INSURERD: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE Sp POLICY NUMBER MMDDIYYYF MM DDIYYYY—P—OLICY EXP LIMBS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ GA—MAGETO RENTED CLAIMS-MADE DOCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ POLICY PRJECT O [:] ❑LOC PRODUCTS-COMPIOP AGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Perperson) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETORIPARTNER/EXECUTIVE YIN 6S59UB-4605P27.246 04/14/2016 04/14/2017 E.L EACH ACCIDENT $ 100,000 '.. OFFICERIMEMBER EXCLUDED? N I A ¢,Aandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1®0,00® If yes,describe under DESCRIPTION OF OPERATIONS belo^a I I I I E.L.DISEASE-POLICY LIMIT $ 500,000 LL DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION NORTAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Building Department Fax: 978-688-9542 AUTHORIZED REPRESENTATIVE 1600 Osgood Street North Andover MA 01845 (r]4000 )n4A A/"n®r1 f^nDDnDATInAi All nro Ht�ennnrunA Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 132752 Type: DBA Expiration: 4/2/2017 Tr# 262961 ARENA CONSTRUCTION CHRISTOPHER ARENA 139 FOREST ST - _ FRANKLIN, MA 02038 Update Address and return card.Mark reason for change. SCA 1 20M-05/11 Address E] Renewal n Employment ❑ Lost Card The 6(wimon(vo-Al, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: C egistration: 132752 Type: Office of Consumer Affairs and Business Regulation Expiration: 4/2/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 ARENA CONSTRUCTION- CHRISTOPHER ARENA 139 FOREST ST FRANKLIN,MA 02038 Undersecretary Not valid without signature a> Massachusetts -Department of Public Safety Board of Building Regulations and Standards I,I/ILLI UlLll/11 .1U I/CI,i>I/1 License: CS-057W9 Wit.rrz CHRIS TOPYHER 139 FOREST ST FRANKLIN MA:1Z r pis �1iN�a Expiration Commissioner 07/16/2017