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Home My WebLink AboutBuilding Permit # 8/17/2016 %AOIR FI BUILDING PERMIT oI%-1US0 ( TOWN OF NORTH ANDOVER � � - APPLICATION FOR PLAN EXAMINATION Permit No#: bate Received Date Issued: ORTANT: Applicant must complete, alt item on this page LOCATION 125 Flagship Drive Print PROPERTY OWNER WOR Associates Print 100 Year Structure yesAno MAP 25 PARCEL: 80 ZONING DISTRICT: Indus,l Historic District yes Machine Shop Village yes.: TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building ❑ One family ❑Addition ❑Two or more family IKIndustrial [KAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ,(Demolition ❑ Other DESCRIPTION OF WORK TO BE PERFORMED: denti6cation- Please Type or Print Clearly OWNER: Name: WOR Associates/Robert E. Webster Phone: 978-988-9200 Address. 355 Middlesex Ave, Wilmin ton, MA 01887 Steven R. Webster � - Contractor Name: Dutton & Garfield, Inc. Phone: 603-401-7601 Email. swebster@duflongarfield.com Address: 43 Gigante Drive,Hampstead,NH 03841 Supervisor's Construction License: CS-039771 Exp. Date: 03-17-16 Home Improvement License: NIA Exp. Date: ARCH ITECTfENGINEER Joseph E. Tatone Phone: 978-276-1960 178 Park Street, Suite 102 Address: North Reading, MA 01864 Reg. No. 9080 FEF SCHEDULE.,BULDING PEMT.,$12.00 PER$9000.00 OF THE TOTAL.ESTIMATED COST BASED ON$425.00 PER S.F. Total Project Cost: $ fi -3 I f& FEE: $ Check No.: -304,18- Receipt No.: NOTE: Persons contracting with unregisteredontr etors do not have access to the guaranty fund +77—, ._ •-;..,..:F..-cam=-a. �r'n-'-�.^r^y T-m- -.-,"ar--�.. ,T-�nZ f°. r., _ r _ - c—":. F� m Plans Submitted Plans Waived ❑ Certified Plot Plan Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Pabjic,Sewer El Tat mingWassageffiody Att EJ swimmiDgP001s ❑ w6ff EJ Tobacco Wes El Food Packaging/Sales El Private(.-cptiG tank etc. El Permanent Dwnpstor on Site El THE FOLLOWING SECTIONS FOR OFFICF USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signatui-6 I �4 V COMMENTS- 1U0 r1-FAj T E CONSERVATION Reviewed onSignature . . ......... COMMENT& HEALTH Reviewed on' Si nature COMMENTS ZoningBoard of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision. Comments Water Sewer Connectionisignature& Date Drivewa y Permit DPW Town Engineer: Signature: Located 384 0:3 ood Street zr -I F0 I T E ' rot 1,sr t ,0! pnil s 1�3.,Js . i Va �N 00 Z , F RgH Town of _ 6 ndover Q .f ,� oh ver, Mass, _AW&_4 1 2" coc.ncHew�cM Y' A�RATEP tet S V BOARD OF HEALTH Food/Kitchen LD f� 1 Septic System THIS CERTIFIES THAT !. PERMIT I Y!� ........................ ..................... BUILDING INSPECTOR Foundation has permission to erect.... .................... buildings on .1 . -A...... ' ... .....,P., .. .,.......•....,.. p � Rough to be occupied as .....,�. .... .,t .... ! ...... N�... ...... A/�,c. � Chimney p provided that the person accepting this permit shall in every respect conform toe terms of the application Final 01 p p p g 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST ON Rough Service .. .......WBUILDIN .... .. Final IN CT GAS INSPECTOR OcculZancl7Permit Required to Occup-y Buildin 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. Smoke Det. JDL Construction & Aggregate, Inc. Estimate 45 Route 125 Date Estimate# Kingston,NH 03848 7/20/2016 300 Name/Address Dutton&Garfield, Inc. RECEIVED 43 Gigante Drive Hampstead,NH 03841 Duffon & Gafftld, MO. Project Description Qty Cost Total 125 Flagship Drive,North Andover,MA-Roof top units after made 28,700-00 28,700-00 safe by others.Lift work,rug removal,block walls,all abandoned electrical,water and air.Perimeter trees less stumps to be ground by others. Additional work 2,900.00 2,900.00 Page I oft Total $31,600.00 Customer Signature Button a WHOP Inc. _.� CONTRACTORS August 8, 2016 Town of North Andover, MA 1600 Osgood Street North Andover, MA 01845 Attn: Donald Belanger, Inspector of Buildings Re: 125 Flagship Drive, North Andover Dear Don, Per our meeting last month, we have assembled the enclosed package for the demolition permit at the subject property. It includes a plan signed off by Lt. Robert Bonenfant, Fire Prevention Officer at the Fire Department. Please feel free to call me if you have any questions. Thank you in advance, StevenVWebster 0%.......... ...... BUILDER 43 Gigante Drive• Hampstead, NH 03841 www.duttongarfield.com Tel: (603)329-5300 Fax: (603) 329-5368 JOSEPH TATONE & ASSOCIATES LLC ARCHITECTURE PLANNING INTERIOR DES 1 GN July 13, 2016 Town of North Andover Building Department 1600 Osgood Street, Building 20 Suite 2035 North Andover, MA 01845 Attn: Mr. Donald Belanger, Inspector of Buildings Re: 125 Flagship Drive, North Andover, MA 01845 Dear Mr, Belanger, I am working with Mr. Steven R. Webster of Dutton & Garfield, Inc. on the renovations at 125 Flagship Drive,North Andover, MA. I will be the design professional involved with the architectural design and building code review moving forward once they acquire a new tenant. Please feel free to contact me should you have any questions. Sincerely, ot�� z;� Joseph Tatone Registered Architect 178 Park Street Suite 102 North Reading , Massachusetts 01864 voice {978) 276- 1960 fax (978) 276- 1961 email: jtatone a jta-areltitects.conl C Ply ( ---------- The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Makshal P.O.Box IO25State Road,Stow,MA01775 T PERMIT _15--1 Permit No pplicibDig Safe-N—uw-ber ity o£ (rf A -le) In accordance with the provisions of MGL. Chapter 10asprovided insection 527 CMR 34 StartDate This Permit is granted to: :a, Zia, Full naive of person,Firm or Corporation' Pennissionto locate dumpster for construction/renovation/demolition of structure Comments-, dumDster be 25 ' from structure or covered with tarp or plywood Restrictions: a-t--- end of workday at Give locati6dby street and no.,or describe in such manner as pzovicd ode nate identification of location) Fee Paid This Permit will expire ZaIZ-a Signature ofofficalgranting permit) - Officalgrating permit TWIG 131=PUIT MI IAT"AP InI IRI V Pr)-QTi:n I IPrWJ TWI= PP;ZUI-QP-q The Commonwealth of Massachusetts Department of'IndustrialAccidents 9-2 Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LegibI Name (Business/Organization/Individual): Dutton & Garfield, Inc. Address:43 Gigante Drive City/State/Zip: Hampstead, NH 03841 Phone#:603-329-5300 Are you an employer? Check the appropriate box: Type of project(required): 1.n I am a employer with 4. Fol I am a general contractor and 1 6. [] New construction employees (full and/or part-time).* have hired the sub-contractors 2.[] 1 am a sole proprietor or partner- listed on the attached sheet. 7. E] Remodeling ship and have no employees These sub-contractors have 8. n Demolition working for me in any capacity, employees and have workers' 9. n Building addition [No workers' comp. insurance comp• insurance.1 required.] 5. n We are a corporation and its 10.E] Electrical repairs or additions 3.El I am a homeowner doing all work officers have exercised their I L E] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.n Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'cornp,policy number. I am an employer that is providing workers'compensation insurance far nty employees. Below is thepolicy and job site information. Insurance Company Name: Firemen's Insurance Co. of Washington Policy#or Self-ins. Lic. #:WPA517670311 Expiration Date: 11/1/16 Job Site Address: 125 Flagship Drive City/State/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der the pains and penalties of perjury that the information provided above is true and correct. Signat Date: (e Phone#: 603- 295300 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: A6O0 CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDrrNY) 10/27/2015 THIS CERTIF)CAVE 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 QEPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. RORTANT: 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 Pauline prOulx NAME: Infantine Insurance PHONE (800)937-0704WNc:(603)669-6831 P. O. Box 5125 ADDRIESS:pproulx@infantine_com fNSURERS AFFORDING COVERAGE NArca Manchester NH 03108 INSURER A:Fireman Is Ins. Co. of Washington INSURED INSURERB Acadia Insurance GroLiR, LLC 31325 Dutton & Garfield, Inc. €NSURERC: 43 Gigante Drive INSURER p INSURER E: Hampstead NH 03841 1INSURER F: COVERAGES CERTIFICATE NUMBER:15/16 Master 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. INTRR TYPEOFINSURANCE ADD POLICY NUMBER LSUBR POLICY EFF PMIDUUYI: X LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A, CLAIMS-MADE W OCCUR G ORE TED 250,000 P EMI E Eaoecu�re--- $ X CPA517669911 11/1/2015 11/1/2016 MED EXP ftone person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY❑PRO- PRODUCTS $CT 2,000,000 OTHER: $ I AUTOMOBILE LIABILITY lOMB€tle0 SINGLE LIMIT $ 1,000,000 A X ANYAUTO BODILYINJURY(Par person) $ ALL AUTOS FR SCHEDAUTOS X CAA517670111 11/1/2015 11/1/2016 BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS PRer acc€dan) $ $ X UMBRELI.ALIAB X OCCUR EACROCCURRLNCE= $ 5,000,000 H EXCESS UAB CLAIMS-MADE AGGREGATE $ 5,000,000 Mn I X RETENTION 0 X CUAS17670211 11/1/2015 11/1/2015 $ WORKERS COMPENSATION 3A Statcs: NA, yam{ X I PER O AND EMPLOYERS'LIABILITY Y r N STATUTE ER ANY PROPRIETOR/PARTNERlEXECUTIVE E.L.EACHACODENT $ 1 ODO OOD A OFFICERIMEfJSER EXCLUDED? NIA (Mandatory I NH) WPA517670311 11/1/2015 11/1/2016 E_L_DISEASE-EA EMPLOYEE $ 1,000,000 TkdowAbeunder DRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 A Leaaed/ttented Equipment CPA517669911 11/1/2015 11/1/2016 Umit $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORO 101,Additlonal Rama(ks SoRadu€s,may be attached If mors apace Is required) MASTER WORDING FOR CERTIFICATES: It is agreed and understood that ( ) is included as additional insured on General Liability, Business Auto and Umbrella when required by written contract. General Liability applies on a primary and non-contributory basis when required by written contract, Includes Completed Operations Coverage for Additional Insureds, waiver of subrogation applies to General Liability, Business Auto, and Umbrella I when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Dutton $ Garf±eld, Inc THE EXPIRATION DATE THEREOF, NOTICE WILL IIE DELIVERED IN 43 Gigante Dri va ACCORDANCE WITH THE POLICY PROVISIONS, Hampstead, N11 03841 AUTHORIZED REPRESENTATIVE \� Charles Hamlin/PI'312 g ®1988-2014 ACORD CORPORATION, All rights reserved. ACORD 26(2014107) The ACORD name and logo are registered marks of ACORD INS025(201401) i Massachusetts Department of Public Safety Board of wilding Regulations and Standards t License: CS-039771 Construction Supervisor No- STEVEN R WEBSTER 26 PORT "WEDELN RD 1NOLPEBORO NH 03894 Expiration' Commisioner 03117/2016 I Gb '1