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HomeMy WebLinkAboutBuilding Permit # 8/26/2016 BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATq(P 1-1 Permit N0:Z­L-I-- Date Received,, Date Issued IMPORTANT:Applicant must complete all items on this page TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential lIjew Building One family VAddition Two or more family Industrial Alteration No.of units: Commercial Repair,replacement Assessory Bldg Others: Demolition Other ILM A 1-11 f Identificatio p Please Type or Print Clearly) b OWNER: Name: U_Ajd' fru L,; t 4 17 ,VQ Phone: i. - , �'j � - I . -P th U v Address: 1 - - - 20 —--------- ARCH ITECT/ENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$12. PER S1000.00 OF THE TOTAL ES77MATED COST BASEDON 512 Total Project Cost:S —FEE-$ C�'d/ Check No,: Receipt No.: 70:;Z-2� NOTE: Persons contracting with unregistered contractors do not have access rg-the guarantrfund d ...... Town ;'0 "aRTH � Andover No. p�4� — . a 11 h ver, Mass, Are wF'F�,c'c5 s u BOARD OF HEALTH Food/Kitchen PER T T ILD/,/I�/� ��j Septic System THIS CERTIFIES THAT , ,�,,,....( �►rw/�� BUILDING INSPECTOR .... .. Z 5� � T Foundation has permission to erect.............. ..........buildings on. ..... ....... f Rough nug to be occupied as..� '... .., ..�. .� .. Chimney provided that the person accepting this permits all in ry respect conform to the terms of the application 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 PERMIT EXPIRES II+ 6 MONT S ELECTRICAL INSPECTOR UNLESS CONS I Rough P.NICe ... ... .... ... ........... Final BUILDING IN TOR �_..._. GAS INSPECTOR Oceupancy Permit required to OccupV Puildin 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. Pians Submitted❑ Plans Waived❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanaing/Massage/SodyAit ❑ SwivanmgPools Nvoll ❑ Tobacco Sales ❑ Food Packaging/Sales 11 Private{septic tank,etc. ❑ Permanent Dempster an Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM /PLANNING&DEVELOPMENT Reviewed On i t Signature,it-001`1' COMMENT'S 1�1�`� �1� SI� AlYl E i CONSERVATION Reviewed on to /o�11e Signature ��� � COMMENTS ./HEALTH Revietived an Sinature F 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 n'h—uav Permit DPW Town Engineer:Signature: Located 384 Osgood Street FIRE,DEPARTMENT -Terrlp'Dumpster on site yes no Locatetl at 124 Ma-n.Street Firebepariment signatureldate COMMENTS MDJ #.o i! Building Code Evaluation Project: Ojutalayo,MD. Date:7/19/2016 Address:242 Sutton St.North Andover MA Revised: For: Ayobami O.Oyutalayo The Following evaluation is based upon: 1. The survey of the site,including measured drawings 2. The corresponding research of the Massachusetts Building Code-8`h Edition-,and Please find the list of standards necessary to prove that the facility meets Code Compliance.Attached are the Plans. Section (303.1) Existing Condition Use Group Classification Business B Construction Type Assumed VB (Noncombustible/combustible Unprotected). Height and Area Limitations[Table 5031 Use Group:B w/o sprinklers Height(Story) 2 Sprinkler increase N/A Total Allowed 2 Actual Stories 2 It complies Height(feet) 28 Sprinkler increase N/A Total Allowed 40 Actual(Feet) 28+(- It complies Area per Floor 900 Sq.ft. Street frontage increase(2%Increase for every 1%above 25%as an approved Fire Line) N/A (Sprinkler increase(200%) N/A jMultistory reduction N/A Total Allowed 9,000 sq.ft. It complies Actual Area 900 Sq. Ft.(gross). It complies Gross Area 1,800 Sq.ft. Means of Egress 2(36"and 36") Occupant Load[Table 1004.1.11 For Business Areas the floor area in sq.ft.per occupant is 100 gross.Therefore,Occupancy=18 persons Minimum Egress width:[1005.1]/[3023.2]For Occupant load less than 50,min.width is 36",It complies Stairs[.3 x local occupant Load]: .3 x 18=5.4",Existing/proposed 36",Therefore,It complies. Doors,ramps,and corridors[.2 X local occupant load]: .2 x 18=3.6",Existing/proposed 36"It complies Required number of approved Exits per floor(table 1021.1) 2(under 500 persons) it complies Exit Remoteness: 43'max Actual Distance: 40 feet Length of Egress travel:(Section 1016.11 w/o Sprinklers 200 feet It complies Maximum Length Most remote [Table 1016.1.] 200 feet It complies Actual Length of travel: 45'-0" Common path of travel,[Section 1028.8] Less than 30' It complies Dead end corridors[Section 1018.4] None It complies Fire Resistant construction[Section 6021 Type VB(combustible W/o Sprinklers) Exterior Wall[Table 705.5]Greater than 10 ft. Tables 601/602 0 hours It complies Fire walls/party walls N/A Exits(stairs)Under 4 stories[1026.1] N/A Shafts N/A Exits access corridors[Table 1011.41: N/A Smoke barriers N/A Emergency Lighting Required and existing; It complies Exit Signage [1011.1] Required and existing; It complies Fire Protection Systems Code Requirement:(Chapter 9) Fre Suppression Systems(903.2.1.2) 'sprinklers' Un-sprinkled Not required(Fire Area<5,000 s.f.) Fire Suppression Systems(905)'standpipe systems" does not exist not required(under 300 Occupants,under three stories,No auditorium or stage) It complies Fire Signaling Systems(917)'alarms' Pull Stations Do exist required for B Occupancies Horn/strobe Do exist required for B Occupancies Fire Detection systems(918)'Smoke detectors' Existing to remain Fire Extinguishing Systems(906.1)'extinguishers' Existing Required in Use Group B update Respectfully: ' Marcos Devers PE. `' #133848 Registered Professional Engineer Mass.Reg. 16 Woodland Street,Lawrence MA 01841 Email:mdtincorporatedI comcast.net Tel: 978-804-7588 PIP RP Management,Inc. (978)310-1050 120 Main Street www.rpremodel.com North Chelmsford,MA 01863 custom erservice@rpremodel.com Date:May 02,2016 242 Sutton Street—No,Andover,MA Demolition,Rooting,and Expand Office Building Section A:Parties_involved. 29th We are pleased to provide the following proposal dated 2 day of April between Customer:Dr.Ayobami ojutalayo,MD. 242 Sutton Street North Andover,Massachusetts 01845 AND Contractor:RP Management 120 Main Street Chelmsford,Massachusetts 01863 Telephone:(978)310-1050 Home improvement contractor license#182161 Section B:Description of work and terms: We hereby propose to furnish the materials,necessary labor,and obtaining the necessary permits from the building department. Expand(1)Office for the 1st floor and(2)offices for the 2nd floor. We will also be adding a flat rubber roof.The addition portion will be completed shown on plans dated 3-27-16.Work will be done in the following manner: Obtain any necessary permits(if necessary) v Demolition—Exterior • Demolition of existing porch back to main structure including footings • Demolition of existing stairs that corresponds with porch • Remove existing siding from back portion of office building • Office building portion of the rear exterior wall will be removed according to plans • Demolition of existing roof as shown on the plan Rough Framing • Per drawing we are going to use 5/8 plywood for exterior walls • 2'x6"wood studs for exterior walls • Proper headers for windows and doorways • Installing insulation R-21 for exterior walls • Providing(4)new fitting 4'deep or as deep as the ground permits • Providing(4)6'x6"post to new addition Floor joists will be made of 2"x10" • Sub floor will be 3W thick Rubber Roofing . Installing rubber roof on the addition portion of building drawing made up with 5/8 plywood . Decking is per square footage on . Rafters will be made with 2"x12"per drawing . providing and installing 2 stack collars . Roof underlayment to be used on this project Grace Ultra Roof Underlayment or- equivalent • Install synthetic Grace Ultra rooting underlayment to prevents wind-driven rain or water from infiltrating under your shingles and causing damage to your roof deck RP Management,Inc (sus)310-1050 220 Main Street www.rpremodel.com North Chelmsford,MA 01863 customerservice@rpremodel,com ME — • Trumbull Built-Up Roofing Asphalt product will be used for a smooth and durable,safe and r quiet and most versatile pavement material or equivalent. • A vapor retarder will be used to substantially reduce the movement of water vapor into the roof system,where it can condense. Siding • Install insulation,polar wrap underlayment 1/2 inch 1.0 R Value around the office building. + Install siding to addition portion of office building to match as close as possible to existing color. o Siding Extras:firing Casings around siding accordingly o Siding Extras:Sheathing(add substrate) • Providing facial board and soffit if necessary • wrap all the windows,doors,and vents with aluminum coil Interior Work • Paint new windows&doors trim throughout rooms as well as the new baseboards • Paint new walls to blend with original room • provide and install VCT tiles in new office building • Provide and install new carpet in upstairs office areas if necessary to match existing or close as possible, l s Windows and Exterior Doors 1 • Provide and install(6)six windows for office building;windows to be furnished JELD-WEN Sierra Horizontal Sliding Vinyl Window 60 in.x 46 in.White with LowE Glass Grille and Screen or equivalent • Furnish and install(2)two solid core doors 6-panel colonial casing will be used for the trim of the interior doors.(If you want us to match existing trim it would be additional$250) v All of the debris/trash generated will be properly removed from the premises and handled according to the Hazardous Waste Regulations. The Owner agrees to provide RP Management with at least four 15-amp circuits at the Subject I st of the electrical power,water and utilities needed to Property. The Owner agrees to pay for the co complete the Contracted Work. The owner is responsible for having the house prepared according to the listed requirements enclosed.If these requirements are not completed before we are scheduled to arrive,work will not begin and the owner will incur additional charges. Once the contract is signed,we will file for a permit if it is necessary for this job.Once permit is obtained, this work will to be completed within 120 days(not included weekends and holidays)of receiving permit from the building Department barring any inclement weather. All material is guaranteed to be as specified,and the above work will be performed in accordance with methods described,for the sum of Fifty Thousand One Hundred Twenty-five Dollars and 00/100. a [$50,125.00} With payments to be as follows:$10,000.00 to schedule the start date of job,getting permits and materials.Second payment of$10,000.00 once demolition of the backside of existing building and roof has been completed.Third payment of$15,000.00 after framing and roofing has been completed.Forth 411�3I��ST0.SllSI�1 !RT!S ! � RP Management,Inc. (978)310-1050 120 Main Street www.rpremodel.com jbtANorth Chelmsford,MA 01863 customerservice@rpremodel.com payment of$t o,000.00 once siding of existing building and windows and doors have been installed.Final payment of$5,125.00 upon completion and once the final walk-through is done shall be given to RP Management.Contingency must be carried for this job in the amount of$6,250.00 for any unforeseen problems that may arise from the project. If any additional work is added to this job a weekly payment arrangement will be set up. A Holdback may be held by the Owner to assure the Owner that RP Management will complete any remaining Contracted Work,such as work associated with back-ordered material. The amount of the Holdback shall be two times(200%)the value of the outstanding work. Upon total Gompletion of the G Contracted Work,in a manner consistent with the terms of this contract and general trade practice,the amount of the Holdback will become due and payable. Owner agrees to pay all attorney fees and cost of collection in the event any sums become past due and are placed in the hands of an attorney for collection. Any alteration or deviation from the above specifications involving extra costs,will be executed only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikes, accidents or delays beyond our control,any items that were overlooked by the inspector during the initial inspection and were not on the report at the time of toy estimate will be considered an extra.This proposal may be withdrawn by us if not accepted within 90 days. GUARANTEES A) RP Management guarantees the workmanship on all door,window and associated hardware installations for one(1)year. B) RP Management guarantees that the quality of carpentry will equal or exceed the quality of the i existing carpentry. C) Unless otherwise noted within,this Contract does not imply that any lien or other security interest has been placed on the residence. D) RP Management guarantees to secure any necessary permits that may be required,on the behalf of the Owner. Please Note. Owners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGL c.142A. E) The Contracted Work will be conducted in compliance with Mass.General Laws,Chapter 111, Sections 190-199(also known as the"Mass.Lead Paint Statute")and its associated regulation, i 105 CMR 460.000 and 454 CMR 22.00. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and hereby accepted.RP Management is authorized to do the work as specified.Payments will be made as outlined above. Signature Signature Date l S Thank you for the opportunity to bid on this job. Respectfully submitted, Vatias Roody Herold-President CS-106968 VALFASRHEROLDJR IZO MAIN STREET North Cftelmf. MA 01063 --xp-2-,- 011C?/2017 �RDe CERTIFICATE OF LIABILITY INSURANCE DA8/1/zo16ODl16 /1/ 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($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate hostler is an ADDITIONAL INSURED,the policy(les)must be endorsed. H 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 ofsuch endorsement(s). PRODUCER CONTACT ELLEN FREEMAN Dooley Insurance Agency, Inc.ePHONE (978)356-0581 FAx (978)356-9651 2 Central Stret - ffnl ScELLEN@DOQLEYINS.COM PQ BOR 264 - ` iNSURER(5)AFFAROlNG COVERAGE —.._..,NAICF_ Ipswich MA 01938 INSURERA:Liberty Mutual Ins Cc INSURED INSURER e: Rp Management INSUftERC:__ _ 120 main at INSURERD: INSURER E: Chelmsford NA 01863 INSURER F: COVERAGES CERTIFICATE NUMBER:CL168156193 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. NOTNATHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT HATH 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 RAVE BEEN REDUCED BY PAID CLAIMS. IN _..... ._..__ ADOL-OB - —.. ..... — POS POLICY FAP .... LIMITS _.. LT TYPE OF INSURANCE POLICY NUMBER COMMECOMMERCIAL GENERAL"I" ! I EACH OCCURRENCE RCIAL GWMS-MAGE OCCUR ?REMISES IEa aaurtgnce.. t_ _.._. 1 ;MEO EXP(My ane person} I$ PERSONAL&ADVINJURY $ GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ _POLICY JE LOC 1 ' PRODUCTS-COMPIOP AGO S OTHER COMINED SINGLE AUTOMOBILE LIABRITY sal±de�Xi L MIT $ __ ANYAUTO .BODILY INJURY(Pe Person) 1$ SCHEDLL O5�ED AUTOSULED BODILY INJURY(Pe Midenyj$ NON 0WNEO L... HIRED AUTOS _i AUTOS -- $ UMBRELLA UABIDCGUR ! 'EACH OCCURRENCE S_ r_t EXCESS UAB : ..CLAIM&MADE I + +AGGREG47E ..S IDE RETENTION$ WORKERS COMPENSATION j P + TH- A 'WC531S3B3676-023 Obj07/201610EJ07J2037STATUTE ER _ AND EM FLOYERS'LUIBUTY 1.tN f - ANYPROPRIETORtPARTNEED4 RIEXECUTIVE OFFICER/MEMBER MIM ❑:NtA EL EACH ACCIDENT __L$ 100,000 (MandalorY In NH) E.L.DISEASE-EA EMPLOYEE_$ 500,000 If yas,doacdba wldat DESCRIPTION OFO OPERATIONS W- I E.L.DISEASE-POLIGY LIMIT $ 100 000 I I DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES(ACORD 191,AddMomi RemeNa Schedala,May De aaaa vd Rmme apace Is ragelrzd) PER THE AGREEMENT BETWEEN INSURED AND CERTIFICATE HOLDER CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF NORTH ANDOVER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED,IN 1600 OSGOOD STREET SUITE 2043 ACCORDANCE WITH THE POLICY PROVISIONS, N. ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE - f� - - Jay DooleylE EREEH ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD INS026(x1401) t Office of Consumer Affairs and Business Regulation _ 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 182161 Type: Corporation Expiration: 61112017 Tat 266983 RP MANAGEMENT,INC. _ VALIAS HEROLD _ 120 MAIN ST. - NORTH CHELMSFORD,MA 01863 Update Address and return card.Mark reason for change - Address -'Renewal Employment '.Lass Card `� Ofirec aFf o s mcr Af€,ra 8 stmsruzss Rc4mtaiwn License or registration valid for individul use only _: before the expiration date.If found return to: .. OSE IMPROVEMENT CONTRACTOR = Office of Consumer Affairs and Business Regulations2eglstrat�on: 1&2761 Type: Milan: 012617 012617; Co:paratxin lg Pack Plaza-Suite 5174 Basten,AIA k2116 RP MANAGEMENT,INC,. VALtAS HERGLD 120 MAIN ST. :-.� �. — _ All .-. NORTH CHELMSFORD,KA 01863 tlmderscrretary 'Not valid witho�t signature I ,.� RPMAN-1 OP ID:SW ,4�orzn CERTIFICATE OF LIABILITY INSURANCE _0Erzrz0212al 6 6 s 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 endorsements. PRODUCER Phone:732-842-2012 NAME:cr York-Jersey Underwriters,Inc. Fax:732-530-7080 P 0� alc No: 185 Newman Springs Road Alc Ext: PO Box 810 —A., : Red Bank,NJ 07701 ADDRESS Johnnie Rumbaugh INSURER(S)AFFOROINO COVERAGE NAIca INSURER A:Underwriters atLlo d's,London INSURED RP Management INSURER B: Valias R Herold Jr INSURER C: 120 Main St N Chelmsford,MA 01863 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. ggMM MgT- PO F E ICTR TYPE OF INSURANCE i g POLICYNUMSER AMIODlYYYY MMIDDIYYYY LIMBS GENERALLIASILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL 16NAMS0343 02123(2016i02t23l2017 PREMSESSEeo<curDAMA'L TO �rence $ 50,000 X CLAIMS-MADE ❑OCCUR , I MED EU(Any ane Gerson} $ X $2500 ded I PERSONAL A ADV INJURY $ 1,000,000 'GENERAL AGGREGATE $ 2,000,000 ' GEN'LAGGREGATE LIMIT APPLIES PER: I 'PRODUCTS-COMPQPAGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LABILITY i 'Eaa aa��t INoLE UM1T $ ANY AUTO SOCILY+N.A/RY(Pec Person) $ ALL OWNED SCHE.7JLED ISODLYINJURY(Petacciden[ $ AUTOS AUTOS NON-GINNED PeVac RtlerDAMA $ HIRED AUTOS AUTOS UMBRELLA LW6 OCCVR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE 8 DED RETENTION $ WOWERS COMPENSATION WC STA U- OTH- ANDEMPLOYERVLIABILITY YIN ANYPROPRIETORrARTNERF_hECUI1 E E.L.EACH ACCT $ OFFICERlIVEMSER EXCLUDED? ❑jNIA I (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE$ i'Yes,describe under ONn'beiow E.L.DISEASE LIMIT $ DESCRIPTION OF OPERATIONS i DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES(Attach ACORD 1Ot,Addiu.nm Remelka SchedWe,ITmora IPate Is regWrad) Mortgage Field Services - Errors & Omissions $1,000,000 (claims-made) $2500 deductible. Extended Property Damage $50,000 occurrence/$100,000 aggregat RE: Work at 242 Sutton Street, North Andover, MA CERTIFICATE HOLDER CANCELLATION NORTHAN 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. 1600 Osgood Street Ste 2043 North Andover,MA 01845 AUTHORIZED REPRESENTATIVE 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD The Commonwealth qJ'Alassachitselts Depat-Duent of lrulttslrial Accidents I CongnlssYfreet,Suite 100 Boston,NIA 02114-2017 wwlv.ntas.v.goi,/dia ti'nrlters'Compensation Insurance Affidavit: TO BE HIA"D WI I'll'HIF PERM]THM;At HIORYI 1'. Amilicant Information Please Print Leoffil Name tri,,,i..../o,gani,ati.aji RP Management Address:120 Main Street City-l'state."Zip:N.Chelmsford Phone#:978-310-1050 Type Of project(requiredy 7. []Nev,construction pa'J"i'lo,,,[,aut r hy.ad h-i plo­,­,k,,,,tonne P, S.E]Rernodelhig 1 9. El Demolition �t,mahisid ,III ht i, londla,'­, "'ll"'al, to p'lI V 1-11 10 nVtluildirig addition ­,,c,,h,t all coAt'a'i"', olw,hu,­.k...... I I.E]Electrical repairs or additions o1.'c Galhu')-1,6, 12.0 Plumbing repairs o r add i I ion s g-­l t i K-h 1 h t t t 7 d ul llach,l,hco 13.nRoof repairs h" a,sl .­­,k­ da­ffi­,h­........dd-­gh! 1-\IGIL 14.E]Otlicr_ affid"a i att.1"! mg Itlaill,11 the,,,b­wn�ck,­ not Irth, j'­d,,i,­ 'sl, mP 1'.1� -A ­ I ain art emplqver that is providing worAers'conipensation hisurancefor iar einplqvees, Boort'isthe policj-slid job Site information. Insurance Company Name:Liberty Mutual I 01-Self-jos.I,icj�:WC5-31S-363676-023 6-19-17 Fxpiration Date: job Site Address:242 Sutton Street Coyistate!,Zin:No.Andover,MA attach it copy of the Nvorkers,compensation policy declaration page(showing the policy number anti expiration(late), Pailnre to secure mserage as Inquired under 14iG1 e I5-'-,a35A is a criminal viplation punishable by a tine np to 51,500,00 and.or One-year imprisonment,mprisminvero,is well as civil penalties in the toms ot'a STOP Oil WORK ORDER and a fine of kip to$250,00 it day against the violator.A copy al this statement may be forwarded to the Otiee c>f Inveslieatians of the Dar\Cat'insurance coverage verification. I do hemki,cer ,I del.he aii�q idpenatti� pa to rat the injorinationprovidedo#ovelstrueandcarrect. 11*nature: Date: pilmle#:978-310-1050 Qjjicial rise onty. Do not write in I&N area,to he complefed hr Cat,or town official. City or Town: Permit/lAcense Issuing Authority(circle one): 1.Board offlealtlit 2.Building Department 3.Cilyffown Clerh 4.Electrical Inspector 5,Plumbing Inspector 6,Other Contact Pelson:— Phone#: The Contntainusealth of Slassachusetts Department of fudustrial Accidents 1 Congress Street,Suite 100 Bnsiotz,,17-f 02I1$-20I7 % tt wrttanass.aot'rflta !i'orkers'Cmnpensstintt Insurance Affidavit:Builders/Conte-actorslEfeetricianslPlennbers. TO BE FILED W FI-B THE PER31I 1-1 ING At FROM I Y. Applicant Information Please Print Lesible Name{8asines.`-O gani est,{-I{,di idtevl):RP Management Address:120 Main Street CitylSiate!Zip:N.Chelmsford Phone _378-310-1050 Ire—an entplorer'.Cbecs the appropriate bos. Type of project(required)' i-Q t aaz a p3--"'ah cnp r '(f;;i nr,- 7. n New construction 2F1I—vac P.pn,tor,,,:an—h.p -i.,-cr.ec{rr - :ottinE for Fre t1 &©Remodeling m,•e r v I Na„Y a .�nrr t • 9. ElDemolition 3[Ia,-naS ae C-E a t:-rka tt ti - m3 +,- 1` 10 {�Building addition ..—c th,a all-,ah,r U,-, a _ I I.D Electrical repairs or additions th emp on_ t _ a .=I reF`i. 12❑Pimnbmta repairs or additions —hoe. I_.n Roc f repairs I We 5 acr�arativn -it3 cFi}vir.h s.d{icu—,t uF r,E'1161,c 14.QOther 152_ -tm3}>ptham eha[eFsex���Pi,.tit al-.i:=iout[:at sec,z",kn:.a_k� _ ae:irrr.;�r��m}K:1- �I��y,t.mta;ian. i a,c M1,sx-.k: d th,n im,,ut�idc rcnt,ea 7o�s Ft u-.•h,Ftf a,a. - siz dine.,, 3,. -C-FVM1b..c.ttrak it1{Etn N}iS fes.,- .. -et)i{dl sni<1.(x't- -COf the ( �ct9:v 3�*d�tar2.�nCi -. tih4aec .i.:5aec I alit all ettipleteer that is providing ivorilersconspeaverfirnt insurance for enp entplot'ees. Below is tire policy and jolt site lftforntatian- Insurance Company Name:Liberty Mutual Police A,or Self-ins.Lic. :WC5-31S-383676-023 _ _ Expiration Date:6-19-17 242 Sutton Street ChvrSiate,Zi No Andover.MA Job Site Address:242 � '.. Attach a copy of the workers'compensation policy declaration page(showing the police"number and expiration date). Failure to secure wvera&e as required under s,1Ul-c.152,§°`A is a criminal violation punishable by a tine up to£3:{00.00 andtor one-year imprisonment-as well as civil penalties in the farm ofa STOP WORK ORDER and a fine of tip to$250.00 a day against the violator_A copy of this statement may be fortrarded to the Office of investigations of the DIA for insurance (cSoi v3enntgde-Verification.ficatiot-n. er do IlefCf10 dealt d peltj natrb Pboee -31050e97 ieS () ft iIl at fhL'tn,fQltnatfaDft aptFea; t'td<d a m"e S f�f 1fE'alfd calfefil. Official use tuft}.Do not write in this area.to be completed hr citr or town official City or Town: Permit/License Issuing authority(circle one): L Board of Health 2.Building Department J.Cityfown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person- Phone#: D-!ARI ES `,STRFE I ANE;G"t.l LL.0 BK: /IM6 PG: 102 R:11_ 112. 210/39 0023_00 C,11AINl_INK F,N(.E N76'28'46"E 57.17' GRASS c� 'j LOT AREA = 7020 SF 2:30 � TONI S IP"L I o N 0.161 ACRES N/f LO I,A M �A7N ?, AND TIMOTII .i. IAON'LR' 1i2usIFN G3` 12240 PC 2,, F>AR7 E ID: 210/39 17 �n s I _ PROPOSED ADDITION FOUNDATION 2 STORY WOOD I_ OFFICE EXTENSION N N ~ _, tJ I X14.72' r 11.72' i C_J� #242 2 STORY WOODLo c? i 14.82` 11.38,-.......... -- wnuu unmnioarww�, "l 1�3-t37 ann n � � 20. S8 09 57"w'BIT I 57.85' e TC 1.. 31T SIDEWgi_K F F6VNtiILN - ` I SUTTON (PUBLIC_ . 60 WIDE) STREET n v D c.Yt > f N/LK 4�--- ENT CURRENT ZONING: OWNER OF RECORD CERTIFICATION: ZONING DISTRICT: IS-INDUSTRIAL 242 SUTTON STREET, LLC I CERTIFY THAT THIS PLAN AS SHOWN "IS DISTRICT BK: 9992 PG: 205 IS BASED OUND SURVEY PARCEL ID: 210/39-18 CNOFMas MIN. LOT AREA 50,000 SF LOT AREA = 7,020 SIF MIN. LOT FRONTAGE 150' AN MIN. FRONT SETBACK 30' a,8;,R 1. MIN. REAR SETBACK 30' 'as MIN. SIDE SETBACK 20' ��� 0 4 SCALE 0 FEET 20 40 60 P FESSIONAL LAND SURVEYOR DATE JOB. NO: 16-368 FLO. BK:TAJ-16 PLOT PLAN OF LAND ATAJ ENGINEERING,LLC DATE: 08/24/2016 CHECK: HSA 242 SUTTON ST -- NORTH ANDOVER,MA TEDMAN ST,SUITE 36B,LOWELL,MA,01851 SCALE: 1" = 20 FT. SURVEY: SK/YM 225 S7MONTVIEWROAD,CHELMSFORD,MA,01824 CALC: HSA PREPARED FOR: SHEET: 1 OF 1 DRAFT: SK EJ PR INC �Pj078"250-8173 l: Toj-ngg@5 l.co -770-0632 / e-mail: TojenggC�ool.com