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HomeMy WebLinkAboutBuilding Permit # 9/13/2016 BUILDING PERMIT 4' y �� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ; 2 Permit NO: Date Received �P �RSSAC Huski�� Date Issued: I ORTANT: Ap licanf must complete all items on this page LOCATiQN PROPI=RTY aWNER Fir rnt NiAP ND PARCEL ZONING QiSTRI( T' Histar�c;D�strlct des n I far ft Shoji Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential i New Building One family Addition Two or more family Industrial 1,711 Alteration No. of units: C_' Commercial Repair, replacement _ Assessory Bldg Others: �i Demolition Other Setrc ©lltfell D Fla©dplart� 'V�Ietlartcls Watershed District Ci WaerlSewer .- Identification Please Type or Print Clearly) OWNER: Name: ] � Phone: Address: CONTRACTOR Name Phone ' Address Zh Supetvlso s Gslructlol Lleense Exp Dafe -lorn lllprovemeht, -2 YaF Icerlse Exp late ARCHITECT/ENGINEER ' � Phone- 2 ' Address: > 2 F / G Reg. No. ' FEF SCHEDULE.BULGING PERMIT:$12.00 PER$9000.00 OF THE'TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: FEE: $ b _ Check No.: Receipt No.- M NOTE: Persons contractingwith u regis erect contractors do not have access to the guarantyfund Signa#ure'o Agee C)�uri r " Signa#ure:ofi contractor ov 6 41111ZI s � - F t� Wk ov ear No, x.61 soh ver, Mass CO[n�Gnl w�GK 1' S U BOARD OF HEALTH Food/Kitchen . .PER I T Septic System os THI5.CERTIFIES THAT ............... .... .......................................,.,.........,.,.... .........,...... ................ BUILDING INSPECTOR f pais permission to erect buildings on ., ,,, Foundation ... ...................... R ou gh to be occupied as .... Vis . ,, ! .... Chimney provided that the person acceptingermishall in every respect nform he terms of the application Final on file in this office, and to the provisions of the Codes and By-La s relatin to he Inspection, Alteration and Construction of Buildings in the Town of North Andover. J� C �ti C .�r-/ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rp1gh Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTJWTI0Rough Service .. ............ . .. . . ........ BUIL©IN INSPE TOR Final GAS INSPECTOR Occupancy Permit Rgquired to Occupy Building 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. Date Printed Purchase Order Wheelabrator 9/13/2016 Purchase Order Blanket Change Order Number Release T E C H N 0 L 0 G I E S Official Copy 05160893 0000 000 Supplier No. 316084 Ship Via BEST WAY Date 9/13/2016 Issued Mailing Address Ship Point Helfrich Brothers Boiler Works Inc Freight Pre-Paid and Add 39 Merrimack St Lawrence, MA 01843 Terms 2% 10 Net 30 USA FOB Buyer Jack Cannon Phone: Fax: Phone 978-688-9011 ext Fax 978-794-8058 218 Submit Invoices To Ship To Wheelabrator North Andover Inc. Wheelabrator North Andover Attn:Accounts Payable 285 Holt Road 100 Arboretum Drive, Suite 310 North Andover, MA 01845 Portsmouth, NH 03801 Line Item Quantity U/M Unit Cost Extended Cost Sales Tax 1 RT026604-19 1.00 Job $15,000.0000 $15,000.0000 $0.0000 remove/replace building roof sections Account No 000.17521 End Use 15-109-223 Crane Mechanical Stores Acct Due Date 9/13/2016 Manufacturer Manufacturer Part No n/a remove/replace building roof sections to facilitate intenal equipment repairs A Total Extended Cost: $15,000.00 Total Tax: 0.00 Signature Total: $15,000.00 Page: 1 of 1 9/13/2016 8:44:32 AM Initial Construction Control Document (This Document is for Structural Design and Construction Review.) Submitted by a Registered Design Professional for work per the 8'h edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Wheelabrator-Refuse Handling Building Crane Replacement Date: September 12,2016 Project Address: 285 Holt Road-North Andover,MA 01845 DEI Proj.No.: D2643.2 Project: Check(x)one or both as applicable: Z New Construction F1 Existing Construction Project Description: Bracing-gf a of em orary removal of roof fr min2 for therenlacement of the refuse handling crane_ger DEI Drawin s T 02-29-102-Ri 103-R, 107-R, 112-R, & S-1 dated 08-12-15. 1, Jonathan M. Longchamp,P.E., of Daigle Engineers, Inc. MA Registration Number: 35867 Expiration Date: June 30, 2018, am a registered design professional, and I have prepared or directly supervised the preparation of the structural de- sign plans, computations and specifications concerning: F-1 Architectural M Structural F] Mechanical F-1 Fire Protection F] Electrical El Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engi- neering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary pro- fessional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Pei-form the duties for registered design professionals in 780 CMR Chapter 17, as deemed necessary based upon the complexity of the work. 3. Be present at intervals appropriate to the stage of construction to become genet-ally familiar with the progress and quality of the work and to formulate our professional opinion if the work is being performed in a manner con- sistent with the intent of the construction documents,industry standards, and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I shall submit field/progress reports (see item 3.) together with pertinent com- ments, in a form acceptable to the building official. Upon completion of our construction review services, I shall submit to the building official a 'Final Construction Control Document'. DEI shall be relieved of all construction verification responsibility if the final construction control document can not be provided. �Iv S JONATH Enter in the space to the right a"wet"or W electronic signature and seal: LONGGIAMP STRUCTURAL No.35867 rs.com Phone Number: 1-978-682-1748 ext. 117 Email: jlon n1i .1 1 jlon champ(�)daigleengince Building Official Use Only Building Official Narne: Pennit No,.: Date: Xie Commonwealth ofHus"s ch efts I�eczeffi of.�ic��t� o� cclde �. I Crongraysstreet,Saue.COQ -8 ogtov,HA 02114 2 017 1 w "bt a wppwunass.g'OYIdId *vokexs'Copeata:nsZancacavzt: /C0ILtr TO BDI MM W"tTHE BMUOUT`NG "UTHORTEY A scant n�°�xza nn Please print Leezbl ��31e{Bnsi�.ess/Drganitia�zoa�I.�nd�vzdual): � l� � . Cxtylstatefz p: �✓� Axeycu an empinyex?C ieeT fi3ieJappr,()pria e box-, Type of project(T�gdxbd)- 1.e l an.a"employer'"-.....� —i -liPioyrm(M andlozpat-,ims).* r: Q New cad�c{lort 2.�IamascIe�rap e�oxnrparinersTupandhanenae�nplayeess azI �ormern $. 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TthesrSb-cortacasl%aFeemployeDS, GeymusEproAidef7aeizraorkers'camp.paTzcynutubez Z tr�x eraiplayer iTz 4tr�ravitFifzgaxkeYs'cox�zpensaart insrxxace fo Or r epnployees:' Bero7vs fhepoZicy aradfo szte Et2f'o��.�atiox2. _ - 7ugarance Company Name: Policy#or Salf 12c,-.s.3� .#: 0 V zap aiio�a ?aEa f Sob Sito Address: Qty/State/zdp: c ttacb a copyo th a 7rexs'compea sa o pal eyde�axaa'�on)Page(Showing�laepo)zcynumbex ande�i�atoxx Failr�xe to sacur�carr age as required uzzderll�GL c. 1 2, §2SA s a cximinal.-viola-Ron prn ishabla by a.flue up to$1,500.00 and/or one-year nwrJsn31mant,as well as civil peDaHL us iia the foam.o9a STOT WORK ORDM anal a fine,dup to$250.00 a day agal st the-tdofator_A.copy of f liI9 sfatexoent may be fo.Twarded to fhb Ofti co ofrnvestigatioras Of-9"e DfA for insurance Cow"TagG V0 GatWL- Xdo Izereby cavapenttitces afpeJArV that ae irafornzaiiofprovided above is sue toad coF�-d ature: Data Si - Phone 9: Official rise ory. Do fzotxita zn ihzs arstt, K. tone completed`by raty or tarprz afficztt CzLy or Towjx: 3'exxndl�licex7Se ssuigg A oxz (circXe ozze): 4,BZeetxzca ectU 5�'IuMbzngl spectu �.]Boaxd of�'eaSt:�z 2.�3n�div�g 7�eparf�nex�-t 3.Ci€y/To�z�.Clerk � 6.Ofher cowtact pexson.: Phaxce#; HELFBRO-01 TAYER ACOROe DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 911312016 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 License#1780862 NAME:ACT HUB International New England PHONE FAX 275 Great Road AIc No Edt:(978)263-9577 (AIC,No): (978)263-4189 Acton,MA 01720-4739 ADDRESS: INSURERIS)AFFORDING COVERAGE NAiC# INSURERA:The Continental insurance Company 35289 INSURED INSURERB:Zurich American Insurance Company 16535 Helfrich Bros Boiler Works,Inc. INSURER C:National Fire Insurance of Hartford 20478 HB Air LLC 39 Merrimack Street INSURER D Lawrence,MA 01843 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X 6020461799 06/0112016 06/01/2017 DAMAGETO S(RENTED 100 00 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ r 0 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 1`1u PEC- FX]LOC PRODUCTS-COMPIOP AGG $ 2,000,000 GTN ER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000,000 Ea accident A ANY AUTO 6020516252 06/01/2016 06/01/2017 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Peraccidenl UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAR CLAIMS-MADE AUC017109402 06109/2016 06101/2016 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STAIN TUTE ER ,,,,,, .,,,,,, C ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ NIA 6023936640 05/29/2016 05/29/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 IF yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached If more space Is required) 9-13-16 Evidence of insurance 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 Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St,Bldg 20,Suite 2035 North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ?gray ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Y' M Ma' ssachuse##s Department of`pufrc$ �# i3oa ''0f n5';;egittion� anc .anar ti ��@iFS#fliCfl0if License 65-0.59008 MICHAEL PARE,* !• =8.4 ELM.ST r � HAVERRILL Mk 01 J Cammrssr ExpiraL 6— 1010�131A7S .�