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Home My WebLink AboutBuilding Permit # 11/4/2016 BUILDING PERMIT 4 TOWN OF NORTH ANDOVER :0 APPLICATION FOR PLAN EXAMINATION '-- Permit No#: Date Received 11- el-�042 CHUS Date Issued: EVITORTANT:Applicant must complete all items on this page '� j7b LOCATIONo Print PROPliRT- Y OWN Y structure yes MAP OA ye.s no , RQ Y_ �0) Machine .............. Ls no, ------ ---—------ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building D One family 0 Addition 0 Two or more family Ll Industrial Ll Alteration No. of units: k,Commercial 1i Repair, replacement E Assessory Bldg [:1 Others: 11 Demolition Ll Other " qpfic, bMli' El Floodp 81 n Wetlands El Watershed ist fir-,t El Water/ ewer DESCRIPTION OF WORK TO BE PERFORMED: ------- ........... Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: e7 7* 119 a_ 2 LA(' Phbne Address:/0.57. hW 5 S .722 e c: 4 21 chv I Exp. [Date: ,// �``"....,.-..r..-Y `""etlw-2t Construction Ljc-ense:.*/(/'// Horne Im pTov!pqne,, 't License: Date-. ti ARCHITECT/ENGINEER Phone: Address------- Rea. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F. Total Project Cost: $ 1�,2 I22 , FEE: $ l Check No.: t Receipt No.: 3M-15-09,4P 3 Z 13 3 _3 NOTE: Pervons contracting witli unregistered contractors (to not have-acc tot g ran a t1l e 8 ure of contracto k tAORTi j '4 own of _ 6Andover O �" 0 No. 10L � h ver, Mass, Coc"ICM[WK 1 �•4 4�rE o S � U BOARD OF HEALTH Food/Kitchen PERMIT . T LD Septic System THIS CERTIFIES THAT Q M.MttAtA C.......C.10.4.. „� . r...,�Q!i�.�..C.�.,. BUILDING INSPECTOR has permission to erect ................. buildings on ...3_smq�...... .. i*m Foundation Rough to be occupied as ....... ............u*x!r......../......oor........ k......._....... Chimney provided that the person accepting this permit shall in every 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. #6411 A' 1 5#1 1.^00 PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS C®NSTRUCTI® TARTS Rough . Service ......... Fin . ... .G... . ...................................... d BUILDING INSPECTOR GAS INSPECTOR -••Occupancy to Occupy.�uaddan� Rough Permit 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 pet. Commonwealth of Massachusetts Sheet Metal Permit Date : Permit Estimated Job Cost: Permit Fee: Plans Submitted: YES NO plans Reviewed: YES NO Applicant License 0 Business License Business information: property Owner/Job Location Information: old Name: Name: ev 2 ! 0 V,�f Street Street: City/Town: a?u��– Telephone: Telephone: Photo I.D. required Copy of Photo I.D. attached: YES No Building Type: Residential: 1-2 family Multi-family— Condo/Townhouses commercial: Office_ Retail ---'j-adusftjal_ Educational— institutional Building Cubic Footage: under 35,000cu. ft. over 35,000 cu. ft. Sheet — S et metal work to be completed: New Work Renovation: M Chinmey Vents Utchem-Exhaast System-etal Roofing I HVAC Provide,brief description Of work to be done: :5 MD W7, JOB: NEW TENANT ROOF TOP UNITS BRANAGAN ENGINEERING, INC. MARKET BASKET #12 160 OLD DERBY ST., SUITE #335 350 WINTHROP AVE, HINGHAM, MA 02043 NORTH ANDOVER, MASSACHUSETTS (781) 749-5400 DATE: OCT. 17, 2016 SKETCH NO. SK-4 A (E) CMU WALL --- ---------�8 —' �.-,.--- T�--'-�' � q PETER B. _- -- �I-- -- BRANAGAN STRUCTURAL No32748 A 9 O 4 (E) CMU --- —L4x4x1/4 UNDER CURB, TYP. I) Inf WALL VERIFY RTU LOCATION WITH II � MECH-L. DWGS. (TYP.) I II o -- ----- ®I NEW 10 TON RTU WEIGHT=1.250# I II II L3x3x 1/4 AROUND I I( 1 I I I D UCPT)OPENING I (( I 11NEW 8.5 TQN RT f I WEIGHT 1.200#U II ° If GENTLE DENTAL I I I NAIL SALON f f I I II I II f I � I I II I PARTIAL EXISTING ROOF FRAMING PLAN SCALE: 11/8"=V-0" NOTES. 1.) ALL CONSTRUCTION IS NEW, EXCEPT THAT WHICH IS NOTED (E) EXISTING. 2.) COORDINATE FRAME DIMENSIONS WITH "APPROVED" RTU. 3.) SEE SK-3 FOR "NOTES" AND "TYPICAL DETAILS". 4.) NO OTHER NEW OR EXISTING MECHANICAL EQUIPMENT TO SHARE JOISTS WITH NEW RTU. C:\DRAwlNGS\16129 Information and Instructiions Massachusetts General Laws chapter 152 requites all employers to provide workers'compensation for their emp dyes. Pursuant to this statute,an employee is defined as"...every person in the sex-vice of another under any contract of hire, express or implied,oral or written," Ain eraaployer is d'efnied as"an individual;partnership,assaoiation,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receivbtbr-tra8tee Qfau individual,partnership,association or other legal entity,employing employees:.However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant ofthe dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be domed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicaAt who has not produced-acceptable evidence of compliance with tho insurance coverage ieguited" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter intp any contract for the performance ofpublic work until,acceptable evidence of compliance with tho insurance requirements of this chapter have been presented to the contracting authority," Applicants Plcasb fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub'contcactor(s)name(s),address(cs)and phone number(s) along with their certificates)Of insurance. Limited Liability Companies(LLC)or Limited LiabilityPattaerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC oz•LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retmued to the city or town that the application for the permit or license is being requested,not the Dai artm-ent of 7n-dustrial•Aceidonis. Should you have any questions regarding the law or if you are required to obtain a workers' compensatr'oni policy,please Gail the 1)apartment at the nuruber listed below. Self insured companies shoo-Id entor their sal�C�-insura'nco license number on the appropriate lino. City or Town Officials Please be sure that the affidavit is complete and printed legibly_ The Department has provided a space at the bottom ofth G affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant thai:must submit multiple perinit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"lob Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has b can officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for ftwe pennits or licenses. Anew affidavit must be filled out each Year.Where ahome owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn Ieaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The, Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 021142017 Tel. #617-7274900 ort.7406 or 1-877-MASSAFD Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia, AC RV CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 9/19/2016 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(ies) 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 NAME CT Patricia Capadanno Tonry Northwest Insurance Agency, Inc. PHONE (781)861-1800 AX1AIC.No.Exit: (AIC No.(781)861-1804 238 Bedford Street E-MAIL certs@tonry.com ADDRESS: y' INSURERS AFFORDING COVERAGE NAIC# Lexington MA 02420 INSURER A:Harle sville Preferred Ins. 35696 INSURED NSURER B:Harleysva.3.l.e Insurance 23582 Commercial Comfort Service Inc. INSURERG.Harl.eysville Worcester Ins Co 26182 1059 Bast Street INSURERDAmGUARD insurance CompanV 42390 INSURER E; Tewksbury MA 01876 114SURERF: COVERAGES CERTIFICATE NUMBER:CL1621912526 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. IN5R TYPE OF INSURANCE _. P, S BR POLICY EFF POLICY EXP LIMITS LTR 5 POLICY NUMBER MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OX OCCUR .-PAHA E PREMISES TOEa occurrRENTEDe50,000 nce $ SPP00000029007Q 2/22/2016 2/22/2017 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 PRO LOC PRODUCTS-COMPIQP AGG $ 2,000,000 E-]JECT ❑ ____._ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea auidem ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULER ...�._ AUTOS X AUTOS BA00000029086Q 2/22/2016 2/22/2017 BODILY INJURY(Per accident) $ ._.� NON-OWNED PROPERTY DAMAGE HIRED AUTOSX AUTOS Per accident PIP-Basic $ 8,000 X UMBRELLA LIAS OCCUR EACH OCCURRENCES 10,000,000 C EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 LIED RETENTION CMB00000029085Q 2/22/2016 2/22/2017 $ WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN ANY PROPMETORIPARTNERIEXECUTIVE ❑NIA E.L.EACH ACCIDENT $ 1,000 OOO OFFICERIMEMBER EXCLUDED? n D {Mandatory In NH) COWC700192 2/22/2016 2/22/2017 E,L,DISEASE-EAEMPLQYE $ 2,009,000 It 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 be attached if more space Is required) Certificate Holder is an Additional Insured, when required by written contract, but only to the extent provided in the Additional Insured endorsement(s) attached to the policy, a copy of which.is available upon request. 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 ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE L Tonry Jr./PCAPAD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD iNSn25 f7nlan1l COMM.ONWEAM OF M. 'S 4YyH JSE S BPARD O $HEMI METAL1 �?Cdr� KFR5 13SUES 7 HOLLOWNG LFCEN$E"A5 A 1V)AS1 ER UNRESti�'RI� ICTEt , RAYMOND SAWLAN 017!. 2268 p a „,„ � i wra•��+waw1esu"'r:we 4i 414` afar MCWmWYNw °COMMONWEALTH QF MASSACHUSETTS BU iRL?OF ° f SHEE ,- OTAL.WaRKERS:. ISSUES THE FOLLOWING LICE NSE:AS A ` MASTER-UNRESTRpCTEDcc RANDALL E BURNS.. " C 999 WEARE RIS. ” HENNIKR, NH 03242(}687.. 5071 6412812018 30469cw Fold,Then Detach Along All Perforations OMMQNWEALTH OF MASSACHUSETTS BOARD Of SHEET ME fAL V1lORKERS'. ISSUES THE FQL,LOWIN0 LI6Lf SE BUSINESS . DWI(IGHT L DAVIS .,.3. f Cl7MMERCIAL COMFORT SERVICE INC ' 1059 FgT. 7F2IWET ' TEWI(SSCJR`(, MA $7.6464 91.,', 01261201 B. 188720