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Home My WebLink AboutBuilding Permit # 12/22/2016 BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Date Received Permit Nc#: rza SS C U Date Issued:/ IMPORTANT: Applicant complete all items on this page M Al ,V7, rteN/ wm emmlpqlg,��, fir III 1. NO, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building Li One family 11 Addition Li Two or more family 0 Industrial L4Alteration No. of units: commercial D Repair, replacernent U Assessory Bldg 0 Others: 11 Demolition 11 Other p a ih,,,/, a or p 0, Won( E-11 I d" I W"t"",S hiia"d, "M �7 ig 2, IN I t ,Ti 4,4 DESCRIPTION OF WORK TO BE PERFORMED: Identi icatio Please Type or Print Clearly OWNER: Name: ti-14 Phone: 1'7- 71-S-L&J Address: ........... No P V ............ 1011011F E_x p, ......... ARCH ITECTIENG I NEEFa) Phone:_t?,Y--4-'17 —"LV?ef Address:2-LO fl,5(,mrevsc!�g: 0X.W,9vA4e0pj_ 'Reg. No. J - FEE SCHEDULE.BULDING PERMIT-7$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ r r FEE: $ Z- Z-4 4- 1W Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund conk Signature of FFa 6.o �0RT11 To wn of ndover 0 . No. Aq_ a1 o h ver, Mass COCMICHEWICHATED 1' P � V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .Ift VJ&; t BUILDING INSPECTOR has permission to erect.......................... buildings on S& . . P&W. Foundation , ... Rough to be Occupied asP................................... .., ` 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TION Rough Service .. . .. . .... Final TO BUILDING INS GAS INSPECTOR Occupancy Permit Required 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. OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER, PROJECT TITLE:® WeSt 50 High St. 4-th Floor PROJECT LOCATION: 50 Street, N. Andover, MA NAME OF BUILDING:- demising and tenant fit out. NATURE OF PROJECT, IN ACCORDANCE ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, REGISTRATION NO. BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR D!R!,'_-CTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND Sf-'1I'Z--,',!FlCATIONS CONCERNING: ENTIRE PROJECT ; XR--CHITECTURA—L-_*j STRUCTURAL MECHANICAL ........... FIRE PROTECTION ELECTRICAL OTHER (SPECIFY) FOR THE ABOVE NAMED '_`JECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPEC_'i;FICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE, ALL PCCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AW) ,0RDINANCES. FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I i,I:ALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND 13 EPRESENT ON THE CON STIFUC TION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEED;1'rY,,,.-., .1N ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL. BE RES','EINSSLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conforrnanc,, c, 'the design concept, shop drawings, samples and other submittals which are submitted by contractor in accordance with the requirements of the construction documents. MA 2. Review and approvzil of ,'io quality control procedures for all code-required controlled eA 3. Be present at intervnis ,_"-,ppopriate to the stage of construction to become, generally fa Is N0.9 6 a.Ry of the work and to determine, In general, if the work Is be' with6the progress and qo, SLIT E. performed in a manner cx:,,rsisent with the construction documents. A PURSUANT TO SECTION .2 1 SHALL SUBMIT WEEKLY , A PROGRESS REPOR THE NORTH ANDOVER BUILDING INSP TOGETHER WITH PERTINFi"Tr COMMENTS TO UPON COMPLETION OF WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLE-r7L AND READINESS OF THE PROJECT FOR OCCUPANCY. 1111ATURE SUBSCRIBED AND BEFORE ME THIS _ DAY OF URKINSHAW Notary Pt.Y1311c famr"anylealfli OF My COMMISSION EXPI P BLIC QkMaHn Expires NOTA 6P March 7, 2019 JK Contracting LLG Proposal 4 High Street, Suite 108 North Andover, MA 01845 617-592-6775 (Kieran) 781-254-2862 (Judy) Proposal Date: 12/14/2016 Proposal #: 203-73 Project: 50 High,4th Fl, N... E p Bill TO: Ship To RCG West Mill NA LI-C Northern Capital Daviid Steinberghi 17 Ivaloo Street 4th Floor,Smite 43 Somerville, MA 02143North Andover,MA 01845 Description Est. Hours]Qty. Rate Total Permit and C of O. 1,204.00 1,204.00 Demo, Includes dumpsters 4,500.00 4,500.00 Dust Containment, seal around perirf az it 300.00 300.00 Wall Framing 71500.00 71500.00. Coors &Trim 6,000.00 6,000.00 Glass walls 10,000.00, 10,000.00 Plumbing 4,500.00 4,500.00 Heating &Cooling, Ductwork only 15,900.QA 15,900.00 Electrical & Lighting 10,000.00 10,000.00 TelelData 5;000.00 5;000.00 Insulation 1,500.00 1,500.00 Board 2,500.00 2,500.00 Interior Walls, tape ,sand 4,500.00 4,500.00 Cabinets`&Vanities 4,000.00 4;00.0.00 Millwork&Trim 300.00 300.00 Floor Coverings $,500.00 8,500.00 Painting 6,000.00 6,000.00 Cleanup 500.00 :500.00 Supervision 9,270.40 9,270.40 Insurance 927.04 927.04 Total $102,901.44 Approved; (Initials) SIGNATURE i The Commonwealth of Massaehusetts bepan"met3t of'.IndustriglAccidints Qffieace of lavesfigatrrons 6§0 Washingion Street Bostony 31A 02111 lVW.Ma'ss govlrlia Workers' Compensation sm--a c—,Affidavit: Builders/Contractors/Ele.et�ricians/JPlumbears A licalnt Information .,_._ ... Please Print Le `bl Name(Business/0rgani-7ationgndividual) �- Address: u V( , r t --- City/State/Zip: !� �' qA ` Phone#: � CI —3� �— Are you an employer?Check the appro ataez7r.,t.ox:� Typo of project(required): I.. I am a employer with LY' 4. f-.� am a general contractor and I 6 []New construction employees(full and/or part-time)."` :�1 eve fired the sub-coirtractors . 2.❑ I am a solaproprtetor or partner- 17 steel on the attached sheet. 7.79 Remodeling ship and'have no employees `bwse sub-contractors have S. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. El Building addition [No workers'comp.insurance 5. E__3 YWe are,a coaporation and its required.] oiicers have exercised their ME]Electrical repairs or additions 3.[ l am a homeowner doing all work fight of exemption per MGI; 11.❑Plumbing repairs or additions myself.[No workers'comp. s,. 152,§1(4),and we have no I2.QRoofrepairs insurance required.]t employees.[No workers' - r ,omp.insurance required.] l3. Other 'Any applicant that checks bDx4f must also fill out the se,0",«.!'„W showing their workers'compensation policy information. T Homeowners who submit this affidavit indioatingtbey:;fe wE3'rEL,all work and then hire outside contractors roust submit a now affidavit indicating suck tContractors that check this box must attached an additic.za i 1;,;,c:t iznwiragthename ofthesub-contractors andtheir workers'comp.policy information. I am an employers that is providing wo?kers no,-,qand istation itnurancefor my employees. Below is iMe polley and joh site information. Insurance CompanyName:. C_S CN.M �iry Policy##or Self-ins.Lic. WL _; Expiration Date: 1 -7 f Yob Site Address: -� _ 1 ��+ �t J :" ` ��" City/State/Zip OK)f10 O Lr"-- Attach a copy of the workers'compensation jm'0,.y declaration page(showing the policy number-and expiration date). Failure to secure coverage as requiredunder Pisi 4i t:' : ofMGL o. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprlsomna:u:-as Stell m civil penalties in the form of a STOP WORK ORDER.and a fine ofup to$250.00 a day against the violator. Do adkfits,,E ld r at a copy of this statement maybe forwarded to the Office of Cnvestigations of the DIA for insurance coverage roiHfoafial. C do hereby ce under flee alns andpen xlei�s �;,°�r�juzy d/irfe Me information provided ahoy is true and correct. - _ .. j r � d G _ . a Official use only. Do not write In this area,r`c,. e: by city or iolvra official, City or Town: I�errnitllicense Issuing Authority(circle one): 1.Board of Health 2.Building Departme �t :-. ,:'::fjll'c�'tyra Clerk 4.Electrical Inspector 5.PZumbing71nspec#or 6.Other - - i Contact Person: Phone#: ---------- �y /� JKCON-1 OP ID: CD ER F O AT LIABILITY INSURANCE DATE(MMIDDIYYYYI 07/26/2016 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 INSU1 ANL,F;: DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,ANIS 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,urfaifi policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such end omt. nent(s)- PRODUCER CONTACT — NAME:----- — --- DeSanctis Insurance Agcy,Inc. PHONE — ._. — ---- ._]_FAX 100 Unicorn Park Drive E-MAIL. Woburn,MA 01801 _ Y- --f LL _!NURER[S}AFFORDING COVERAGE MAIC# INSURER A: Insurance Compan 012245 -- INSURED JK Contracting, LLC. INSURER B:Selective Insurance Company19269 4 High Street Suite 108 INSURER C -_--- _- North Andover, MA 0184;1 -- INSURER D-;-- �.---- _LN SURER E _ INSURER F COVERAGES --- CERT Ii I` A I Z NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES Or iN;URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE—FOR THE POLICY PES.UD INDICATED. NOTWITHSTANDING ANY REQQTIuIM N s TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, 7HE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH Fi)t.lc;,'.: . v!K4IHS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EF�POLICY EXP ILTR TYPE OF INSURANCE ,I J,r!�_ POLICY NUMBER ! MM1DDlYYYY MMIDDIYYYY LIMITS B I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I$ 1,000,00 CLAIMS-MADE CLn OCCUR ;i>2?(95113 1 0211012016 02110/2017PRENM SES E�u re�nCe $ 100,00 MED EXP(Any ane parson) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER— I GENERAL.AGGREGATE $_ 3,000,00 X , POLICY 7!jE 0 I, LOC 1 I PRODUCTS-COMPIOP AGG $ 3,000,00 OTHER: — "— I COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident _--_— $ BODILY INJURY INJURY(per porscn) $ ANY AUTO ALL OWNED SCHEDULED I I BODILY INJURY(Per accident), AUTOS __I AUTOS PR5FCRTY DAMAGE HIRED AUTOS _ NON-OWNED I II PROPE $ Pei accident} AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MAUL AGGREGATE $ DEO RETENTION I $ WORKERS COM ,_ T..,_.___.. X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETORlPARTN£RlEXECUTIVE r--, ilVCC�f63742 02117I2016 10211712017 I E.L.EACH ACCIDENT— $ '100,00 OFFICERlMEMSER EXCLUDED? 1 N l --�- — (Mandatory In NHi L-i I;hiir'k i E.L.DISEASE-EA EMPLOY@E $ 100,00 If yes,describe under 500,000 DESGRIPTION OF OPERATIONS 1 elow E.L.DISEASE-POLICY LIMIT $ -- - DESCRIPTION OF OPERATIONS!LOCATIONS 1 VEHI('FS 101,,additional Remarks Schedule,maybe attaoted If more spaco Is required) "ADDITIONAL INSURED LIMITS ARE No GREATER R THAN THOSE REQUIRED BY WRITTEN CONTRACT" Illustration of Coverage; Tca+r ri of North Andover is add'I ins'd as respects to the GL policy. CERTIFICATE HOLDER - ny CANCELLATION - -- NGIRTHA- 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. 43 High Street N. Andover, MA 0184 AUTHORIZ PRESENTATIVE I O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The CORD name and logo are registered marks of ACORD S jt Massachusetts Department of public Safety }. Board of Building " g Regulations and Standards i License: CS-066334 Construction Supervisor E t KIERAN T WHELAN" ~' 31 RICHMOND STREP_;k � WEYMOUTH MA_02ii1 .l f 5 Iii Expiration i cainm.issioner Og! _ 2&120'17 ,�; ^%�r �rvrrurr=nrcrrrll/r r�^llr.l.;rrr/rr.;r//; ,, Off ce of Consumer Affairs&.Business Regulation (HOME IMPROVEMENT CONTRACTOR } .1 Reglstrafion 17,1393 Type: t r Expiration. 3/ 5120]8 Individual _.amu KIERAN WHELAN KIERAN WHELAN 31 RICHMOND ST WEYMOUTH, MA 02188 Undersecretary License or registration valid for iaidivjddal«se only '-hefore the expiration dAte. If found return to: Offiee of Consumer Affairs and Business Regulation. )!4 Park Plaza-Suite 5174 ` Boston,MA 02116 iotot valid withoat signature r CALL V.'O,W MO%rCC1p, 1111-QL bj"A"idCLCiL((JE;m Office:of CoMiriner Affairs&Business Regula#inn H,dME[iWIPROVEMENT..COTRACTOR Eiegi'sti'at;ori r:`1^71393 TY - Explratiait'.:-z'_._1 :5t2&18 Corporation X CONTRACTING LLO KIERAN WHELAN 31. RICHMOND ST WEYMOUTH,MA 02188 Undersecretary