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Home My WebLink AboutBuilding Permit # 1/3/2017 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: mm Date, Received�71, D27 a _f�jj_ - )ate Issued:. RT T: Applicant must complete all items on this page -0y _LLM J 1€7 J ........... P '(0 P PZ4 1 Y OWN P "A I- r FygaTs 0 F621L fe- yp§ 10 Kstb-ria�IDistribit [MAR P 1 8-, 1, ��ul�-]_ P A R.2�-1i L 21 0 NI N, b S T I Cp T!i Mb i ,,.. ........ n n 6,S t L00 ill' og", TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building Ll One family 11 Addition El Two or more family [I Industrial 0 Alteration No. of units: 0 Commercial Repair, replacement 0 Assessory Bldg E Others: 0 Demolition 0 Other 0 A Ist v_v A IN dNria" d ain E Wet a�rj-s. Well , 0 S, vvFIRIP, er, ?IPTION OF WORK TO BE PERFORMED: e VaTation Please Type orvi. Clearly' OWNER: Name: Phone: Address: eco�a ------------ t.fat-to e N Ad res ki Sil 01---6ogtrubti-bri, .S t ARCHITECTIENG I NEER- Phone. Address: Reg. N-o.__: FEE-SCHEDULE:BULDING PERMIT.$12.00 PER$1000,00 OFTHE TOTAL ESTIMATED COST BASED ON$125,00 PER SF, " 5 $ Cost- $ FEE: otal ProjeeA ------- Check No.: Receipt No.,• __121i4l ( :NOTE: 1?erso rcae A 4th unregistered contractors do not have.-access to the guar arty fund ------------ ORT Town of ndover `F • � a 9 Teo BOARD OF HEALTH Food/Kitchen PERMIT Septic System THIS CERTIFIES THAT ........Arm . BUILDING INSPECTOR Foundation has permission to erect .......................... buil ins on ..... ........... . ....... ... . .. .. .... .. ,. . Rough t0 be occupied a5 ......, .. . . ... ..... ...... t Chimney provided that the person accepting this permit an in ev spect conf t th rms of the appli ation Final on file in this office, and to the provisions of thCodes and B aws rel g to Inspection, Altera Construction of Buildings in the Town of North` hover, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulation 'Voids this Permit. Rough Final RMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough Service ............ .. .. .... ............. BUILDING INP TOR Final GAS INSPECTOR Occupan ' Permit Rough Display i Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building ® Burner Street No. Smoke Det. own ® _ tT. b ver No. (A#4'9�a ver, Nass, ® 3 [pc.uCr/I w�CR �' s u BOARD OF HEALTH Food/Kitchen PER LD Septic System THIS CERTIFIES THAT . BUILDING INSPECTOR ... ... Foundation has permission to erect .. ..................... buildings on . .. ......9 . 4 .... ............,.,, ...... Rough to be occupied as ............ .. ... .. ,.,..��....................................................................... 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 LESS CONST Rough Service I .....ST* .. ............................ Fina! BUiLD1NG INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy RuildinRough 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. Enter construction cost for fee cal - North Andover Fee Calculation Construction cost�! *�f t1, �1�,�1 1 G��V�.VV m � 150.00 18.75 Plumbin Fee 1pp pp Gas Fee 100 comm. 18.75 Electrical Fee 287.50 Total fees collected 7 Royal Crest Drive 683-2017 on 1/312017 Bathroom Remodel i ............. ------ ....... .......... ........................ ......................... ........... T V%OR il I own of ..'it, Andover . No. COCKIC.2wic. ver, Mass, ATED C BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ......4tA4.04.1V......GrA.rc................................. ......... ............. has permission to erect.......................... buildings on ....... ..... Foundation Rough to be occupied as . . ........ ....... Chimney .7 Final provided that the person accepting this permit shall in ev respect conform to the terms of the application 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 CONSTRUCTION T RTS Rough ... . Service ... 4 � ......... Final BUILDING TOR GAS INSPECTOR Occupancy Permit Required t® Occupy Rou'gh 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. i I 55 Main St ' Saugus MA 01906 Fax 781-605-1017 Cell 781-962-99801 Sidnei Eleoterio 12/30/2016 Royal Crest Estates 50 Royal Crest Dr North Andover MA 018045 Bldg 7 unit 5 contract Abate-Demo bathroom walls and ceiling *Install new drywall *compound,sand,prime &painting *install new plumbing fixture *install new electrical fixture Total $12,500 Manager si natur �' � l / `"Date � � 9 9 Contractor ` Date Sincerely, Sidnei Eleoterio CELL#781-962-9801 FAX# 781-605-1017 Golden Gates Services Inc. ACL # 000793 1 ASL #900973 CSL #097988 HIC #167403 12/3012016 12:01 Prescott& Son Insurance Agency ('AX)7813333278 P.0011002 � RV CERTIFICATE OF LIABILITY INSURANCE DA7E(MMIDD1YYYy) 22130/2016 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 ENSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(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 rlghks to the certificate holder In lieu of such endorsement(s), e PRODUCPR P Prescott: and San Insurance Agencyjna. E (781)3222350wetFAI, Ne: 963 Eastern AvanueESS: INSURERS AFFORDING COVERAGE NAIG e Maiden MA 02148 INBURERA INOMOlatf,d InUVX41306 Co of Naw York INGURrm INSURER B:ArhG111A PZQtwQtiPn Ins Co 41360 Golden Gate Sarviaes, Ino IN3UReRc:N,3.uti1as Ins. Co. 55 Main Street INSURER D.Travelers Indemnity Comany INBURER E: e� HauguMA 01906 INSURER P: COVERAGES CERTIFICATE.NUMBER CL16123024505 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 CONOITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TYPE OF INSURANCE POLICY NUMBER r4P LILY EFY POLICY E%P LIMITS X COMMERCIAL GENERAL LIABILITY EACHoCcuRRENCE S 1,DOU,D00 A CLA(M9•MADE a OCCUR p EN ttenes t .- 5DD,000 7$3-00-36-1D-0001 9/25/2016 9/25/2017 MED EXP(Any one person) 8 31000 PERSONALAADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 13ENERAL AGGREGATE ; 2,000,000 X POUOY❑ 11#6T ❑LOC PRODUCTS-COMP/OP AGO i 2,DOD,000 OTHPW b AUTOMOBILE LIABILITYsal IN LE LIMIT S 1,000,000 Ii ANY AUTO BODILY INJURY(Par perron) 9 ALL AUTO&OWNGo SCHEDULED 1020005485 9/21/2018 9/21/2017 BODILY INJURY(Per accident) S AUTOS NON-OWNED PROPERTY pAMA X HIRED AUTOS AUTO$ $ COMBI UMBRELLALIAB OCCUR EACH OCCURRENCE $ 2,000,000 Er(CE98 LIAB CLAIMS-MADE AGGREGATE 8 2 000 000 DED RETENTION S3 9/21/2016 9/21/2017 3 W0RKr.RS COMPENSATION SPER TAT TE OTH AND EMPLOYER$'UASILITY Y 1 NER ANY PROPRIPTORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFECERIMEMBER EXCLUDED? EINIA (Mandatory In NH) Regwetaa Prem tho Company 10/28/2016 10/28/2017 E.L.DISEASE-EA EMPLOYE S if Yoe,dQacrlbe under De 6RIPTION OF OPERATION$below E,L,DI8EASE-POLICY LIMIT 3 DESOMPTIoN of OPERATIONS I LOCATIONS I VEHICLES(ACORo 101,Addlt(onal Remarks Schedule,may ba%trach9d If mora space le requlmd) I CERTIFICATE HOLDEN CANCELLATION (978) 688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATIOBI DATE THEREOF, NOTICE WILL. BE DELIVERED IN Attn., Paul Filxtehillla ACCORDANCE WITH THE POLICY PROVISIONS. 1.20 Main St North ,Andover, MA 01845 AUTMORI2:PDRPPRC6SNTATIVG ,T S SCholniCk/PJA 01988.2014ACORD CORPORATION. All rights reserved- ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) 12130/2016 12:01 Prescott& Son Insurance Agency (I:AX)7813333278 P.0021002 CERTIFICATE OF LIABILITY INSURANCE DATE(MMoorrvwl 12/30/2046 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 DOCS 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 pOiloy(les) must ba endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the polloy,Certain policies may require an endorsement. A statement on this Certificate does not confer rights to the Certificate holder In Ilou of such endorsement(s). PRODUCER ACT VAMP: Paul Rackl PRESCOTT& SON INS. AGENCY INC. rrloNs 322-2350 FAX 7s as: paul@prescottundson.com 953 EASTERN AVENUE INOURER a AFFORDING COVERAGS NAIL S MALDEN MA 02148 1N19URI;R A; TRAVELERS INDEMNITY CO OF AMERICA 25688 1NE1,rp✓"r1 IN9UR6R e GOLDEN GATES SERVICES INC INSURERC: INSURER D 55 MAIN ST INSURER 6: .SAUGUS MA 01906 INSURER F: COVERAGES CERTIFICATE NUMBER: 114786 REVISION HUMBER: 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. LTR TYPE OP INSURANCE Po i'AUCY ExP POLICY NUMBER MWDD UTArrB COMMERCIAL GENERAL LIABILITY F.ACHOCCURRENGE $ CLAIMS-MADE OCCUR PREMISES iE@ Qw%jimc@) $ MED EXP ft one pv wn $ NIA PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGOREGATE $ RO. POLICY❑JPECT EILOC PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED $ iL„ ,. ANYAUTO INJURY(Per peraon) $ ALL OWNED SCHEDULED NIA INJURY(Per ecddent) $ AUTOS AUTOS NON-OWNED $ H1RiOAUT08 AUTOS dnt S UMeReLtlt uAD OCCUR EACH OCCURRENCE $ EXCESS LIAe CLAIMS-MADE NIA AGOREOATE $ OED RETENTION $ WORKERBCOMPENSAT10N X PER AND EMPLOYEW LIABILITY YIN QP'E ANYPROPRIETORIPARTNERlEXE,UTtVE E.L.EACH ACCIDENT $ 500,000 A OFFICERJMEMBEREXCLUDED7 I NIA NIA NIA 8HUB4898P83816 10/28/2016 10/28/2017 (Mandatory In NMI E.L.DISEASE-EA EMKOYEE $ 500,000 IF p d,1,"I undo, SG�RIPTIOreN OF OPERATIONS below E.L.DISEASE•POLICY LIMIT s 500,000 NIA DESCRIPTION OF OPERATIONO;LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarha Schedule,may be,attaahgd If mora apace la raquirad) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees In states other than Massachusetts if the Insured hires,or has hired those employees Outside of Massachusetts. This certificate of Insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of Insurance). The atatus of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www-mass.govilwd1workers-compeneaticnAnvestigatiansl. CERTIFICATE MOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THP EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Noah Andover ACCORDAN01i WITH THE.POLICY PROVISIONS. 120 Main Street AUTHORIZED REPRES ENTATIVE North Andover MA 01645 Daniel M.Crq�ky,CPCU,Vice President—Residual Market—WCRISMA ®1960.2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD 1' NOTICE W NOTICE TO a TO EMPLOYEES EMPLOYEES V Q"�M Sig The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114 — 2017 617-727-4900 — http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152,Sections 21,22&30, this will give you notice that I(we) have provided for payment to our inured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO A 02344-1450 ADDRESS OF INSURANCE COMPANY (CHUB-489BP83-8-16) 10-28-16 TO 10-2a-17 POLICY NUMBER EFFECTIVE DATES PRESCOTT & SON INS AGCY 963 EASTERN AVE MALDEN MA 02148 �— NAME OF INSURANCE AGENT ADDRESS PHONE# o GOLDEN GATES SERVICES INC 74 SPRINGVALE AVE UNIT 8 CHELSEA MA 02150 �'--- EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions-of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the s NAME OF HOSPITAL ADDRESS 001402 W20PI016 TO BE POSTED BY EMPLOYER I 1 I a1t1 �w 41slerl MIAs .. asci a1maiWim b � E �� M�1°r:ia a1ss��11� VN CS-0988 Sidnei die°terio -244 Kennedy Dri"#402 48 }y�alden MA 021 ��sit is~s s�r 49 0211SI2011 c1�11z re �._ �. "! •. ' LICENSE :,.,: I. a ui i i IYP � 'r.,flaF1�D 4d W, 9N, NE �m 'rz 81DN r 9 55 MAIN STREET SAU6US,MA 01906 6 DD 01.06]916 Rev91.10"2009 f I cr�,Pr/r rta;Vc�/J�R IT Office Of( $usigcss Re�nlsttfiola WE IMPROVEMENT CONTRACTOR ! giStration: 167403 ExpiratipW 5/22120 Types' GOLDEN GATES SE Corporatian RVUCE8 INC. f SIDNEr ELEOTERIO j 244 KENNEDY DR.402 IUTALDEAI,MA 0214 C'. JJndersccrctaryM ._