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Home My WebLink AboutBuilding Permit # 2/13/2017�717 t%ORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit NO:: Date Received 4 .0 �fl US Date Issued: IWORTANT: I items on this TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential C1 New Building []One family El Industrial i-1 Addition [i Two or more family DkIteration No. of units: El Commercial Ci,Repair, replacement D Assessory Bldg El Others: 11 Demolition 11 Other MEMEMEM 1111'vul Identification Please Type or Print Clearly) OWNER: Name: Malcolm Beal Phone: 978-746-1339 Add 27 Trull Brook Lane Tewksbury Ma 01876 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.,SULDING PERMIT.,$JZOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE- $ 7 t" oe" Check No.: Receipt No.: ' NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund P1, Complete Facilities&Project Management �raou�aacemac«, m,Fro�ae 71 Certified Plot Plan El Stamped Plans F1 CAD CAFM Suawt-plemeNabon s gruni�ng Pools f Malcolm Beal �ageBody Axt 0.., : , [ , 27 Trull Brook Lane s ❑ Pood Packaging/Sales C7 Tewksbury,MA.,01876 El978-746-13391 malcohn bea1@yah--- Mpstar on site i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ R COMMENTS CONSERVATION Reviewed on 5i nature COMMENTS HEALTH Reviewed on Si nature COMMENTS Zoning Board of Appeals:Variance, petition No: Zoning Decisionlreceiptsubrmtted yes Planning Board Decislon: Comments Conservation Decision: Com[nents Water & Sewer Co17Y➢eGtion/si nata�re�Bate Drivewa Permit DPW Town E+n.gineek: Signature: Located 384 Os ood Street FfKE=DEPARTMc-h -Temp Dumpster on site yes no Located-at-124 Main'Street- Fire De1J6r inef sigrlatureldate COMMENTS �`- ---a NORTH �9 Town of R6 ndover No. T t r h ver, Mass, i P LAK. .1. _ ,q A�RRT�o r44`�.c5 `$ U BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR ....................................... ... . THIS CERTIFIES THAT ..M.�1C MAI,......•13'& .. ..............`.. ��ww � .�.� Foundation buildings on ....... 1..f S..........� t.�. �.. ,!�.... Rough has permission to erect.........•.....•.•••.••.. g � �i ww to be occupied as ........ rrChimney *.9...,. .. WI�..........! ,t .. r ......Jl!.� ]4►.. 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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT E I ! MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI T RTS Rough Service ......... .. .. ........ ...........I—........ Final BUILDING INSPECTOR GAS INSPECTOR oecupaneV Permit Pe aired t® occupv Puildin-ar Rough Final Display in a Conspicuous Place on the Premises - Do Not Remove FIRE DEPARTMENT No Lathing or Dry Wall To Be Done Burner Until Inspected and Approved by the Building Inspector. Street No. Smoke pet. DATE(MIODD1YYYY) ACI R0) CERTIFICATE 4F LIABILITY INSURANCE 01/20/2017 Fthe EIS RTICFICATE DOES NOT AFFIRMATIVELYEOR NEGAT VEI YR OF IAMEND EXTEND OR ALTER THE COVERAGE AFFON ONLY AND CONFERS NO 1:IGHTS Ul:Of'It' ORDED R( HE POLICIES TE HOLDER, 5 ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. It She ceriiicate holder is an ADDITIONAL INSURED,the p,11b, fes)must be endorsed. ItSUBROGATObject to terms and f the cions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the con certificate holder In lieu of such endorsement(s). Caleb Kirby NAME'C No Ext 603-432-4732 PRODUCER 603-432-2344 A1C Ne P Caleb Kirbyckirby@amfamtinancial.com NAIC A American Family Financial Group LLC ADDRESS: INSURER(B)AFFORDING COVERAGE 34 Crystal Avenue INSURERA: Farm Family Casualty Insurance Company Derry NH 03038 INSURERS: i INSURED INSURER C Malcolm Beal INSURER D: INSURER E t 27 Trull Brook Lane ry MA 01876 Tweksbu INSURERF: REVISfON NUMBER: COVERAGES GERTIFICATE NUMBER: THIS IS TO CNOTII:i I1 AND NG ANY REQUIREMENT,TERM OR CONDILISTED TION OF ANHAVE EY CONTRACTTOR OTHER DOC MENT W iTH RESPECT TO WHICH PERIOD INDICATED. BY THE CERTIFICATE MAY BE ISSUE NS OF SUCH TAI POLICIES, INSURANCE SHOWN MAYHAVEBEEN REDUCED BY AID CLAIMS. EIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CO LIMITS EACH OCCURRENCE $ TYPE or INSURANCE INSR WVD POLICY NUMBER MMlDDlYY MMIDDIYYY 1,000,000 LTR GENERAL LIABILTTV 100,000 PREMISES Ea occurrence $ COMMERCIAL GENERAL LIABILITY MED EXP(Any one parson) CLAIMS-MADE N OCCUR 1,000,000 2001 X 1278 08/05/2016 08105!2017 PERSONAL&ADV INJURY $ 2 000,000 A Select Business Package GENERALAGGREGATE $ PRODUCTS-COMPIOP AGG $ 2,000,000 GERLAGGREGATE LIMITAPPLIES PER: $ PRO POLICY JECT LOC Ea acddent $ AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ ANYAUTO BODILY INJURY{Peracc!dent) $ ALLOWNEDSCHEDULED $ AUTOS NoN. Per aCFideM on-owNeD g HIREDAUTOS AUTOS - EACH OCCURRENCE $ UMBRELIJSLIAB OCCUR AGGREGATE $ EXCESS LIAB CLAIMS-MADE $ DED RETENTION$ TORYLIMITS ER WORKERS COMPENSATION AND EMPLOYERS'LIABILIYI TY E.L.EACH ACCIDENT $ ANY PROPRIETORIPARTNEFVEXECUTIVEN NIA E.L.DISEASE-EAEMPLOYE $ ( AlaEXCLUDED? nd tory in NH) tl yes descnbe Undue EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DFSCRIpTION OF OPERATIONS!LOCATIONS 1 VEHICLES(Attach ACOR0101,Addillonal Remarks Schedule,if more apace Is ret{ulred) Carpentry-585 Chickerning Rd(125)North Andover,MA Email: hubbardcarpentry@hotmail.com ANn:Samuel Hubbard CANCELLATION CERTIFICATE HOLDER 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. AUTHORIZED REPRESENTATIVE North Andover MA Caleb Kirby i98&201 D ACORD CORPORATION. All rights reserved. ACORD 25(2010!05) The ACORD name and logo are registered marks of ACORD License or registration valid for individul use only UVM? 0?IIIII)tolrrr:nirr111 uJ.l-_Htcr -rr l�ii Ojrjcc pFiveEnsntller Aftirir9&BUsilless Regulaflon before the expiration date. if found return to: OME IMPROV COtsTRACTOR Type. pfftee of Consumer Affairs and Business Regulation egistration 183855 i tl park plaza-Suite 5170 Expiration 111171211.17 Individual Boston,MA 02116 MALCOLM G.BEAT. mALCOLM BEAL 27 TRULL BROOK LANE ' Not valid witltiont signature TEWKSBURY.MA 01876 Undersecretary Massachusetts Department of Public Safety Jr' r Board of Building Regulations and Standards License-CS-086893 Construction Supervisor . � siti r, . 1 MALCOLM G BEAC `r, 27 TRULL BROOK } TEWKSBURY MA Oj' //�� 1 IfS�i'l (�- CA— Expiration: Commissioner 10/03/2017 `�'he Co xzrnax weaZt of MHassachuseds Depairt�ment of fndas��ia1 ccz Brats Ca„g ess Sire et,, AUu 100 ostorz,AIA 82114'2017 Wwwavass.go-v1dia arisli'1 �exs. rea W Vkexs'Coxapensadavit:J3�).dexo/Coactnxs� 7ectrXci tionhisuraWI TBE EFXt1V[I C"1 C DC7 07C 7C - OE Tease kxint X,e `bI t foxutatign. 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'Ax'you au exupToyea?Claeekt ie appropritafebox: % � �p 'CCIY]StCUOtigA employees(fallantl/aa°parEiiuie). $ r; .+lae�nodo ig l.ElS am a amployer with _� ={ �azuasoloproprietororp ershipandhavonoemployees tao�kin'g ormeln 9 �pezngl]iigLt oy orkers'camp.insuranaa iecluired.] any capacity:VT dn.eerc nired.] 10�Building addition am ahameownea doing auworkmyself.j1JbVoIkPrS'aomp. .. rl behiring ra e pwili 11.�Flecti ical repaazs ox- 1 h,�ZauaahameowzAerandwill oantrac#orstocondnaiali�arozk:anmYp P�Y• ' . enation insmanoe or are sole or addztion,9 annrethatA contrac�ors aithezhave woa3cers'camp 12 :?XuLtt171Ti le alter proprietorsw.it,"19 enip7oyees• 13..[]E'go£rejiaits T am a general eontuiat,x am 3lhi Yeehire ha4o vrcw kers'tccf comp. aaarthe so ceaEEached shee# 1�f.M Cltj]eT Thesosub-nontractarshaioeuap Y ttan,erGLa- �•�� o are a coaporatigzi Faxad:its,of cars cavo e rercisedtheis light onancamro laired.] __.. ---- 152, aad�e hava no dmployoe3 [l(o war-ers'comp. clic information' ��i �� heirworkcr eOla enationp Y *tiny airPpceaxtfilratcheaks bx#1 ra'nst alsa fill aut#hs a etio ingfaw sbowzn$ day%t imdicatingthay are sl ee showing the name of the outside oatira tors and stataRILt rontzactOTP whoa° ntitiesh ve T3omeowners who submit#his.affi.' — must toyidatheir workers°comp.palicyzaumliez. Contrac#ars that checlathis l7DX llU5Y attacked ian.additional :. oes. 7fthe sub-aontractars have employees,they p — —� i'ee.5. X3e7Ojj)is t/ae vo'Iiey rtr2d)oh'site --- ,,atIOTTI insurancefor rzy erax Zoy X am aft ernpZayer tlizz�t is pr'aviziirzg7�vnr'kers'comp information. - ip lirance Company e:-- — ----� —� Expiration.Date:�_ --- - PO]icy IP or Self iris. �- -� �e sbowcogtTaepoSacyaaiaxrairex aixd ex -.a date). Tnb,Site Addrea�----- -- deciarafion pad (" 5©b.00 a ensatian palicy AttacIL a copy ofthe"rkei:s comp 1-violatioxi purzis7aabiebS'"a uO f to o $ pailuxe to secuxo coverage as required Midex 1 G7.c.1`i2,§25A is a exiini:aa e as�geli.as civil penalties in the orm of a STM WGKTt- l atiaizs q the� ibxixxs xance a and/or onf'ysai MPTjsoam nt7' Toe foawaxdedto the C)�fzce ofSl vesti nftbis stataimn=tmay -- day again.t the violator.�.cagy _ — cnyexagever` cation._ _---- e Pop fPe�7u y treat t7ze in"11- ation rove ecl move is t zze anJ carred... y cer under if,epczirzs anclp �.i'itolzere� .F' Q•ff2ciatYdSL QrZry. .DO"'0 City in$Sin GGfeCz,,to he P.4r'f2XJ1'etL'C.1..�y City Or'ta'Wi2 Of�Cia. 'f xmItlz Yce71 e - _ - -- City or fawa,- -- ---- Xn ?ectar issiung AntTxoxitY(ci7rcie ozze): owx+Clexlt. z�,�jectxicaTXx�spectoa 5.i'Znxabin� si. J.:Boardo:f.fiea:fth ?,.T3ritSciiiit Depai:tment 3.+City/7' C.Othex T _ 7777 I s >MIS x. as Avp w .i,"vva 7 irk 4 { Malcolm Beal herein called the CONTRACTOR agrees to manage the renovation of the North Andover ProEx office area.We will provide all labour,materials,permits and insurance certificates as required. Date: 1/19/2017 CLIENT: ProEx Physical Therapy Michael J. Mulrenan CEO&President Portsmouth,NH 03801 P: 603-427-8066 ext. 153 F:603-501-0495 E C: 239-272-3616 m Site Details:595 Chickerning Rd(125)North Andover,MA Approximated Area:800 sq.ft. Payment details:Client agrees to make payments upon request as outlined below. Total amount:$8,000 Payment terms: $5,000 is due upon signing-permit submittal. Remainder$3,000 to be paid on completion of work listed below.Materials are to be paid on delivery to the lob site. Scope as discussed: Remove partitions currently used for manager's office and exam room in back right hand corner. Remove old ceiling,raise sprinklers and lights to match existing ceiling height.Patch walls,replace ceiling tiles as needed and touch up paint to ProEx standard colors.This does not include any fire alarms or flooring. The work shall begin on receipt of payment and the permit.The estimated time for completion will be 2 weeks(weather permitting).This is dependent upon payments,inspections and availability of materials. Terms and conditions to be obliged by: ■ The client hereby employs the contractor to do all the work and arrange all materials, labour,tools and machinery. ■ The construction shall be carried out in accordance with the drawings and sketches submitted after normal business hours. ■ The contractor shall carry liability insurance for the duration of the construction work. ■ The contractor shall protect and defend the client in case of complaints of unpaid work from any labourers. ■ The contractor and client agree not to change schedule,design or other specifications of work without prior written consent. Signatures: Michael J. Mulrenan,PT, Malcolm G.Beal CPM (ProEx Physical Therapy) (Contractor) � V 1 u r i kL+ AX E Lot& S � �� I � t, i f I .W. I x m lie DO { i g� 9 .tib