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HomeMy WebLinkAboutBuilding Permit #650 - 158 MAIN STREET 4/7/2007 (3) BUILDING PERMIT NORTF� pf�t�cCO �e„. ..... e p TOWN OF NORTH ANDOVER 0 i APPLICATION FOR PLAN EXAMINATION Permit NO: UP Date Received °qAT.° CH Date Issued: IMPORTANT Applicant must complete all items on this page w 17 LC7CATIC)N . 58 Main Street -`; Pont , PROPERTY OWNER Sly: Gr�aory s Armenian Clirch MAP NO, _41 _ PARCEL: 5 c __ Z(�IING'DISTRIGT H{STURkC I .1STF2(C�l' Yes :t no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family [I Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial C Repair, replacement ❑ Assessory Bldg k Others: Church ❑ Demolition Other Church 0 Septic §❑ Weng 1=laodplain Vte#iandsb5 Watershed �srtt� Water/Sewer a 1 ) Replace roof DESCRIPTION OF WORK TO BE PREFORMED:2) Replace white vinyl 1l Replace exis i ng wi ndows c1 ose ux�; windows on east side . 4)New front door with emergency exit crash bars . 5) Remove paneling and install sheetrock. 6) New Altro flooring to encapsulate existing f.:-,,or . 7) 2 Handicap bathrooms where office is . 8 ) Storage closet where existing sta�ie are is 9) Repair and/or replace front stairs,_ Identification Please Type or Print Clearly) OWNER: Name: St Gregory ' s Armenian Church Phone: 978 685-5038 Address: 158 Main Street North Andover , MA F Mlchae'�L",A ,, ollxns Phone (60 ) 571 274_, CONTRACtC3i Name o� �n��._ of �. : 29 Address , - 1Torth.T'fa�n St. :� SaleNH; 03079 619 S �O[15tTt�IC#�C?n icertse S,uperVlSOf' C5 1 at, r 73 07� 7� Home`ImprorrernentLicense a �n ESP Date..,, ARCHITECT/ENGINEER Joel Silverwatch Arch. LLCPhone: ( 603 ) 894-4450 Address: 163 Main St . Salem, NH 03079 Reg. No. 2384 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ h-s0non t n 7-, .nno FEE: $ Check No.: hl�lk Receipt No.: ;2 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of.AgenlOwn j ignature ofcontraetor . NORTH Town 0 4Andover 0 No. (P TO `�/�/ ° C, 0 LA E over, Mass., cc C.. IC ICK �qs -r E D BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System 7'- THIS CERTIFIES THAT.......................................... .................................... ...................... •................................... FoundationBUILDING INSPECTOR has permission to erect........................................ buildings on.... gh ...................................................... Rou to be occupied as................. ....... ............................. ........ Chimney ..... . ................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 PERM E- EXPIRES IN. 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS Rough ...................... ............................. ........................................ Service BUILDING Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE _jl Smoke Det. NORTH Town of No. (i SO - �` dover, Mass.,— CCiNICMEWICK y ' t A7ED PPpt�� BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System /� � ��Ni� BUILDING INSPECTOR THIS CERTIFIES THAT ..... ............................... ...............�.................................. Foundation �' � G �o� � a v� .......................................... ..... . has permission to erect........................................ buildings on ... ...... ............................. Rough p J r �/" l ys Chimney to be occupied as................. .... `.�I1�va.. ..�. "r.......'. .....� ....... ........................................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR Rough Service BUILDING INSPE R Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. i _ Board of Building Regulations and Standards - HOME IMPROVEMENT CONTRACTOR Registration;.. 149508 Expiration: 1/18/2010 Tr# 262439 Type: Individual MICHAEL A COLLINS MICHAEL COLLINS 429 NORTH MAIN ST:, SALEM,NH 03079 `" Administrator r-- " 1te �onv�rra�u�reac aaaaariu \ Board of Building Regulations and Standards �n Construction Supervisor License License: CS 61961 Ir Birthdate: 717/1954 Expiration: 717/2009 Tr# 15526 Restriction: 1G. MICHAEL A COLLINS. 429 N MAIN ST/PO BOX 281 N SALEM,NH 03073 Commissioner Lte: 12/4/2008 Time: 2 : 38 PM To : @ 8986338 L� 3idel Page: 002-003 M CERTIFICATE OF LIABILITY INSURANCE 12/04 i 8 PRODUCER (603)898-6500 FAX (603)870-9444 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION C & G - Cross Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 288 North Broadway HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Salem, NH 03079 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ' Susan Gause INSURERS AFFORDING COVERAGE NAIC# INSURED Collins, Michael INSURERA: Western World Insurance Co DBA: The Collins Company INSURERB: LIBERTY MUTUAL INSURANCE CO P.O. BOX 281 INSURER C' North Salem, NH 03073-0281 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR INSR DTE MMIDD DATE MMIDO LIMITS GENERAL LIABILITY PENDING 05/25/2008 05/25/2009 EACH OCCURRENCE $ 300,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,000 CLAIMS MADE a OCCUR EREMISFS(Fn orcur a)MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER:POLICY F PPRODUCTS-COMPlOP AGG $ 600,000 O- JERCT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC5-31S-227489-037 06/13/2008 06/13/2009 1 WCSTATLL OTH- EMPLOYERS'LIABILITY TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100,000 SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, St. Gregory's A rmani an Church BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 158 Main Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ACORD25(2001/08) FAX: (603)890-1166 William Corcoran ©ACORD CORPORATION 1988 iv MAR-29-2007 12:50PM FROM-C G INSURANCE +1 683 694 6383 T-406 P.001/002 F-926 (603)898-6500 FAX (603)870-9444 THIS CERTIFICATE 1 ISSUED AS A MATTER OF INFORMATION C & G Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 288 North Broadway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Salem, NH 03079 Michael Caruso INSURERS AFFORDING COVERAGE NA1C# msuASO Collins, Michael WSURERA One Beacon Insurance DBA: The Collins Company INSURER s' LIBERTY MUTUAL INSURANCE CO P.O. BOX 281 INSURER C. North Salem, NH 03073-0281 INSURER D- JINSURER E: COVERAGES 764E POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ti+v^f?EQUIrZE)d�"��.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 1V,Y PERTAIN.TNF INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH PCUCIES.,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF VOURANCE pOuCY NUMBER DATE MMIDDlYY DATEPOLICY MMIDDIYY LIMITS GEkMRALLiAmurr 753-01-69-03 05/25/2006 05/25/2007 EACH OCCURRENCE s 300,00 DAMAGE TO REN I tu X C`&VE-ER L`.CEN-S ALL"ILITY PREMISES Esooaxence 300,000 CL',zjS u.4;. a OCCUR MED EXP(Any one perefln) S 5,000 A PERSONAL s ADV INJURY S 300.QQQ j GENERAL AGGREGATE $ 300,000 M?.L33K-G THE LW5rT .P"+i LJ=S PER PRODUCTS-COMP/OP AGG S 300,000 X LOC Ak(TOMOBI E LIABILITY { COMBINED SINGLE LIMIT xxr..UTO (EA=Xlenl) S I-7^L OS BODILY INJURY Sv'K-��L-D n:fTCS (Per parson) S tincb.UTOS BODILY INJURY $ T 1706 (Per smaent) PROPERTY DAMAGEk S i (Per accRwM) GARAGE LL;3CJ Y AUTO ONLY-EA ACCIDENT $ I OTHER THAN £A ACC S AUTO ONLY: AGO $ 1 DfCEMIJUBRELLA LIABILfTY EACH OCCURRENCE S ref -CCL'R CLAIMS MAO£ AGGREGATE 5 S :;=C Z;7!5LE S ! -TtiT,ON S $ wOR>¢3MCOUPeNUTIONAND WC5-315-227489-036 06/13/2006 06/13/2007 X I TORY LIMITS I I ER EYPLOY�iS'LtA�I.jTY B A& >'P"4'L'cTORIP;wRTNERIFJCECUTTVE E.L.EACH ACCIDENT 5 100,000 CA :5KV5A1_Eiz EXCLUDED E.L.DISEASE-EA EMPLOYE $ 100,000 .es aewj)e u^a±r $a:_-a+;PRQ%SCNS 7eCw E.I..DISEASE-POLICY LIMIT S 500,000 OTI 15A DFSCibPTION OF OPERATIONS J LCGATIONS+VFHtCLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL -in_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, St. Gregory's Church BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 158 Main Street OF ANY KIND UPON THE INSURER,ITS AGENTS O EPRE5ENTATIVES. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ACORD 25(2001108) FAX: (603)890-1166 OACORD CORPORATION 1981 Of NORTH 1ti TOWN OF NORTH ANDOVSax ' PERMIT FOR GAS INSTA TION SACNU5ESt This certifies that . . . . I . . . . . . . . . . . has permission for gas installation . . . . in the buildings of . . . S: n�.G,A . . . . . . . . . . . . . . . . . . . at .^. . . . . . . . . . . . . . . North Andover, Mass. Fee. . . . . Lic. No../. ?.3. f�. . . . .... . . GAS INSPECTOR Check# G 63�;�0 MASSACHUSETTS UNIFORM APPUCATON FOR PERNIrr TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS eTS Building Locations �� Permit# !> Amount$ Owner's Name NewEr 7e--vlion 1:1 Replacement Plans Submitted D R w o wW FW a 0 O z F w z Z x W W w W ' x pS Z W > SUB -BASEM ENT > BASEM ENT 1ST. FLOOR !!' 2ND. FLOOR i 3RD . FLOOR 4TH . F L 0 0 R 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR f — M — (Print or typef) Check one: Certificate Installing Company Name `1 Corp. Add ss - &A, �., O 4 7 0 Partner. Business a ep one _ — 6ylrqFinn/Co. Name of Licensed Plumber'or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance,policy or it's substantial equivalent. Yes 13 No 13 If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 13 Bond 13 Owner's Insurance Waiver: I,am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 13 Agent I hereby certify that all of the details and information I have submitted(or entered)in above appli13 cation are true and accurate to the best of my knowledge and that all plumbing work and install ' ns performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachu S e Ga§tCode and Ch r 14 General La By: �ature of Licensed Plumber Or GasFin Title Plumber City/Town: Gas er Ic se um er aster 11 APPROVED(OFFICE USE ONLY) D Journeyman