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HomeMy WebLinkAboutBuilding Permit #178-15 - 1620 TURNPIKE STREET 8/19/2014 d V10RTF/ � BUILDING PERMIT �r ��a�'``a�'°'°•a�°� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION h Permit NO: Date Received qq< oAATED Date Issued: 9SSACHUS�� "M#(ORTANT:A licant must complete all items on this page LOCATION O ��b5"o fu.niy,Lc r<�cN. AnJoer MA / Print PROPERTY OWNER_. Ckarlt5 6r�Lco Print MAP NO: , 07.13 PARCEL:001 7ZONING DISTRICT: Historic District yes =; Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: IXCommercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer 2(nve✓ ��cf5°�:��i Mt r T©CT w+��` Gl lltw SiA,S - a�7 roo STS�tW► tV-2W l�lcr. brc..w w®Jtc� �E �. G� /' � r�d �(�y �ksrcl . Identification Please Type or Print Clearly) OWNER: Name: C^O.rlf_S Grieco Phone: 71q /yo Address: 16�10 -��SO _L1,� Sfr,et Mori k AJ,,,• M CONTRACTOR Name. 0? Phone: 871?- 35 6 _ tl MC p0 i� 0 rqJ � Address: 3 0 ' rrcw �c� /U 4-J �a r. ��. .1 /y a 30 Supervisor's Construction License: CS' (oa ' U Exp. Date: 04 /b3/ao' i Home Improvement-license: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. t Total Project Cos�$ 6 0y,t70 FEE: $ Check No.: Receipt No.: y NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund .� . Signature of Agent/Owner I Signature of contractor r— — � * t&ORTly BUILDING PERMIT =- ka Of TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 70 h Permit No#: Date Received SACHus�t�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER_ _ Print 100 Year Structure yes no MAP ___ . __ _PARCEL: _ _ ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑Well 0 Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: _ Phone: -- _ Address: Supervisor's Construction. License: __Exp. Date:__ Home Improvement.License _ _. - Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund S nature of Agent/Qwner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit " DPW Town Engineer: Signature: Located 384 Osgood Street AFIRE DEPARTMENT - Temp Dumpster on site yes 'no Located at 124 Main Street .Fire'Departmentsignature/date COMMENTS s +I I i I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. 1 Total land area, sq. ft.: F ELECTRICAL: Movement of Meter location, mast or service drop requires approval of J Electrical Inspector Yes No I DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) I I i ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 1 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ CopY of Contract o Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dum ster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that thea appeal period is over.pp a . Thea applicant must then et this recorded at the Registry of Deeds. One co and roof of recording P PP g Y g g Y P P must be submitted with the building application Doc:Building Permit Revised 2014 Locations-�✓ No. Date t . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ � TOTAL $ ► Check# 27915 Building Inspector f r 7 NORTFI - 0 No. Ke * _ h ver, Mass, cocHicHewlC" y1. RATED Jkle U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ....C. 4ft... BUILDING INSPECTOR 1.4..2.0 ..� �i x/1._.1/�.�. ., t Foundation has permission to erect .......................... buildings on } M . ............. !or►•--�K . ..... 1 Rough to be Occupied as .. Chimney p .. .'�... ............ . ..�'.� ......... .� ..�F.....�!! .. V provided that the person accepting this permit shall in every respect confor t the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating he 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 log I , PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T S Rough Service ...............FAtwoo..................... .:.::........................... Final BUILDING INSPECTOR 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. N Prime RoofinCorp.Cor x- g p PO Box 478 /New 1pswick NH 03071/ Tel. 603-878-3550 /Fax: 603-878-4646. August 11,2014 TSD 1620-1650 Turnpike Street North Andover,MA 01845 Re: 1620& 1650 Roof Repairs& Recover The following is a breakdown to supply labor and materials necessary to complete a(19,230 so .060 TPO fully adhered roof system on both buildings to correct current rook leaks. 1.) Infill metal roofing flutes with 1"thick EAS flute fillers so height comes up flush with high ribs on roof panels. 2.) Supply and install(1)layer of 1.5"polyisocyanurate insulation over the entire roof. Insulation to be fastened through the flute filler and into the existing metal roof with the manufacturers screw and insulation plates. 3.) Supply and install(1) layer of.060(Gray)TPO fully adhered. 4.) Flash existing vent stacks. 5.) Raise(1)existing 7"B Vent that is too low. We will have to add approx 12"of new piping so that we have enough flashing height to flash it on the roof level. 6.) Install(1)layer of%:"plywood sheathing over metal wall panels on vertical face of parapet will at building 1620. 7.) Flash over%'plywood sheathing and over the top of the parapet wall with .060(Gray)TPO fully adhered at building 1620 8.) Supply and install(1)layer of 2x 12 wood blocking on top of parapet wall. 9.) Supply and install wood blocking at perimeter edges for new perimeter edge metal. Each flute will be infilled to bring up flush with high rib and then(1)layer of 2x6 wood nailer will be installed on top to bring flush with 1.5"roof insulation. 10.)Fabricate and install 24 ga steel gravelstop at perimeter edges.Color to be a standard color chosen from the manufacturers color chart. 11.)Fabricate and install a 24 ga steel box style commercial gutter with downspouts on both sides of each building at the eaves. 12.)Town of North Andover Building Permit 13.)Supply and install 24 ga steel rain diverters over doorways at both buildings. 14.)Hoisting,cleanup,safety per OSHA 15.)(15)year labor and material warranty. Exclusions:bonds,interior protection Page 1 We propose to furnish labor and materials-complete in accordance with above specifications,and subject to conditions of this agreement,for the sum of-. , Ninety four thousand,six hundred four dollars----------------------------------------------------($94,604.00) Payment to be made as follows: Per AIA Documents Respectfully submitted. Prime Roofing Corp. By:Tyler Seppala Note:This proposal may be withdrawn if not accepted within(30)days. Date of Acceptance: 2U1 By: Page 2 ,aco CERTIFICATE OF LIABILITY INSURANCE DMM/DD/YYYY) `•-� 8//1414/2014 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 CONTACT NAME: Yvette Fanaras Infantine Insurance PHG'tuCNE (603)669-0704 FAX No):603-669-6831 P. O. Box 5125 E-MAIL ADDRESS:Yv m ette@infantine.co INSURERS AFFORDING COVERAGE NAIC# Manchester NH 03108 INSURERAAcadia Insurance Co. 31325 INSURED INSURER B: Prime Roofing Corporation INSURER C: Appleton Business Center INSURER D: P.O. BOX 478 INSURER E: New Ipswich NH 03071 INSURER F: COVERAGES CERTIFICATE NUMBER:2014/2015 Master 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 250,000 A CLAIMS-MADE I—XI OCCUR CPA024028716 /10/2019 /10/2015 MED EXP(Any one person) $ 5,000 LA025238416 (Mass) /10/2019 /10/2015 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 POLICY X PRO jECT [XI LOC $ AUTOMOBILE LIABILITY (Ea aBINEDtSINGLE LIMIT $ 1,000,000 A IR ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 024028816 /10/2014 /10/2015 BODILY INJURY Per accident $ AUTOSAUTOS ( )NON-OWNEDHIRED AUTOS X PROPERTY DAMAGE $ AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ FUA024029116 /10/2014 /10/2015 $ A WORKERS COMPENSATION X I WC STATU- I X OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE NIA CA024028916 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) States: NH,CT,VT,ME,RI /10/2014 /10/2015 E.L.DISEASE-EA EMPLOYE $ 1 000 000 If yes,describe under MA & NYDESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: 1620-1650 Turnpike St. North Andover MA. CERTIFICATE HOLDER CANCELLATION 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. 120 Main St. N. Andover, MA 01845 AUTHORIZED REPRESENTATIVE n Jim Harrison/BYM r" � �— ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25nntnnsim Tha Arrion nems enrl Inn^era ranict—el—Lea of Ar non The Commonwealth of Massachusetts Print Form iDepartment of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Prime Roofing Corp. Address: P.O. Box 478 30 Tricnit Road #13 City/State/Zip: New Ipswich, NH 03071 Phone #: (603)878-3550 Are you an employer? Check the appropriate box: Type of project(required): 1.12 I am a employer with 35 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.E] I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp, insurance. 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.F] Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. No workers' com right of exemption per MGL y [ p• 12.91 Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.❑ Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Acadia Insurance Company Policy#or Self-ins. Lic. #: WCA024028916 Expiration Date: 3/10/2015 Job Site Address: 1620-1650 Turnpike Street City/State/Zip: N. Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certift under the aims and enalties oer'u that the information provided above is true and correct~ Signa —__—_-- Date: 8/14/14 Phone#: (603)878-3550 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Super-icor License: CS-102180 TYLER W SEPPAtA 43 MALTHOUSE ZD New Ipswich NH 713071 1 I S1 Expiration Commissioner 04/03/2015