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HomeMy WebLinkAboutBuilding Permit #368-2011 - 1820 TURNPIKE STREET 5/1/2018 BUILDING PERMIT NORTH q � �t�eo i6ti r 6b.pro• ..,a, V6 0 TOWN OF NORTH ANDOVER 3 - - APPLICATION FOR PLAN EXAMINATION r Permit NO: e Ao Date Received �qs 44too Date Issued: SCHUSE IMPORTANT A licant must complete all items on this page L Y 0 r 4 Y V 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 y r' 'lMrf4'YrLu� w j .: ., DESCRIue2PTION OF W :. .• ;: ,� ,�a _,:;� ...�: RK TO BE PREFORMED: Identification Please Type or rint Clearly) OWNER: Name: �o o� c-o. Cry ,•, o Phone: 6/17-F/'7-'M/23 Address: 32 ��. �� �► S�; e r7 * ©/9 u a " 1 '� k r� .h •its W'�`� t 'iy t a terse. ARCHITECT/ENGINEER -M A#'11trCASJ-rVSo,&clarw CylPhone: 0- Address: c n J F�lM/n A6, O 70/Reg. No. � �C9 ?C) FEE SCHEDULE.,BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. yes no Vft Total Project Cost: f 0'0.O O J $ FEE: $ �Y Check No.: � Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund JgnatbefAget/0wnec contras#o " A Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL/ Public Sewer t/ 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 DATE REJECTED DATE PPR VED PLANNING & DEVELOPMENT �71 COMMENTS �µ 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 C sen/ation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street .r Dimension Number of Stories:_Total square feet of floor area, based on Exterior dimensions.03OF 130 Total land area, sq. ft.: RIF� '� 7 ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No 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 0 Notified for pickup - Date Doc.Building Permit Revised 2010 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 o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster 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 o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o 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 the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2008 ad 1,,F-?o Location �� 2 O/ _, 1111-9116) No. � � Date c' i TOWN OF NORTH ANDOVER 40 � w 9 Certificate of Occupancy $ <� v NUsE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ "R -9 ' Check # 23650 [uilding Inspector F ACORP CERTIFICATE OF LIABILITY INSURANCE OP ID Ce OATE(MMAfOD/YYTYI pFUCO-1 06/14110 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IDadgar insurance Agenoy, znC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 400 West Cummings Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 6725 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn NA 01801 Phone:781-933-2626 FaX11781-932-6341 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: polyol+ watual Ing cc Ln Salim 14206 INSURER& _ QgFMg Contracting INSURERC: 05 Northleton MainMA St Unit 158 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN L4SUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED OR MAY PERTAIN,THE INSURANCE AFFOROED 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. POLICY RATION LTR R TYPE OF INSURANCE POLICY NUMBER DATE D OATS /YY VIIMIT9 GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL CPP7017604 O1/O1/10 01/01/11 PREMISES(Eeoccurence $ 100000 --J CLAIMSMAOE FX]OCCUR MED EXP(Any one person) $ 5000 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $2,000000 GEMLAGGREGATE LIMIT APPLIES PER� PRODUCTS-COMP/OP AGG $2000000 POLICY PER& LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f 1000000 A _ ANYAUTO CA9012129 01/01/10 01/01/11 (Eaaaloent) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AU'T'OS (Per person) s x HIRED AUTOS BODILY INJURY = X NON-OW NEO AUTOS (Per eccleent) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG S EXCESSIUMORELLALIABILrTY EACH OCCURRENCE S 1000000 A X�OCCUR CLAIMSMADE CU0006054185 01/01/10 01/01/11 AGGREGATE $ 1000000 I rX— DEDUCTIBLE $ 111.RETENTION E 5,0000 S WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OCFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ t y99,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER A Property section CPP7017804 01/01/09 01/01/10 Contents 10404 A EquiPMent rloate ICPP7017004 01/01/09 01/01/10 Deductibl S00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CONTRACTOR FAX 781-944-2609 CERTIFICATE MOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE YME EXPIRATION DATE THEREOF.THE ISSUING INSVRER WILL ENDEAVOR TO MAIL 10 GAYS WRITTEN XXxxxxxxxxxxxxxxxxxxxxxxxxxxxx NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 60 SHALL XXXXxxxxxxxxx1=xXXxxxxXZxx=x "POW NO OALIOATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR XXXXXRRXXXXXXXxxxx7,xX=xxxxxx REPRESENTATIVES. AyfffRZED RE ATWE ACORD 25(2001108) 0 ACORD CORPORA110N 1988 f ACORU® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIVYYY) 3/13/2008 PRODUCER (978) 696-0007 FAX: (978)345-6811 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Employers Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 281 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 7B Fitchburg MA 01420 INSURERS AFFORDING COVERAGE NAIC# - - — _---------- INSURED INSURERA:Savers Property & Casualty Resource Management, Inc. INSURER B Alternate Employer: GFM General Contracting INSURER Corp. , 281 Main Street, Suite 5 INSURER D: Fitchburg MA 01420INSURER 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 POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONLIR INSRO TYPE OF INSURANCE DATE tMMIODNYYYi LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS MADE OCCUR ; MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER:: PRODUCTS-COMP/OPAGG $ POLICY PRO• — _ EC LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY li i AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN .EA ACC $ AUTO ONLY: AGG 1$ - EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ r � f__.__ ..... _ OCCUR `_ I CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION WC STATU- OTH. AND EMPLOYERS'LIABILITY Y/N TORY LIMITS X...ER ANY (MandatOFFICEory NHR/EXCLUDED ECUTIVE Y WC0002526 E.L.EACH,ACCIDEN-T 1�1�2010 1�1�2011 �.E1.D SEASE-EA EMPLOYEE $ 1,000,000 ry $ _-. 1,000,000 If es,describe under i - - SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Covers the employees of the named insured leased to: GFM GENERAL CONTRACTING CORPORATION 325 NORTH MAIN STREET - UNIT 15 B MIDDLETON, MA 01949 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION for record only DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Judy Prescott/KATHYM ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200901) The ACORD name and logo are registered marks of AGORD 'Vlassachusetts - Department of, Public �afct.% Board of Building,: Reglulations and Standards Construction Supervisor License License: CS 17935 Restricted to: 00 FRANCESCO FODERA 2 FRANKLIN ST READING, MA 01867 Expiration: 7/29/2011 ( uumi..i net Trus 19552 DM V'".1 I ftt' I NUMBE f'at n' sM �"F. 5.5483054. �a k' "074-2013 07 21 P^ CassREST MGT SE% D S:p7 M �y, $i FODERA M45 ��ae Y 7� FRANCESCO "F%• 2 FRANKLIN ST READING.MA 01867.1117 Gr,M Con(r,-1ctl,,,. tz,� CUf, 325 North Main Strect Unit 15-B Middleton, MA 01949 Office: 978-777-8007 Fax: 978-777-5004 ct,--}- 1990 To cri p,A An d fl ,/c �- � n � 9-0 57 a r � e r � �a � - mac. �� � e� 2 � i -ZO OO .� �, o . n C Ca/-iT c i Total '�/ / , ano. 60