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Home My WebLink AboutBuilding Permit #982-2016 - 2230 TURNPIKE STREET 3/18/2016Plans Submitted Plans Waived F1 Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art 0 Swil�g Pools Well Tobacco Sales F1 Food Packaging/Sales 11 Private (septic tank, etc. Pennanent Dumpster on Site F1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature. COMMENTS CONSERVATION Reviewed on Si qnature COMMENTS HEALTH COMMENTS Reviewed on nature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Gomm Conservation Decision: Comments j Water & Sewer ConneGtion DrivewaV Permit DPW Town Engineer: Signature: Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.:. ELECTRIGAL.- 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.$100-$l 000 fine Doc.Building Permit Revised 2014 -j— 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 4-: Building Permit Application 4� Workers Comp Affidavit 4� Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to i ! ssuance of Bldg Permit 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) Mass check Energy Compliance Report (If Applicab le) -- Eng in . eer . ing A . ff - i - d . avi t . s - fo . r - E - ngi -1 neer I e - d 1. products OTE: Ail 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 Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (if Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products 10TE: 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 Doe: Building Permit Revised 2014 Location X -- No. Date o Af - Check #k7 �t,5, �01 35 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee $ TOTA L Building Inspector ;No W 4� rA W I Cb LLI LL 0 0 co 0 0 E ai CL (1) V) 0 u , . (A z z co -0 c D 0 U- w =3 0 W E :E U U- 0 I-- u LLI z z :3 0 LL 0 Ln z LU to 0 0 V) 10 r- LL. 1= 0 F - u LLJ CL (A z o cc ra s LL z LLI LLJ LU LL. co 6 (u IV -�e 0 E 2 CD <, E cL CD cn E cp r jo- 40- CL Cc cc ow .--o 0 LE 0 0 Ur 0 0 a---- a 0 O� CL ci 0 U) tm 0 CL W cc = -0— o 2 w u) (n - Ln CL=:E.2 E CD 0 (D CL (D U) cn -0 04- o " c .- rL o E CL 0 .2 -7- U) 0 m to z CO LU w IL x .Lu LU CL 0 E 0 0 z CL 0 U) 0 U) 4) im Q 0 0 CL a— 0 CL a OM .2 CL 0 4) CD z r_ 0 CL CL (n 0 LU CL co 0 z Cl) Cl) LLI z Z t 0 E 0 0 z CL 0 U) 0 U) 4) im Q 0 0 CL a— 0 CL a OM .2 CL 0 4) CD z r_ 0 CL CL (n k..o DI't V V UUU wu I Kb 90 Boston St. No. Andover, MA 0 1845 Tel: 978-305-2547 Fax: 978-208-8.333 Email: cbawoodworks@gmail.com www.cbawoodworks.com M-1 Z" to N C -X) 90 Boston St. North Andover, MA 01845 Tel: 978-305-2547 Fax: 978-208-8333 Email: ebawoodworks@cbawoodworks.com 7lie Commonwealth ofMassachusefts Departinent ofIndustrialAcddents Office ofInvesligadons 600 Washington Street Boston, MA 02111 wwityxiassgovIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ARRlicant Information Please frintlWb Name (Busineworganizationftdividual): L, 1 (3 /-, k I CIA Address: qO Are you an employer? Check the appropriate box: 1. [11 am a employer with 4. E] I am a general contractor and I _,,,��ployees (M and/or part-fime).* 2. E3 I am a sole proprietor or partner- ship and have no employees workiug for me in any capacity. [No workers' comp. insurance required.] 3. F1 I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors fisted on the attached sheet. These sub -contractors have employees and have workers' comp. insuzanceJ 5,0 We arc a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. 0 New construction 7. Remodeling 8. Demolition 9. []Building addition 10.[:] Electrical repairs or additions I M Plumbing repairs or additions 12.0 Roof repairs 13.[] Other *Any applicant that cbcckr. box #1 must also IM out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all woric and then hire outside contractors must submit a ne%v affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contmoors and state whether or not those entities have employees. If the sub -contractors 1mve employees, they must provide their woricers' comp. policy number. I am an employer that is providing workers I compensadon insurancefor my employem Below is diepolicy widjob site informadon- Insurance Company Name: Policy # or Sclf-ins. Lic. #: Expiration Date: JobSiteAddress: Abk-_?Q -`lVrYt0,'L---_ �2i'- - CitylState/Zip: Ale./" 4,A�-V-rA A 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 $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerot under thepains and ,penalties ofperjury that the informadon provided above is true and corred. Phone#: q?,7— Official use only. Do not wrile ht this area, to be completed by city or Imert oftial City or Town: Permit/License # M Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Cityffbwn Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone 0: CERTIFICATE OF LIABILITY INSURANCE DATF (MM;DcvyYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRObUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(IGs) must be endorsed. If S UIRROGATION. IS WAIVED, subject to the terms ancl conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In llouof such andorsamant(r). PRODUCER NAQ�CTPaul T. MacDonald CPCV, CIC CONT MTM InBurance Associates PRONI! (9713)681-5700 (976)661-5777 (AId. No. Ext): No): &MAIL ADDRESS, certificate 8 @mtmi-n sure, Qom. 1320 Osgood Street INSURGR(S) AFFORDING covr=PtAr.E NAIC 9 EACH OCCURRENCE S00,000 INSURER A:Preferred Mutual Ins Cc 15024 North Andover MA 03.845 INSURFD, ------- 7- INSURERB: INSURFRC: Brian SeaalQy dba C5A Woodworks INSURERD: 90 BOSTCH ST INBURERE: LIABILITY ANY AUTO ALLOWNED SCHEDULED AUT05 AUTOS NON-0\NNED HIRED AUTOS AUT03 INSURER F: INorth Andover M& 01845 COVERAGES C1711TWICATIFNI-11MRIFIR-15-16 Master RFVIRInN fJ11N4FAr-P- THIS I$ TO CERTIFY TMAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO 717 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 AFFORDr:D 13Y THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF $VCH POLICIES. Limus stiowN MAY tiAvE i3EEN REDUGED BY PAID CLAIMS. INSR LTR TYP9 OF INSURANCE ADDL SLIBR POLICY NUM13ER POLICY EFF (MIVVDDIYYYYI PO Y X WMID A X COMMrFZClAL.GFNM4AL LIABILITY CLAIMS -MADE -1 OCCUR I Fx ROPOIO0715042 11/1/2013 11/1/2016 EACH OCCURRENCE S00,000 -0FMAUE70-FM= 50,000 -EaEm4qI;�Occ �91106 S MED EXP (Anyone person) $ 10,000 PERSONAL & ADV INJURY S 500,000 C-PN'L AGGRFGATG LIMIT APPLIES FER: POLICY 0 1P -119T 1:1 LOC OTHRR: GrNERAL AQ( . 3RrOATR S 11000,000 LPRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUT05 AUTOS NON-0\NNED HIRED AUTOS AUT03 COMBINED SINGLE LIMIT (a.., BODILY INJURY (Per Persan) S BODILY INJURY (Per accident) $ �ent MAGE ----F-T- UMBRELLA LIAO EXCESS LIAB OOCUR CLAIM3-MADE EACH OCCURRENCE AGGREGATE. $ DED RET11TION$ I WORKFP,S COMPENUATION AND RMPLOYRRS'LIABILITY YON ANY PROPRIETORIPARTNERIEXECUTIVE OFFICEI'VNIUMDER EXCLUDED? I ( f Mandatory In HH) : yes, clescnba unOor DESCRIFYTION OF OPERATIONS below NIA PER ISTATUTE I I OETH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEd S E.L. DISEASE - POLICY LIMIT $ Dr6CPj"0N OF OP15RATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached if more space is required) This certificate Of ;in31ur&n00 represents coverage curz-ontly in effect and may or may not he in compliance with aAy —itton contract. Town of North Andover Building DepartmQnt 1600 Osgood Street Building 20, Suits 2035 North Andover, HA 01845 9.;ANk;tLLA I lVr4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIKATIQN DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRQVI$IQN4. AUTHORIZED REPRESENTATIVE P MacDonald CPCU, CIC 0 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of AGORD INS025 pr)iacil ssac Board of Building RegWations and Starld,61ds .,truction Supervisor CS407038 MAN BEASLEV 68 RUSSELL STREET-�'.7 -1 A Ot ier North Ando - Expiration 0312912017 Cummissioner License or registration valid for indi vidutuk 614 before the expiration date�- It found' r"e' turn to- Offic-e of Consumer Afra irs and 9tisinessRegulation 10-Pirk Plaza - �uite 5170 Boston, AM 02116 e - Not valid wit gnature �:; —rx " . ....... ///" Office of Consumer Affairs & Business Regu664-n-, MEIMPROVEMENTCONTRACTOR egistration: .-:'181826 Type, Expiration:��5/5/2019�K DBA CBA WOODS BRIAN BEASLEY 90 BOSTON ST NORTH ANDOVER, MA 01'84� Undersecretary