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HomeMy WebLinkAboutBuilding Permit #284-11 - 2350 TURNPIKE STREET 10/7/2010 BUILDING PERMIT OF NORTH '9ti TOWN OF NORTH ANDOVER o2 hFtij,• +i; •6 a APPLICATION FOR PLAN EXAMINATION ` Permit NO: Date Received ArED FV ��SSACHUSS5 Date Issue IMPORTANT:Applicant must complete all items on this page LOCATION. nt P,ROPER47Y OWNER MAP N 0 �i PARCEL:_ZQNING#DISTRICT ,Hist'onc�Distnct 'yes no 'Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family '❑ Industrial Iteration No. of units: Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other M'Septic (Owdll ❑ Fl.00dplain Wetlands �-'Vv'a— he&JQistrict DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print early) I"( w.� E z8,) Address: -- �� a 7 ' OWNER: Name. (.. .w.�v►�.�h��fT� �r�c Phone:6 2 � �r��,`� Address: 23SZ� I ui S� S U Y ,CO TRA .N.ame: lr :Tr �-. _ :.. �- _ . _. Phone. 5__ Address:.)(.- __ C�ft Q I" + '. i �'_. 1V{��G.y � ...C) L c(X� Supervisor's`Construction.License _ Exp: Date.. t Home ImprovementtiLieense _t.A r.. . Exp. Date:.._ ARCHITECT/ENGINEER (� Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ C l ,�S FEE: $ Check No.: I 10 � Receipt No.: d' NOTE: Persons contracting with unregistered contractors do not have access to e guaranty fund ,SgnafureioIg frAgent/Owner . Snature:of.=contrac �. 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Si nature 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 FIRE DEPARTMENT Temp Dumpster on site yes Located,at 124,M5in Street Fire►Depart-ment+signature/date =- --- - - C4gMMENTiS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: 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 ❑ Notified for pickup - Date j A Doc.Building Permit Revised 2008 I 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 ❑ 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/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ 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 ❑ 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 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:INSPECTIONAL SERVICES DEPARTMENTMFORM07 Revised 2.2008 Location d13 V 1 -N/e t L S� No. i� Date d� HQRTIy TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ uS Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 235L4 Building Inspector ACC> CERTIFICATE OF LIABILITY INSURANC DATE(MWDD/YYYY) /2011 10/6/2010 PRODUCER LOCKTON COMPANIES,LLC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 5847 SAN FELIPE,SUITE 320 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOUSTON TX 77057 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 866-260-3538 INSURERS AFFORDING COVERAGE NAIC# INSURED TECTA AMERICA NEW ENGLAND LLC INSURER A: Arch Insurance Company 11150 1307658 2 STERLING ROAD,UNIT#1 INSURER B: National Union Fire Ins Co Pittsburgh PA 19445 NORTH BILLERICA MA 01862 INSURER C: INSURER D: INSURER E: EEN THE COVERAGES DELRO01 AR SIURER SFIAUHORIZED INSURANCEOF PRESENTATIVOE OR PRODUCER AND HE CERTCONSTITUTE A CONTRACTE F CATE HOLDERING 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 DD' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE DATE MM/DDNYY DATE MM/DDNYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 2,000,000 A X COMMERCIAL GENERAL LIABILITY 41PKG2279501 2/28/2010 2/28/2011 DAMAGE TO RENTED PREMISES REIT rrence $ 1,000,000 CLAIMS MADE IX OCCUR MED EXP(Any one person) $ 10,000 X XCU INCLBRD FM PROP PERSONAL&ADV INJURY $ 1,000,000 X POL.AGG.$20,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 POLICY X PRO- __1 LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO 41PKG2279501(AOS) 2/28/2010 2/28/2011 (Ea accident) $ 2,000,000 A X ALL OWNED AUTOS 41CAB2279601(MA) 2/28/2010 2/28/2011 BODILY INJURY (Per person $ XXXXXXX SCHEDULED AUTOS (P ) X HIRED AUTOS BODILY INJURY $ XXXXXXX X NON-OWNED AUTOS (Per accident) X AUTO PHYSICAL DAMAG PROPERTY Per accident X DED/COLL$100,000 ROPE dem) AGE $ XXXXXXX GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 B X OCCUR CLAIMS MADE BE4891213 2/28/2010 2/28/2011 AGGREGATE $ 5,000,000 X UMBRELLA $ XXXXXXX DEDUCTIBLE FORM $ XXXXXXX Hx RETENTION $10,000 $ XXXXXXX WORKERS COMPENSATIONWC STATU- OTH- A AND EMPLOYERS'LIABILITY Y/N 41 WCI2279401 2/28/2010 2/28/2011 X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE F—N] E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CANCELLATION: 30 DAYS AS NOTED BELOW EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT. ADDITIONAL INSURED IN FAVOR OF FLAME LAMINATING CORP(ON ALL POLICIES EXCEPT WORKERS COMP/EL)WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION 11023433 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION FLAME LAMINATING CORP DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 2350 TURNPIKE STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL NORTH ANDOVER MA 01845-6347 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZE aENTATIVE ACORD 25(2009/01) ©1988-2009 ACORD CORPORATIUN. All rights reserved. The ACORD name and logo are registered marks of ACORD For questions regarding this certificate,contact the number listed In the'Producer'section above end specify the client code'DELRO01'. The Comsnonweizlth of Massachusetts Department o f£ndtastr,.al Accidents Office of rnvestigations 600 Washington Street ky Boston, MA 02.111 N7"'"'-M4ssgov1di4 Workers' Compensation Insurance An lieant Information Affda•viit: Builders/Contractors/Electricians/Plumbers Please Print Lembly Name (Business/Or ganization/Indididual): /(?G'-� • Address: �, 01 City/State/Zip: y�,�.. Phone#: 1 v Are u an employer? Cher-".e appropriate boa: 1• I am a employer with�_ 4• ❑ I am a general contractor and I Type of project(required): 2•❑ employees(full and/or part-time).* have hired the sub-contractors 6 New construction I am a sole proprietor or partner_ listed on the'attached sheet X 7• ❑Remodeling ship and have no employees These sub-contractors have working for me in any capacity workers com .insurance. 8• ❑Demolition ' p [No workers'comp. insurance 5. ❑ We are a corporation and its 9 ❑Building addition required] officers have exercised their 10•❑Electrical repairs or additions 3.[] •❑ I am a homeowner doing all work right of e"-= - myself. [No workers'co� cmptn e MGL I1.❑Plumbing repairs or additions required.]insurance ret . 15_,§I(4),and we have no q ] employees• [No workers' 17•❑Roof repairs comp.insurance required] 13•7 Other ny 2PPRMat that check.:box it!., msst also rill cu 1.t I�omeowners w the s= ="L`iaP.'aaCY,W^t • , ao suomit this affidavit indicting the; z.doWg aL'war, and r�r works con r __a +Contractors that cheol;this box then hue Outside con>�c ;v� - u m•�.at�ched an additional sheet showing the torr submit a new amdavit indicting such. name of the sub-conusctors and their,workers'comp-Pouey information. I am an employer that is providing workers'compensation insurance or ni e information. f y mployees' Below is the policy and,job site Insurance Company Name: d,/,L S Policy#or Self-ins.Lic.#: I ( J (�— ;� 7 Expiration Date: Job Site Address: ;US-0 ��� ` Sh j City/State/Zip: t Y , V'I l�G��j•-fV�� Attach a copy of the workers' compensation policy declaration page(showing the poky number.and expiration date). Failure to secure coverage as required under Section 25A ofMGL c. 152 can lead to the imposition of criminal ) 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 one Of up to$250.00 a da aor. penalties of a Investigations of the D g for'durance ov E gen verifiised cation.t a coFY°f this statement may be forwarded to the Office of I do hereby cerci ,under the airs and enalties r J'6 4"the information provided above is true and correct Si�ature: �G _._ Date._._ !O 7 Q Phone#: /�� 3 b ! l G_C FRoardof only. Do not write in this area, to be completed bJcity or to n,n officio n: 1. Permitucense# hority(circle one): Health I Building Department 3. City/To p Clerk 4.Electrical Ins ector 5.Plumbing Inspectorson• 'hone n: Information an d Instructions Massachusetts General Laws chapter 152 requires all employs to provide workers'compensation for their employees. Pursuant to this statute;an employee is defined as"...every person in the service of another under any contract of hire, express or implied oral or written." An employer is deed as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint;nterprise.and including tie legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association ox-other legal entity,employing employees. However the owner of a dwelling house having not more than three aparmz ents and who resides therein,or the occupant of the dwelling house of another who employs persons to do mainte;mance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to c onstruct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work un-1 acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contraLcting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and if necessary,supply sub-contractors)name(s), address(es) and phone number(s)along with their cmtificate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'comp enation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confumation of inruranre coverage. Also be stare to sign and date the affidavit The affidavit should be i vti med to the City Or tov rn that the agpllca.uon for the perri2itor license is being reauestted not the.Depart—ment of Industrial Accidents. Should you have any questions regal diLb the law or if you are:,k^i:ired to attain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly, The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant That must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or t)wn)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each . year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit Tlie Office of Investigations would like to than you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone.and,fax number..... The Cammonwealttt cif Massachusetts. Department of Jmdustial Accidents Office of Investiggations 600 Washington Street Boston,MLA 0.2111 Tel. 4 617-72.7-4900 ea.-t 40.6 or 1-8 7/7-MASS:AFE Revised 5-26-05 Fax #6.17-727 7749 mrVirV 7.Mass._?Ov/dla. NORTH Town of �_ - 0 No.-- o dover, Mass., 16.2 (z) COCKICKEWICK S RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 11.1 vim., l BUILDING INSPECTOR THISCERTIFIES THAT..................a..............i�.........��..��..�..........................................................................:......... ............... Foundation has permission to erect........................................ buildings on ...... 3►,5f...... ..... Rough to be occupied as.....t). }" 4l0 Q. .... ........................................ Chimney ....................................�. provided that the person accepting this permit shall in every spect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-LaTs relating to the Insp 'on, Alteration and Construction of Buildings in the Town of North Andover. AT' L AWO %4. Or1 ,- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS �— ELECTRICAL INSPECTOR UNLESS CONSTRU TAR Rough ................................................. ..... .... .. ...... ... Service . ...... ......... ....... BUILDING INSPECTOR 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. 09/10/'71010 15: ?, 9784369997 PAGE Ht1 09 ECTAA.MERICA ESTIMATE !PROPOSAL September 1.0, 2010 Flame Laminating Corp. 2350 Turnpike Street North Andover MA 0 1845-63 47 Attn: Eric Di.grazia Terms; 30%Down.,60%at Completion, 10%at Presentation o: Warranty Project Name. Front Office Roof Location: 2350 Turnpike Street Re-roof Construction: Roofing work not to exceed 1,500 square feet consisting of Front Office roof only, • Remove and dispose of existing roofs in place. • Supply and. install.R20/3.25"polyisocyanurate roof insu.l.ation and 1/4"tapered insulation.cricket(approx.. 8' wide x 73' long)against;front wall to help promote drainage to scupper locations. • Supply and install a 060 Adhered.Roof System as per m.a.nufacttaer's spccifi,cati.ans. • Perimeter trim: .040 aluminum, shop fabricated,standard color. * Furnish, fabricate,and install white metal counterfl.a.shuag at rising gable end wall to reecive new membrane(fastener removal at existing hat channel by owner as discussed 9/9/1.0). • Roof accessories supplied,installed and flashed. itemized.below; _ 9nti Size Description 2 TBD Roof Scuppers(assumes re-use of ex,i.sting downspouts) + Flashing only for the following units and/or projections: Quantiio,, Size Description. 2 Existing RTU Units Tr_eta America Ncw England 2 Sterling Road,North Billerica,MIX Q1861 1978.43 6.9990 1 fax 97.9,4365,9997 tectaamcriea.com 09/'10/22010 15:37 9784369997 PAGE 02/0-2 September .10.2010 2350 Turnpike Street(con's,) + Manufacturer'-, 1.5-year material.and 15-year labor warranty included. • Tecta.New England.is not responsible for any permits, fees or weather delays. This estimatc`proposai will become a contract once executed by both parlJos. TOTAL LABOR.&MATERiALS; $19,750.00 (Sales tax.is included) Customer Approval: !� _Date: Tecta.America New England: Date, Qu.a.l i'ft cations: 1.. Assumes mechanical disconnects and reconnects at the two raised units are by others(we have included crane to support these units as roofing is installed underneath). 2. Assumes existing roof deck is in good condition and new roofing will be installed directly over said substrate(see unit price)_ 3. We have confirmed.a slope in the wood deck from North to South(towards Turnpike Street and included tapered insulation cricket only to help promote East/West flow to scuppers). 4. Owner to clear all vehicles and trailers from side parking area for dumpster and crane set tip. Alternate: 1. Add$71,900 to install,a.new membrane system(as above)over Auto Body Shop. Again,we have assumed a structural slope in the wood deck from.West to.Hast cuff of that one roof edge(structural slope should be confirmed by checking underside of deck with 2.level). If this slope does not exist, then we may have to substitute tapered insulation for the R20 flat insulation we have already included which would result in added charges,so we should confirm structural slope via a level on the underside of the room deck. Unit Price: 1. Add$3.50 per sgoare foot to remove deteriorated 5/8"piywood deck anjrepUace ith like-]rind material (quantity to be verified by Matt each day). Tech America New rngland 12 Sterling Road;North Billerica,AA,A 0i 8(52 1978.435.9990 {ax 97,1.436.9997 i tectlamcrica.corn � I Massachusetts Board Dcpatrtment of Polic S; of Buildinti Rc�, tfctti:. Construction Supervisor and Standards License: Cs pervisor License Restricted to: 00 X250 PETER J DENN 113 GARDEN ST W NEWBURY MA 01985 mmixxioner Expiration: 4/19/2012 Tr#: 21900 '; i V �