The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #1127-2016 - 315 TURNPIKE STREET 4/22/2016 �"l NORTH BUILDING PERMIT °` h-r ,t,.E° 'bgtio TOWN OF NORTH ANDOVER ( -a o APPLICATION FOR PLAN EXAMINATION 1 ! e J �A�OR p. Permit No#: I Date Received 'Z�° �i� 7 A�RATe° �SSACHUS�'t Date Issued: I PORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER M��^"'I`m�Gk: 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 11 Industrial [I Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg w<thers: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed ism 0 Water/Sewer _ DESCRIPTION OF WORK TO BE PERFORMED: On orabouf ,me. u-i1 t ;mss AA 4 o X96 �0 e�^S Cen�er ra�i0 7 i v l�rrt`�olG 61/ e, Kerte,0VA I 1W d I be Identification- Please Type or Print Clearly OWNER: Name: Merr,mack- Ga I I e4� Phone:�'7S-837-S-zW.3 Address: 315 Torn P Ike- '5-f re-,e--V /V , AA?do4511e4� ` ContractorName:6hrlShAn &-22 JQenkl Phone Email: YY7 q u Jd +e-kA o k--7 Address: ! 8 Gll iloj, PP-J'vc- .51 /Ufa 0310j Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: AlReI lifEei-irAlG49-CR Mio MAIM y cl Phone:—& 03 -Z3fl—el7�D h r I�-.—+i.4 h T7,A r ,*,/ 12 eri Jm Address:I g iChhatop At. . o11,s,; N`N d3 V9 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. $ d� FEE: $ Check No.: �(��1 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Plans Submitted ❑ Planc,,Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanuing[MassageBody Art ❑ Swig ening Pools ❑ Well ❑ To Sales ❑ Food Packaging/Sales ElPrivate(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 r. Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: 4,LFoI._cRaEtedDaEt P12ART MENT• d T Located _d 3tn4_o�Osgood -Street - - ----�- _r I jar4t�mMeamnttSstr'e et pum MhOIP.ep COMMENTS: 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.$10041000 fine NOTES and DATA— (For department use) Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks :rF 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 Applicable) :>F Engineering Affidavits for Engineered products OTE: 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 2012 I ECC Energy code Engineering Affidavits for Engineered products OTE: 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 _. tt No. �1 cif; Date'' e • -+ TOWN OF NORTH ANDOVER m Ytij N` Certificate of Occupancy $ Building/Frame Permit Fee $ =t -- Foundation Permit Fee $ i Other Permit Fee $ ; TOTAL Check# 1 "-Building Inspector C"[ (Ah QT� WENik 0 � Tents I Chairs I Tables I Flooring I Staging I Lighting intents.com "TEAM IN-TENTS" 888.RENTENT Michael Gould (888.736.8368) CEO c:603.234.4760 mgould@intents.com 18 Clinton Drive Hollis,NH 03049 o:603.883.5326 1 f:603.881.8833 00 Th F � Town of ndover 0 yr. 0 No. 48 A ?Ohl C, o'h ver, Mass, 2.1ou COCNICM1 WICK y1• �90 RAreo I'Pp��S U BOARD OF HEALTH PER Food/Kitchen Septic System THIS CERTIFIES THAT ... ... r. � BUILDING INSPECTOR .. ... ...... ...... . Foundation has permission to erect .......................... buildings on .N.5 ... .... ......s:. Rough to be occupied as ..... +e .. ... . ... ,..... .. ................. Chimney provided that the person accepting this permit shall in every respect conf to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to thenspection,Alteration and Construction of Buildings in the Town of North Andover. I _0� PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit: Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough YI_ Service ................................d ................ ........................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. l ♦ � L,14"/ q ., rt —h • rD (D T� IW s s� � Y i Bei.Pref /� s� �� ✓ Y I i r/g" O O p _� C) • �. r . 9 6, ,, 119 Cerfif trate of if fame ifkeot�tanre RMsrt.Rep AZTEC TENTS We buOW or /wpuc,'nOH 2665 COLUMBIA ST menufaedred coNcaRN NO. TORRANCE,CA 90503 CAL COMB F40,01 (800)228-3687 0212008 l Thls is 1b cerbYy met the ma[erlals described below hereof have been flame retandanf healed(or arse lnhem*nonflammable). ` FOR CHRISTIAN PARTYRENTAL 18 CLINTON DRIVE HOLLIS,NH 03049 EY Certrficadon Is hereby made that(check"an or"Wj (a) The articles described below this certificate have been treated with a flame retardant chemical approved and registered by the State Fire Marshal and that the applicationof said chemical was done In oonf'or- ❑ - mance with the laws of California and the Rales and Regulations o Marshal, of the State g f the State Fire Name of chemical used ..»..Chem.Reg.No.»»..»....._.._.... Meathodof application._..._.__...»...»_ ...,»......»»..».......... ... ..........»_........._.._ i ❑ (b) The articles described below hereof are made from aflame-resistant fabric or material registered and `* approved be the State Fre Marshal for such use;Fabric has been tested and passes NFPA701-96. Trade name of frame-resistant fabric or material used..Lffd"'td .Reg.No..»...M&3!...... The Flame Retardant Process Used IS NOT, Be Removed by Washing �E a,„,l .... David Bradley Chuck Miller-President Saar ert Title �" i • r `. ♦s, d. O .(i d' 'd '0�- . ti A ., ... eco �...�? �. �... CUSTOMER ORDER NO. R168629 ITEMS MANUFACTURED: 2-20x20 Fesdwrl Top UW with Double Valance 2-20x40 Ass"Top UW wffh Double Valance 3-40x40 2po.JumboTrac Top UW 6-4&W JumboTiac Middle Top UW f 1-100x730 Series 2000 Middle UW 2-20x20 Series 15001p-Top UW 2-20x30 Series 1500 113,-- Top UW ev 2-20x40 Series fSW 1pc.Top UIV x 1 PDF created with pdfFactory trial version www.pdffactory.com (fexttfirate of jflame ]Aa&tzt�tanre REMsrERED AZTEC TENTS Date vested or APPLICAMN 2665 COLUMBIA ST manufaahrw CONCERN No. TORRANCE,CA90503 02!2008 Ca COW F41.9,01 (fi0a)228-3687 r This is to oertlty that the materials described bebw hemof have been!lame rehwdanf beefed(or are inherently nonflammable). FOR CHRISTIAN PARTYRENTAL aS°.� 18 CLINTON DRAS HOLLIS, NH 03049 EY Certification Is hereby made thal~•(check"a"or"b' F-1 (a) The articles described below this certificate have been treated with a flame retardant chemical approved and registered by the State Fire Marshal and that the appGcationof said chemical was done in confor- mance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal % Name of chemical used...................»......».».....»..Chem.Reg.No...»...»....._ II..... Meathod of application (b) The articles described below hereof are made from a flame-resistant fabric or material registered and 1 approved be the State Fire Marshal for such use;Fabric has been tested and passes NFPA701.96. Trade name of flame-resistant fabric or material used.Liio1ii°"r .Reg.No..»...F !aa...... , The Flame Retardant Process Used .... NOT....... Be Removed by Washing David Bradley Chuck Miller-President Nam fir«Pickidim W*rftr4wft me CUSTOMER ORDER NO. R168629 ITEMS MANUFACTURED: 2-20x10 Fesdval Top UW with Double Valance 2-20x40 FesMl Top UW with Double Valance 3-40x40 20a JumboTrac Top UW 6-4WO JumboTraa Middle Top UW 1-100x30 Sodas 2000 Middle UW 2-20x20 Serres 15001pa Top UW 2.20x30 Series 1500 10—a Top UW 2-20x40 Series 15M 1pc Top UW i PDF created with pdfFactory trial version www.pdffactorv.corn Cerfiltrate of jflame Rezt�tanre m REGISTERED AZTEC TENTS bate vested or APPUCAnON 2665 COLUMBIA ST ma"uf AMA - CONCERN NO. TORRANCE,CA90503 [CAL cove r-419.01 (800)22a-36t:7 02!2008 f This is fo cerW(hat the maiadals described below hereof have been flame retardanf treated(or are inhem*noMammabie). FOR CHRISTIAN PARTYRENTAL os° +� 18 CLINTON DRIVE a HOLM NH 03049 4� >r Cerf kation is hereby made that(check"a"or"b'7 F-1 (a) The articles described below this certificate have been treated with a flame retardant chemical approved and registered by the State Fire Marshal and that the applicationof said chemical was done In confor- mance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used....................»....»..»»»...».Chem.Reg,No...»..._....._..�... Meathod of appllCatfon._.»»»»....»._._..........»»_._ ..._... .......»......._..».....__.. t ❑ (b) The articles described below hereof are made from aflame-resistant fabric or material registered and approved be the State Fire Marshal for such use;Fabric has been tested and passes NFPA701.96. Trade name of flame-resistant fabric or material used. Reg.No.....!L+l4g!...». The Flame Retardant Process Used .IWLL NOT... Be Removed by Washing(wffi or well not).... David Bradley Chuck Miller-President Nam d cAwor n1r4wt T" R p _ \�� n. � �.• � n. �� '\- 1. .'\. \ CUSTOMER ORDER NO. R168629 ITEMS MANUFACTURED: 2-20M Festival Top UW with Double Valance 2-20x40 Festival Top UW with Doable Valance 3-40x40 20c JrrmboTma Top UW 6-4ftM JwnboT=Middle Top UW I-100x30 Sodas 2000 Middle UW 2-20x20 Series 15001p_Top UW 2-20x30 Series fS001prw Top UW 2-20x40 Serfes f5001pm Top UW V Q PDF created with pdfFactory trial version www.pdffactorv.com Certtf t"rate of iffame Re.5t'Oanre m REMSTO ep AZTEC TENTS Date treated or APPLrCAMN 2665 COLUMBIA 5T menufatfived CONCERN NO. > TORRANCE,CA 90503 +4212008 CAL COMB 1WI9.01 (800)228-3687 This Is b Certtry(hat the materials described belowhereof have been flame retardant treated(or are lnhenv*nonflarrrmable). FOR CHRISTIAN PARTY RENTAL 18 CLINTON DRIM a HOLLIS,NH 03049 p Certification is hereby made that(check"an or"b'I a The articles described below this certificate have been treated with a flame retardant chemical approved r and registered by the State Fire Marshal and that the applicationof said chemical was done in confor- mance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used_.............................._.......Chem.Reg.No...W.._....._..__.. Meathodof application._..._.__.._.__.»».,......».__.._........__..»»..........»........ ....» '� ❑ (b) The articles described below hereof are made from a flame-resistant fabric or material registered and a approved be the State Fire Marshal for such use;Fabric has been tested and passes NFPA701-96. i Trade name of flame-resistant fabric or material used.. .Reg.No.....»F!taa...... The Flame Retardant Process Used .......................T Be Removed by Washing (WHE avnl roQ David Bradley Chuck Miller-President ame r�xa TiMe =" i r CUSTOMER ORDER NO. R168629 ITEMS MANUFACTURED: 2-20x20 Festival Top UW with Double Valance 2-2040 Festival Top UW with Double Valance 3-40x40 2pc.JumboTrac Top UW 6-4ftW JumboTrac Middle Top UW I-100x30 Series 2000 Middle UW 2-20x20 Series 15001pc.Top UW 2-20x30 Series 15001 pa Top UW 2-20x40 Series 1500 1pc.Top UW l xe� q,q D PDF created with pdfFactory trial version www.pdffactory.com The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 ,�. www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Christian Delivery& Chair Service, Inc./Christian Party Rental Address:18 Clinton Drive City/State/Zip:Hollis, NH 03049 Phone#.603-883-5326 Are you an employer?Check the appropriate box: Type of project(required): 1.E]I am a employer with 25 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.❑1 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 E]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other TENTS 152,§1(4),and we have no 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. tContractors 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..NH Motor Transport Association Policy#or Self-ins.Lic.#:P000749NHMTA2016 Expiration Date:01-01-2017 Job Site Address: City/State/Zip:/V,14 l it 1,IV/4 6FIkxS— Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under theains and penalties of perjury that th 'formation provided above is true and correct. Signature: Date: Phone#:603-883-532 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#: NEW NAMPSNIRE MOTOR TRANSPORT ASSOCIATION P.O.Box 3898 Concord,NH 03302-3898 (603)224-7337 CERTIFICATE OF INSURANCE i 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. This is to certify that: Christian Delivery&Chair Service Inc. DBA Certificate#: 1 Christian Party Rental 18 Clinton Drive Hollis, NH 03049 Is,at the issue date of this certificate,insured by the Company,under the policy(ies)listed below. The insurance afforded by the listed policy(ies)is subject to all their terms,exclusions and conditions and is not altered by any requirement,term or condition or other document with respect to which this certificate may be issued. COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATE: NH TYPE OF POLICY EXP DATE POLICY NUMBER LIMIT OF LIABILITY j Continuous' Extended Policy Term Workers'Compensation 09/01/2016-01/01/2017 P000749NHMTA2016 Bodily Injury By Accident $1,000,000 Bodily Injury by Disease Policy Limit $1,000,000 Bodily Injury by Disease Each Person $1,000,000 ADDITIONAL COMMENTS: "If the certificate expiration date is continuous or extended term,you will be notified if coverage is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (Not applicable unless a number of days is entered below.) Before the stated expiration date,the company will not cancel or reduce the insurance afforded under the above policies until at least 30 days. Notice of such cancellation has been mailed to: NH MOTOR TRANSPORT ASSOCIATION SELF-INSURANCE GROUP TRUST Christian Delivery&Chair Service Inc. dba Christian Party Rental 18 Clinton Street Hollis, NH 03049 Representative Authorized Concord,NH 603-224-7337 03/25/2016 Office Phone Number Date Issued