Loading...
HomeMy WebLinkAboutBuilding Permit #211-16 - 315 TURNPIKE STREET 8/19/2015 tIORTh BUILDING PERMIT O��tLED ,bqy TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION t Permit No#: Date Received 4 �gArED SSAC14Us���� Date Issued: I P TANT: Applicant must complete all items on this page LOCATION l'� /r.'�,,��;''''' it T� 4r%V �t Print . PROPERTY OWNER,/Crt-f;1'70 Com( � nt 160 Year Structure yes no MAP Qe:�rD PARCEL-tal ZONING DISTRICT:,: Historic Districtes y no Machine Shop V(Hage 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 thers: ❑ Demolition ❑ Other ❑ Septic ❑ Well E Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 8S'/s- /� wr a �19 X� `��l/.7's l wlll b n ora�e jf Identification- Please T pe or rint Clearly OWNER: Name: /��err/�'I�G/c �� ° Phonec/7z? -62-/.)3 Address: 3 5;�- /V Mf e5�/"f— Contractor Name: Phone: Address: j Oh Supervisor's Construction License. Exp. Dater Home Improvement License: , Exp. 'Date:' _ ABOkJT-E-GT-/ /�' / G !J d Phone: 7,3 74, Address: �77�YI �r , k/1 ,AV ,eVe q 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: $ �, G � FEE: $ . Check No.: Receipt No.:=1_ ��� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Al Signature of Agent/Owner -- Signature of contractor Plans Submitted ❑ Plans Waived E Certified Plot Plan. ❑ . Stamped Plans ❑ IYPE�F SEWERAGE DISPOSAL pliblic 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 0 7 ' 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 FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date --, 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.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 i ' 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/Cross Section/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:Building Permit Revised 2014 Location CiJ o NoS—X/ Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# i r Building Inspector NORTH own of EAndover No. II ao I * _ % h ver, Mass, RIA 10 / b COC NIC"I WICK y1' A�4ATE0 I.P��,�S S u BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT . . v/.........( J. BUILDING INSPECTOR has permission to erect .......................... buildings on ....... D. r. '......674X-.-..rn......................... Foundation Rough toto be occupied as ...............J.. .. .................................................................................................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT RTS Rough i Service ............ . ..... ......................................................... 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. Merrimack NORTH315TURNPIKE STREET, .e 1 Loot K St.Ann Apartments K Tower.- '•L Tower Physical ', MTower 1 Plant J Tower C.,' t Marione-Mejail -",H Tow-, Field Q Baseball 0 0 Tower St.Thomas Feld .' Lot J Apartments D Tower' -.C E Tower, Tower� \- \ B Tower Softball F Tower Field, .. ` 0 f,:ATewur \ .Let i Harriet Health& Lot L Spo Ash day Counseling Center Med" e O"NdHealth Centre O'Brien Inns 52f¢nces ' `\ Half.- �' Police Center S ) Lot G Besketbati Department DBtgan �`' Hous, courE'. yoke 1 �lyall East Q 4leSid2ncq` > Montan tRthtette Mertimaclt' ` Il use 2 Centre House Ce re e an Tovwt' ter Athlrltcs g �,. Complex`� `-,Hall West ruse L Hous_e`S •Chelmsford Lot H O - •Dracut House 5, �:y �� •Lowell Rogers Cascia L' •Tewksbury Lot F Center Hatt -,t. 'C�Hamrt` •Pelham for th ` Hoalth •Tyngsborough 0R it A SAM"Building el Y. c.Cam si � Pu •Andover LotE' pqall .Center" �-�, t' •Lawrence �, 5 •Methuen McQuade •Salem Mendel\ Lib ed� Genter 7 i rarY o •Haverhill tee+ Wekame� '��`.. • Georg Haverhill C/ jai Center Lot C l A •NortheAndover I'pt C CuNOR 9 po •Boxford `t p Sullivan Hall - �' Lot @ eJ�e qP Austin i t _ OLot A l� V ,,all (oltegiate `0 be urch of Christ thee Main NTeacher Entrance I '`y t cD° 7 P N e�/ f Q 1 wLwailllr:>.7a7�lPuly�V..7C]� g �U:.�.A7er�7:>:Mrr4C��7�17� ' 0 l 3•uti:tt•1Gr.. p:�!�Ailr4l ty 0 1mejrlam=ik."4 14I!�;.LY:p/ ❑'AjLL'MjWQ ntre,'��t! o 4.rtfStlr'atr7AW-1k o it.L K��Ittw 7 @20@M e e 0,0yWrAtInell,cw. o 10LxMloW L,-Aki Dhoti*wi)64war star lud-aeti ttjvkvu•sz 0 49, -rr i l- .Ya 6 o(LCL". T Lrr It-011rl Igo. Lo-w.tlxki a 13xr ry- e3Nr& 3GT►le7 ❑ ;LptU,:jr n ltii7cat•csi,ritux rll,SCI 0 ¢[b-tditilr o al"ift lir lttw:717r.q 440W a` t�er�ai Lei sur ---...:o.IL,�r^•IYaR17rit .__.-.__ _._._ ...___°P 'Efili�i11C�T(7"_.__... Q Iain., rola'ClW, 0 o�haa1[it h'at l p&M Qk 0 ftQMM IMPORTANT DOCUMENT Certificate of Flame Wfsistawe ISSUED BY Date of Shipment 4/10/2015 Registration Number INDUSTRIES INC.S Sales Order# F-140.01 SO-614935 EVANSVILLE, INDIANA 47726 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and were supplied to: 269800 CHRISTIAN DELIVERY CHAIR SERVICE INC DBA CHRISTIAN PARTY RENTAL 18 CLINTON DR HOLLIS NH 03049 USA cat��o�O N � 9FR Pty P ARE M 4q F RETP Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, ULC 109. Serial# 8150200(2) Description of item certified: CENTURY END 40W X 20 HOLE SNYDER WHITE VINYL WITHOUT WEB GUYS Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric SNYDER MANUFACTURING INC. PHILADELPHIA PA Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC �D IMPORTANT DOCUMENT Ce 'i itate of Flame ftsistance ISSUED BY Date of Shipment 4/10/2015 Registration Number CHOR® Sales Order# F-140.01 CN`INDUSTRIES INC. SO-614935 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and were supplied to: 269800 CHRISTIAN DELIVERY CHAIR SERVICE INC DBA CHRISTIAN PARTY RENTAL 18 CLINTON DR HOLLIS NH 03049 USA G�STE� 4��oF cat�,�o�o N q F R>ET P Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, ULC 109. Serial# 8150300(2) Description of item certified: CENTURY END 40W X 20 LOOP SNYDER WHITE VINYL WITHOUT WEB GUYS Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric SNYDER MANUFACTURING INC. PHILADELPHIA PA Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC IMPORTANT DOCUMENT Certificate of Flame �sstsstance ISSUED BY Date of Shipment 4/7/2015 Registration Number INDUSTRIES INC.® F-140.01 Sales Order# SO-614929 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and were supplied to: 269800 CHRISTIAN DELIVERY CHAIR SERVICE INC DBA CHRISTIAN PARTY RENTAL 18 CLINTON DR HOLLIS NH 03049 USA TE� z� .I� RE QO � RETP Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, ULC 109. Serial# 8150100(4) Description of item certified: CENTURY MIDDLE 40WX20 SNYDER WHITE VINYL WITHOUT WEB GUYS Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric SNYDER MANUFACTURING INC. PHILADELPHIA PA Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC The Commonwealth of Massaehuseas Department oflndustrialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass gov/dia porkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Amlicant Information Please Print Leeibiv Name(Business/Organization/Individual):Christian Delivery&Chair Service, Inc. DBA Christian Party Rental Address:18 Clinton Drive City/State/Zip:Hollis, New Hampshire 033049 Phone#:603-883-5326 Are you an employer?Check the appropriate box: Type of project(required): L.Q✓ I am a employer with 4'� employees(full and/or part-time).* 7. []New construction 2.0 1 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.[]]am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will unsure ihat all coniraciurs eiiber have worKers'compensadon insurance:or mu sole i i.V11311ecu Val repairs or adul—I'd proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.oRoof repairs 'These sub-contractors have employees and have workers'comp.insurance.: TENTS u.� .. .•.. ,. Lvwi 14,n-1 VVC ttte a eUtpol aiNlt iitlii lis V�exIS 11aVe GXCIGtSW ll lGn Itr,tle W CXGIIipilUtt pet t91tJL G. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] I I I 'Any applicant that checks box#I 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 isproviding workers'compensation insurance for my employees. Below is the policy andjob site information. rrstl.M..rce Company Name:New Hampshire Motor Transit Association Policy#or Self-ins.Lic.#: P000749NHMTA2015 Expiration Date:01-01-2016 2`!117%= Job Site Address:,A57 •Sf' City/State/Zipf :/W 'Ar1�I✓��i 1VA e1,Fy1r Attach a copy of the workers'compensation poucy 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. I do hereby certify under the pains and peva ties of perju,pyhat the information provided above is true and correct Signature: Date: . r7�E Phone#:603-8833-53320 O ictal use only. Do not write in this area,to be completed by city or town of eiaL Ciiy of Towa.- Pernh Juicense A 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#: ACOORO CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DDIYYYY) 8/29/2014 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(les)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 CONA E:NTACT Rhonda Noble THE ROWLEY AGENCY INC. PHONE , (603)224-2562 1FAQ 0.(603)224-8012 139 Loudon Road -MAILADDRESS.rnoble@rowleyagenCy.com P.O. BOX 511 INSURERS AFFORDING COVERAGE NAIC q Concord NH 03302-0511 INSURER A:Hanover Insurance Company INSURED INSURER 8: Christian Delivery & Chair Service, Inc, INSURER C: dba Christian Party Rental INSURER D: 18 Clinton Drive INSURER E: Hollis NH 03049 INSURER F: COVERAGES CERTIFICATE NUMBER:14/15 - no me 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYYI (MM1DDfYYYYl LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TUWERTED— X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurrence) $ 100,000 A CLAIMS-MADE FX OCCUR BVOB4436307 /1/2014 9/1/2015 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY E PRO X LOC $ AUTOMOBILE LIABILITY E aoad 5n91011!LIMIT 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ X ALL OWNED r—v-1 SCHEDULED kBV071690907 /1/2014 /1/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per a dent $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 EXCESS I X I RETENTION 084436507 /1/2014 /1/2015 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUflVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS beiow E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLESAttach ACORD 101,Additional Remarks Schedule,K more space Is required) Covering operations of insured during the policy period. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN "For Informational Purposes Only" ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Rhonda Noble/RLN - �-- ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. 1NS025 ronlnnrr n1 The Ar:npn naenc anti Inn^arc roniafarorl marfre^f ar:nRr1