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Home My WebLink AboutBuilding Permit #283-2011 - 315 TURNPIKE STREET 10/6/2010 BUILDING PERMIT O� NORTH q .('"o /6 TOWN OF NORTH ANDOVER o� y '`- J�'° APPLICATION FOR PLAN EXAMINATION So /! T 2 a Permit NO: Date Received a �SSACHUSE� Date Issued: Q l I ORTANT:Applicant must complete all items on this page '/ l f LOCATION. - � w_` ��a�✓__ sP'nnt ._ PROPERTY Q,1/1INER� _ ��0 �-- L. ,� Vim/ , i _. ef " N. ,MAP NO _V 'PARCEL ZONING DISTRICT' Hisfor•ic#Ditract yqs no MadhinerShop Village .yes no 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 O Septic :®�1Nell ❑ Floodplain� 1Netlands :`Watershed Districf .❑tWater/Sewer 1 DSCRIPTION,QF ORK TOB OR D• DOT nl-Halfea J 10\uN ICQ u'WotL-� 7 R a 69M. /'m s)po ), S Identification Please Type or Pr'nt Clearly) . OWNER: Name: �'1 CCS. Phone: qmf Address: 3, V /✓–� '• CONTRACT O.R Name, /t'la �;yheh}-0 Phone Address:._ 3 ._ r- '^.am t S .__ _ '�i� `�►^S �__ __../!�I , __ _ t"7 SupeNrsor s Construction License ` 2. �;S" LExp: iDate_ SIYG Homo lm provement'Licens0- Exp.. ARCHITECT/ENGINEER � �SQ ��'7C�iPfione: -,/Z5–3 Address: 9 U01-z-?I ,54fi r0 �d Reg. No. FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ /�� S`�c) FEE: $ Zero— Check No.: �l � Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sanafureof,Aaent/Qwner R '`')� nature,.of�contractor 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 Signature COMMENTS HEALTH Reviewed on / Si nature r 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 Osq ood Street FIRE�DEPARTMENT =Temp. Dumpster{on site eyes Locati d, 124 Main.Stbeet r'nn'nn'PNJT:S -- 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 - Date Doc.Building Permit Revised 2008 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 pp 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 i Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location3/s— �UlN/-��/l F�74 No. Date / MORT� TOWN OF NORTH ANDOVER F w 9 i • ° Certificate of Occupancy $ Is " <� Building/Frame Permit Fee $ !r0 sAcwusE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 3.3 2 3 5 0 L uilding Inspector NORTIy ov oAndover No. I'i' _ LAK dover, Mass., '21.6 � /C)� COC MIC EWICK oRATED vv V ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR ��1 �9 THISCERTIFIES THAT....................................................................... ....................................................................................... Foundation has permission to erect.................:...................... buildings on .. /. ..�.�! '?', 1... F....5 ................... Rough a to be occupied as f. C..F/ 1...4 .E SS/.Q.'�'.... �1`�.Cl .......................................................... Chimney ............... .... ..... .... .... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 CONSTRUCTION STARTS Rough G....... ............ Service BUI DING INSPECTOR . Final Occupancy Permit Required to Ocatpy 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. dM AL dLft dSL 04 00, A0* CONSTRUCTION CO., INC. GENERAL CONTRACTORS �J October 5,2010 Merrimack College 315 Turnpike St North Andover,Ma Att: Jim Finn Re: Concession Stand PROPOSAL Supply and install: Triple Bowl sink with grease interceptor,Wire equipment supplied by school, lower existing transaction shelf for ADA access, frame valance at vending machines, supply and install sliding grille at vending machines. TOTAL PRICE: $12,500.00 Owners Signature: Anthony Pimentel Anthony Pimentel Sasso Construction Co., Inc. Note: This proposal may be withdrawn by us if not accepted within 30 days. 101 469 231 ANDOVER ST.WILMINGTON,MA 01887 TELEPHONE(978)694-4111 FAX(978)694-9226 Email www.sassoconstruction.com •. Massachusetts- Department of public Safet, Board of Buildin'a Regulations and Standards Construction Supervisor License License: CS 92345 Restricted to: 00 MATT PIMENTEL 16 SPENCER CT ANDOVER, MA 01810 Expiration: 5/4/2011 Tr##: 15314 The Commonwe¢1th of Massachusetts Department o f Industrial Accidents Office of£nves9eg ations 600 WashMOM Street Boston, M4 62111 Workers' ComP enation Insurance Affda as�boy/din vit: o licant Builders/Contractors/Electricians/Plumbers . AInformation Please Print Lem-blv Name(Business/organization/Individtw):_ A_1 C Address: b'�` c �•j- City/State/Zip: Phone#: 'C �-y�11 Are you an employer?Check the appropriate box. 1. am a employer with 4. ❑ I am a Type of project(required): . employees(full and/or part-time).* general contractor and I P trine). have hired the sub-contractors 6 ❑New construction ?•❑ I am a sole proprietor or partner- listed on the attached sheet 1 �• Remodeling ship and have no employees These subcontractors have working for in any capacity. workers, com . ' 8' ❑Demofition [No workers'com : • P insurance. P insurance 5. ❑ We are a coipgration and its 9. �]Building addition 3.❑ required] officers have exercised their 10 0 Electrical repairs I am a homeowner doing all work n t of or additions myself. examption Per MGL I I.❑Plumb' r s [No workers'com . repairs or additions insurance re tilted. t P c. I S2,§I(4),and we have no q � employees. 17•❑Roof repairs ,rn, POMP•Insurance required 13 ❑ Other t g-� hcsat that ch—laz box--#i must also url out , '40meowners who submit this affidavit indicating th V ection-yaw mov Wg tham wori:ws'com s=+:oa Policy :Contract=that check this box must atfa^hed�� doing aL work and then hire Outside coatractcrs must�� . :t tional sheet showing a new afiidavii urdicating such. �the same of the s,•brc.^atr�u,�s and their workers' I am an em comp.Po� information. P J'� is providing workers'compensation insurance for my employees. Below is the policy and job site utformation. Insurance Company Name: Policy#or Self-ins.Lir. C � . y Sob Site Address: Expiration Date: �� I V��i � .. ... Attach a copy of the workers'compensation policy declaration as City/State/Zip: lr ',� l Failure to secure coverage as required under Section 25A ofM Page showing the policy number and expirafiion date). fine up to$1,500.00 and/or one-year imprisonment, as well as 152 G penaltiesan l ad to oaf a STOP Of criminal Of up to$250.00 a da aPenalties of a y against the violator. Be advised that a co WORK ORDER and a fine Investigations of the DIA for insurance coverage verification. of StBtEluIt may be forwarded to the Office of I do hereby cerBfy un er pains and e p nalties of/perjury thtzt the in or C,/G n A f motion.provided above is true and correct Si�ature: . ��., Phone#: v Official use only. Do not write in this area, to be completed by com,or torn official City or Town: permit/License# Issuing Authority(circle one): I. Board of Health 2.Bitilditrg Department .3. City/Town Clerk 4. Electrical Inspector 5.PIumhint" 6. Other b Inspector Contact Per-sotr: Phone#r ISSUING COMPANY ACE PROPERTY s CASUALTY INSURANCE Workers' Compensation NCCI CARRIER CODE and Employers Liability 12254 Insurance Policy Information Page POLICY NUMBER � New � Renewal El Symbol: NWC Number:C4 63 65 42 2 PREVIOUS POLICY NO. Individual 1-1 Partnership Symbol: NWC Number: C45807071 0 Corporation Item 1. FSASSO CONSTRUCTION COMPANY INC Inter/Intrastate ID No.: Named 231 ANDOVER STREET Insured WILMINGTON MA 01887 Federal Employer ID No.:042231373 Mailing Address Employer's ID No.: PIIC CODE:1751 For other named insured see Extension of Information Page-Schedule of Named Insured,WC 99 99 99 A For other workplaces see Extension of Information Page-Schedule of Other Workplaces,WC 99 99 99 B Item 2. Policy period: From 10-01-2010 To 10-01-2011 12:01 A.M.,standard time at the named insured's mailing address. Item 3A. Workers'Compensation Insurance: Part One of the policy applies to the Workers'Compensation Law of the states listed here: MA Item 3B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $1,000,000 each accident Bodily Injury by Disease $1,000,000 policy limit Bodily Injury by Disease $1,000,000 each employee Item 3C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND,OH,WA,WY, AND STATES DESIGNATED IN ITEM 3.A Item 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans.All information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE-CLASSIFICATIONS If indicated here, interim ad'ustments of premium will be made: Minimum Premium collected in MA $ 500. ❑ Semi-Annually Quarterly ❑ Monthly Total Estimated Premium $ 17902. Deposit Premium $ This policy includes these endorsements and schedules: SEE SCHEDULE OF FORMS AND ENDORSEMENTS WC999999D PRODUCER NAME AND MAILING ADDRESS TPA INSURANCE AGENCY INC 10 NEW ENGLAND BUSINESS CENTER SUITE 303 ANDOVER MA 01810 PRODUCER CODE: 249634 04-3296168 SML MARKETING OFFICE: ACE COMPLETE ISSUE DATE: 09/07/2010 Henry Otto Sd rammll (Authorized Representative) WC 00 00 01A(06/03) Copyright 1987 National Council on Compensation Insurance INSURED COPY