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Home My WebLink AboutBuilding Permit #319 - 315 TURNPIKE STREET 10/20/2006 TOWN OF NORTH ANDOVER Th APPLICATION FOR PLAN EXAMINATION 04 V10RkOR h 4 � Perniit NO: 10 Date Received /0 r 2,0'04; Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION J/67 Print PROPERTY OWNER_ Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ❑One family ❑ Addition ❑Two or more family ❑ Industrial Alteration No. of units: Repair, replacement ❑ Assessory Bldg ❑Commercial Demolition C Moving(relocation) ❑Other tethers: Foundation onlyS DESCRIPTION OF WORK TO BE PREFORMED , /'I 0�_ �v its l� 7(,6D TPhT ALe rse 7L f4��'yl�ver'/ dlil llJ�.z3�0,6 Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: 4 011k7 AA r V(! s IV14 CONTRACTOR Name: �i,/S �A�7]/ /<e<-a Phone:9yg-,,-72Z X34' Address: / Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ S5-0 — FEE:$ 30 Check No.: �() Receipt No.: 1 T f Page W4 4 FPublic SEWERAGE DISPOSAL r Swimming Pools C Tanning/Massage/Bo7dyArt wer Tobacco Sales J Food Packaging/Sales L Well Permanent Dumpster on Site — _.! Electric Meter location to Private(septic tank,etc. project NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contracto Plans Submitted ❑ Plans Waived F] Certified Plot Plan 11 Stamp d Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes n Fire Department signature/date 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 Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) ` Pagc 3 uf-4 Doc:INSPECTIONAL SERVICES DEPARTMENTBPFORM05 Created MC.hn._006 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing g, 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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 DEPARTNIENT:111'FORR105 Page 4 of 4 Location '�;1 S No. 3 f�1 _ Date NORTH TOWN OF NORTH ANDOVER 3?O:tt� o ; .�tiOO � R s Certificate of Occupancy $ s''"°''<�' Building/Frame/Frame Permit Fee $ s+CHusa 9 Foundation Permit Fee $ Other Permit Fee $ G TOTAL $ Check # 6 /Fy� 197 ,15 Com,------ V Building Inspector NORTIy Town of over 31 ° ,. - �, No. 9 - �`Y z dover, Mass., T O C- LE I� OC1iICMEWICK V 7�ps RATED 1 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 3i � �� BUILDING INSPECTOR THIS CERTIFIES THAT.. !� //�Q.`..... .�M.� w. . .....................:... .. .... .......... .... ... Foundation has permission to erect........................................ buildings on ........e*201440-11......JTel ....................... Rough to be occupied as....&.0..*...,e...e .* , Y ?!PChimney 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTR . ... . . .N ARTS 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. APARTMENT Merrirma& ST.ANN COMPLEXES C O L L E G E ST.THOMAS MONICAN CENTRE ri^ North Andover,Mascachu.setts sc OT 44 Be ar i--- R a Ow ANTAGATI HALL HOUSESi F PLAYING �� f Hf MEL HEALTH ST.FR ROCK RUJC;E RpAD .�� t6. . CASCIA ., j + •CLADYSSAKOWICH PHYSICAL PLANT ASH CNTRE ��/// torr CAMPUS CENTER O /Re�rJwe►10111 � t��,j� �0,0 A, tar ` CUSHING * ' 01REIL4Y HALL x� DEEGAN HALO' EG T t�2 HALL .. s'N ':� ' �, ��COLLEGIATECHUR-,i t cut A �.\'�/ r • -C K .� .tN fo '1 F:NNIS__ o E o r� �.�� •�- Ube w s F f ...RTS Mc�QQUADE Y _ LIBitARY AUSTIN HAIL YJ +� .y f� epr 'lrlar VOLPE PHYSICAL t�r a MENQEL CENTER �✓! SULLIVAN 1 0ff°i1 EDUCATION CENTER Cl�cu+rreind r^�r^�^'"s4MfJtr�� HALL ~ tr� 2 t r r 'L,,. ?^'�.o'�K'e�.,y,.�o Nat r • �� TO Rattle �,� ToSrlem nen ROUTES 114 AWY 12.5 1URNPIKE Sr. ® , Lot 1-Church Lot Lot 4.Volpe Lot Lot 6-Campus Center Lot Lot 66-St.Ann Lot Lot 3-Rogers Lot Lot 6-Deegan West Lot Lot SA-St.Thomas Lot Lot 8C-St.Ann Extension Lot Certificate of jr1ame Re.501ance REGISTERED ISSUED BY: Date treated or APPLICATION AZTEC TENTS manufactured s CONCERN NO. 042006 • � 490 ALASKA AVENUE TORRANCE,CA 90503 CAL COMB F-419.01 (310)328-5060 $ET This is to certify that the materials described below hereof have been flame retardant treated(or are inher- ently nonflammable). FOR CHRISTIAN PARTY RENTALS ADDRESS IS CUNTON DRIVE CITY HOLLIS STATE NH, 03049 Certification is hereby made that: (check "a" or"b") ,�, (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 application of 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......................... Meathodof application................................................................................................ (b) The articles described below hereof are made from a flame-resistant fabric or material registered and approved by the State Fire Marshal for such use; Fabric has been tested and passes NFPA701-96. Trade name of flame-resistant fabric or material used..Lnf^aWF&b+e .Reg.No. ....."MeE The Flame Retardant Process Used .WILL NOT Be Removed by Washing a ....)..... (will or will not) David Bradley Chuck Miller- President Name of Applicator or Production Superintendent TWO �... 8 .. 4vim CUSTOMER ORDER NO. R160265 ACORD CERTIFICATE OF LIABILITY INSURANCE CHRI�11 y^09/15/06 IODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE yam Bros-Mahoney Insurance HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 91 Pawtucket Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. owell MA 01854 •hone: 978-454-2926 Fax:978-937-0745 INSURERS AFFORDING COVERAGE NAIC# SURED INSURER A: Merchants Insurance Co. Christian Delivery & Chair INSURERS: American International Service Inc. INSURER C: Christian Party Rental 18 Clinton Drive INSURER D: Hollis NH 03049 INSURER E: OVERAGES 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. fR KolnNSR TYPE OF INSURANCE bV POLICY NUMBER DATE MWD TffCTW DATE MM/DDm LIMITS GENERAL LIABILITY OCCURRENCE $ 1,000,000 EACH ru X COMMERCIAL GENERAL LIABILITY CM29147277 09/01/06 09/01/07 PREMISES(Ea occurence) $ 100,000 CLAIMS MADE a OCCUR MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ �. X SCHEDULED AUTOS CAP9264363 09/01/06 09/01/0-7. (Per person) X HIRED AUTOS BODILY INJURY $ (Per accident) X NON-OWNED AUTOS PROPERTY DAMAGE $ -- --- —- (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ ----- AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $3,000,000 A X OCCUR � CLAIMSMADE CUP9137980 09/01/06 09/01/07 AGGREGATE $3,000,000 DEDUCTIBLE $ X RETENTION $10,000 _ $ WORKERS COMPENSATION AND TORY LIMITS X ER B EMPLOYERS'LIABILITY WC8971341 09/01/06 09/01/07 E.L.EACH ACCIDENT'. s500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEES 500,000 Has,describe under E.L.DISEASE-POLICY LIMIT $5001000 SPECIAL PROVISIONS below OTHER )ESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CHRISTI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Christian Delivery & Chair DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Service, Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL dba Christian Party Rental G I URER,ITS AGENTS OR 18 Clinton Drive � '`��WIT:`_' Hollis NH 03049 ORIZED REPRE. U HORIZED REPRESEtI TI VE Se Tebb ACORD 25(2001108) CORD CORPORATION 1988 f w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone F-1 am a homeowner performing all work myself. F-1 I am a sole proprietor and have no one working in any capacity am an employer providing workers'compensation form employees working on this job, b Company name: �heall;in /2401�� / /�P Address Ig (_1/h hO !/�Y City: ly0 �S /U& 030fK? Phone#: &J- �aP3-532 G InsuranceCo. A�e�� ! Tif��u1/ibh a Policv# WrIf97/350V Company name: Address City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of rjury that the information provided above is true and correct. Signature Date AO XO db Print name /CllAC� GOUT Phone# 6i3' ?,:V-J72 L Official use only do not write in this area to be completed by city or town official' E] Building Dept ❑Check if immediate response is required Building Dept p Licensing Board p Selectman's Office Contact person: Phone#: Health Department Other FORM WORKMAN'S COMPENSATION