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Home My WebLink AboutBuilding Permit #055-13 - 35 MAY STREET 5/1/2018 NORTH BUILDING PERMIT °�STL!° ,6'�ti• TOWN OF NORTH ANDOVER '. •_ .s° °p APPLICATION FOR PLAN EXAMINATION Permit NO: 0s� Date Received 41 foD " �1 °gwreo �SSACHU`�E� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER e--;, [`�lp - Print MAP NO: 9,� PARCEL," ZONING DISTRICT: Historic District yes. no Machine Shop.Village yes ("*n ) o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Two or more family Industrial ion No. of units: Commercial replacement Assessory Bldg Others: Demolition Other '�l At�'t!a &AL-►v Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: �`��J�►� 1��wt � 1,��`P��v�s.. ��c -cam ��, A,t,XV OF Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: ' ., Phone:' 41� otco�. Address: `2-ZpC> nA%�- Supervisor's Construction License: G��1S�lS Exp. Date: _ 'Z.7 1,q Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: 7!jJ1 �6Sz{ 004&� Address: V-a'Z %z> Reg. No. 7.-5011 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THPTO�AES�T/MATED COST BASED ON$925.00 PER S.F. Total Project Cost: FEE: $ Se=— Check No.: x"01-7 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Signature of Agen-ubmer Signature of contractor i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools I 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 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 ' i ❑ 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. I 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 DEPARTMENT:BPFORM07 Revised 2.2008 14 D -14 u`>e- Location No. Date - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Y ar,L Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check# r� 25534 /��Building Inspector r PITCH BAR & RIDGE BEAM o FRAMING TO BE 1"x2" 16GA. I GALVANIZED STEEL TUBING. PERIMETER SUPPORT - - - _- FRAMING TO BE 2"x2"x I y n� i 0 Y4" H.S.S. GALVANIZED II // I \� I I I STEEL TUBING. / 12"H. PERIMETER TRUSS-JA - FRAMING AND ANGLED I I// EXISTING (ENTRANCE \I I BRACING TO BE 1"X1" 16GA. I I\ DOOR //I I GALVANIZED STEEL TUBING. i II 4"x4"xY4" H.S.S. GALV. STEEL CANOPY STANCHIONS, TO BE SET IN CONCRETE FOOTINGS, (TYP. OF 4). 7-47 / EXISTING CONCRETE SIDEWALK, TO REMAIN. ------------- SONOTUBES (TYP.) 10'-8" Z>i OF oma' JOHN W. 9�y CANOPY FRAMING DESIGNED TO COMPLY OUEEN N WITH MA. STATE BUILDING CODE, 8TH U srRucruR,,L EDITION, SECTION 780CMR PARAGRAPH 280. ISTPE N 2 3105.0 AWNINGS & CANOPIES. AL FRONT ELEVATION 7-2347, SCALE: The Dorchester Awning Company PROPOSED AWNING FOR 7A-3%12 230 Oak Street 140 PRESCOTT STREET,NORTH ANDOVER,MA 01845 r+oieo F.O.Box 385 Tel: 781-826-9001 &—"-."&- Pembroke,MA 02359 Fax:781-826-1628 PRESCOTT HOUSE NURSING HOME S k- 1 ~1 &4 r, T— I I 1 1"x2" HEADER RAIL, ATTACHED TO o I BUILDING BRICK FACE WITH 3 )'" I I EXPANSION ANCHORS AND Z-CLIPS. f I III F— 7�7iA Z ri PERIMETER SUPPORT FRAMING TO I II I BE 2"x2"xY4" H.S.S. GALVANIZED ED I l i I STEEL TUBING. I I I II I WELD TOP & BOTTOM CHORDS I I E I TO COLUMNS (TYP.) I II I CANOPY STANCHIONS ITO BE o I II 4"x4"xY4" H.S.S. GALVANIZED STEEL TUBING. 14"x4"xY4" H.S.S. GALV. STEEL I CANOPY STANCHIONS, TO BE SET IN f I I 1 CONCRETE FOOTINGS, (TYP. OF 4).- u I WELDED 6"x6"x%8" : < o BASEPLATE r 14"dia. x 4'-0" 6'-0 5'-10" SONOTUBES (TYP.) CANOPY FRAMING DESIGNED TO COMPLY �I" OF Mqs� WITH MA. STATE BUILDING CODE, 8TH �o�' JOHN EDITION, SECTION 780CMR PARAGRAPH QUEEN 3105.0 AWNINGS & CANOPIES. `D STRUCr j d 28011 ELEVATIONTER� '9F 0 SCALE: Y8" = 1'-0" The Dorchester Awning Company PROPOSED AWNING FORF�-�2 2 /,z 140 PRESCOTT STREET,NORTH ANDOVER, MA 01845OTED num W. 230 Oak Street P.O.Sox 385 Tele 781-826-9009 Pembroke,MA 02359 Fax:781-826-1628 PRESCOTT HOUSE NURSING HOME —2 414 4 PITCH BAR & RIDGE BEAM FRAMING TO BE 1"x2" 16GA. O GALVANIZED STEEL TUBING. I 1 PERIMETER SUPPORT71, 1"X1" 16GA. GALVANIZED STEELTUBING FRAMING TO BE 2"x2"XY4" AT ANGLED AND VERTICAL SUPPORT 0 H.S.S. GALVANIZED BRACING AND PERIMETER TRUSS. -I STEEL TUBING. TYPICAL CENTER TRUSS SECTION SCALE: CANOPY FRAMING DESIGNED TO COMPLY WITH MA. STATE BUILDING CODE, 8TH EDITION, SECTION 780CMR PARAGRAPH 3105.0 AWNINGS & CANOPIES. PITCH BAR & RIDGE BEAM FRAMING TO BE 1"x2" 16GA. o GALVANIZED STEEL TUBING. I -�H OF Mgs9 s JOHN W. �y QUEEN m 1"Xl" 16GA. GALVANIZED STEEL TUBING 0 STRUCTURAL ti AT ANGLED AND VERTICAL SUPPORT 28�tt BRACING AND PERIMETER TRUSS. e , ), FSS/Q AL 11)-0))1 —O 7-2-3_(Z END TRUSS SECTION SCALE: i—ea. PROPOSED AWNING FOR 7/23/1 2 The Dorchester Awning Company 140 PRESCOTT STREET,NORTH ANDOVER,MA 01845 230 Oak Street NOTED P.O.Bax 385 Tet: 789-826-3001 m� Pembroke,MA 02359 Fax:781-826-1628 PRESCOTT HOUSE NURSING HOME S k-3 m.a 3 a 4 .10 . z AWNING NOTES : 1. TYPICAL CANOPY STRUCTURE FRAMING TO BE HEAVY DUTY GALVANIZED STEEL TUBING, FY=50,000 PSI: RAIL SIZES: 2"x2"xY4" H.S.S. FOR SUPPORT TRUSS 1%2" 16GA. FOR HEADER RAIL AND PITCH BARS 1"x1" 16GA. FOR PERIMETER TRUSS AND PITCH SUPPORT BARS 4"x4"A" H.S.S. GALV. TUBING FOR CANOPY STANCHIONS. 2. AWNING FASTENERS TO BE STAINLESS STEEL. 3. AWNING FRAME TO BE WELDED AT CONTACT SURFACES OR CONNECTIONS WITH A Y8" CONTINUOUS FILLET WELD. ALL WELD SEAMS TO BE GROUND SMOOTH PRIOR TO FABRIC ATTACHMENT. CONNECTIONS TO CANOPY STANCHIONS TO BE WITH WELDED BASEPLATES. 4. ALL FABRIC DESIGN, CAPACITY AND CONNECTIONS ARE BY DORCHESTER AWNING COMPANY. 5. FABRIC COVERING TO BE FIRE RETARDANT ACRYLIC AWNING MATERIAL, SUNBRELLA FIRESIST, FOREST GREEN #82003. 6. IT IS RECOMMENDED THAT THE FABRIC BE REMOVED FOR ALL WIND SPEEDS ANTICIPATED OVER 60MPH AND FOR ANY HEAVY OR EXCESSIVE BUILD—UP OF ICE OR SNOW. 7. CAPACITY OF THE EXISTING STRUCTURE TO SUPPORT THE CANOPY LOADS AND CAPACITY OF THE SOIL TO SUPPORT THE APPLIED LOADINGS 1S NOT THE RESPONSIBILITY OF THE CERTIFYING ENGINEER. 1"x Z' 16GA GALV. STEEL FRAME TEK SCREW ATTACHMENT TO �,�� OF M AWNING FRAME, SIDES AND As�9 BOTTOM JOHN QUEEN m 00 r--"Z" CLIP U STRUCTURAL t, 28011 G's is 3 Y2 LAG BOLTS 0 WOOD FRAMING LOCATIONS ATTACHMENT DETAIL SCALE: 1 Y2" = 1'-0" PROPOSED AWNING FOR7S�k The Dorchester Awning Company 140 PRESCOTT STREET,NORTH ANDOVER,MAP.O Oak StreetP.O.Box 385 Tel: 783-$26-9001embroke,MA 02359 Fax:781-826-1628 PRESCOTT HOUSE NURSING HOME � 4- 11I11r 14 �47 i � if; ' i i ih4h444hh�'4� d�1�UI�B�hU�!I�h1�1�1�1�1�1� -E� f�w_ � �� 11111 11 Isis , 111111 v ' 4p ., ��j�ig re's �� r: '�•: '' p'h'i S:.�.=. "':'4~;� 1>� _ 4 •�.3 : '"� t �Y. t_ IL 71 t f - 'ok 1 sl� sw la 1,4 ��t. 7 L i1� �� j J"['i 4't ,V .�:.� y !1/.t'•moi L __'.� ,�*'� �. •"`� �" , � r ,�;;',.atm ::�?�.�� ' a4,; Oak 71 W; I 1 07 P—; J,0 yAg.w. G —O, Cza"&L "k S.—C V,1••o _SEeTlou THau h. k C. r-W.J....S N k P N-4- JIZ 7 �fAw Kv ccP(I*qs-A OF W, Coo Poo,GED F _COWC O,E-,E N of _.6'4a -k 4,� X_ 1 .$EC.!ON' NDU COUCOIC TO q, SARKIN<.., IfflIdly t- ij ri STONE VELOWMI MIMI TC !o MI t . � I; Top .�jp' 4- RKI, iT 0 17-MiRiV R NI ............. RePeJ'.ce/p 14, I % FxVITN y P. 12 T. -.1 S OA r 44 LLL To H 1 r %i trom*mnt;�t-plant and specifill F. TROJ.No 02-543 iT — `made ontil a fi for ttuc!ion Chanas. gt ��L: .-c �i.2eiiii. tan be ITECT :'PVE- ERA Form 24 , \ JARCH h)=P_-_I ENONEERS V �;Iand approved. . tar 9' N T)TzGERAI�C J4 6 i V"Z. _j Jun 22 2012 8: 31RM Genesis Healthcare ESPM 1 -878-247-5235 P. 2 i The Dorchester Awning Company PROPOSAL' WO Oak Street,PO Hoar 381 P=Wvla h MA 02339 Cwt Proposal No. The TPhone;(781)826-9001 Fox:(781)62,6162,8 2113/2t}12 10205 56WOM af0l1 Email; in8,oem Cusborner Contact Ship7o WIVORidbeird Premgott House Nurelot Home 978-+4747300 140 Pmoon west Marc Richardard Marsala hCare Nm&Andover,MA 01845.1826 200 Brldutone Square men.dobWd0 .... Andover,MA 01810 pt Ssies Rep. TC Itsrn Deecrdptlon Total "Updated 2/13112 to reflect current proposal date"' 401 00 Manuhclure 5 Installation of'a Fused,A-Frame Style,Commercial Entrance Canopy for side 3,940.00'1' entrance dowwey. Canopy frame to measure I V-V W x 8'-0"N x I T-O"Projection,with an additional VWH fixed side valence, and be conetructed of wsMed 1"x1" Ims.geivenlxed steel tubing.All"d seams to be ground smooth end have a cold galvanize coWng applied to resist corroalon.Canopy post uprights to be fabricated of 2"x2°HD(3alventzed steel tubing and be set In concrete footings art edges of asphalt walkway, Fabric Pattern:TrYantage Patio 500 Vinyl or Starfin Acryilc,color to be determined 'Triventage Patio 500 Vinyl dr Starllre Acrylic both most the fire retardant requirements of the.7th E=dition of the Massachusetts State Building Code "80e1hMn of Sunbreila FlresistAcrylic Fabric is available for an additional$260, to cover extra cost of m*tbri*I' NOTES+ 1)Town Building Department will require an amendment to the Plat Pian for the property, stxWng location of proposed canopy,to ensure no"tbaoks are Infringed upon. Customer will need to coordinate with a Iloahsed CMI Engineer for Plot Pian modFfo+ation. 2)Sulding Department will also require engineer certified frame construction drmkirgs for permit approval.Pie refer to Permit Processing Fee lira item below for detail. 401.02 Permit Procassing t=oe to include creation of photo renderings and engineer cWM@d frame 775.00 constructioMnstallatlon drawings,along with submittal of Permit Applicatkm forms and worker's comp/trourance documentation. Fee Includes wVlneer review and certification charge, Does not it 4ludo any aotu*l Town psrmlt hes,which would be passed on at cost. i Subtotal $4715.00 Dord:e�rl�enlnq 8�neturs ---.-.- Sales Tax (6.23%) 5371:21 c�etanasr abir� t7�a• Tc"I x7,086.25 IF YOU WMH TO PR005M WITH THIS OR Mi REW OW THE O"APC nETIURN ITTO US NATti A t7 %OEPM AVD THE BALANCE I8 DUE AT MALLATIOFI. Aerfms a dr d1M user titans epeIffiWafle blhtrrlAp Oft Cast WO become en extra OMM ahs end More ere ana6rr.Thereto no wpe or looW a guaranba tlart In produ4b er hbor purohged WHl a W"ftMMd or W*1n redherproaf eY+ ,some,$oreen1,44 am b y shah none not W"ftWoo Apreemmb an a omw upon star,aooide*wsedwr aealar delbn beyondaur=ft.Oumero ere o tiny 4anado'�nd ethern.aeeeryIrreunuw�. AoapWw e1fie:Th• above prb m"edl4aaam and omdits ns aa0eactory end aaoaptad•end euft*dm t do ria w *le pro M, LWw autba'W h eddy,payment wti be made a wood abo�% PMThb proposal nag ba wNhdravn by w MnoE aoorpMd rdah 80�yR CA OWL am VPL'O-d x 3 OG'O N owe . MRS S -amw o offs W 0 no - w r 3 . G7 - N . N 2 N a r d 3 0 - - a ST98DL L L900S1 ZIU��J9W I�YI e'TilNVXL+lS-SMT ltvsomm=a JHlldldV I N iR�i J°ei�d �l�T�'Y �a +Si9� ]11tH �N�I jlPj 3 6DY 9Ziw9s-Zi cnrvlm K mqmH -1 I�OILgId0.7 +11I r 1 O 0 (D m S mto Vwadll aRv H 1 bS'EaD VW`MMNM ro Z J.a3 o.L,LoosmTd Otic a me XOa Od`. 33m Wo om .A - - Z 9®tIS�sB�lOS I 8t9i�9Z8'[8L=7LVd - ;� SSS�aQY QS d1ETS 51►BHiVS j B lOH IIOOSM NMAV COQ MU . of w w a a lnvaa-maP03 Vird s veto ► I jo I m2d it mu ON mwwal Tit=dKL upa RNM BmAvd,MWa NAVWa =Nmoftg ZIOTld7�90 i ��V ziwzm mail" 41810 VK'21LMXKV � OZtSBi uoqmW XVd oos nuns` lvnas& am=ou r 005L-6Lt"'�L4�Hd MkMO V3NV JSVMLWK The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street ` Boston,MA 02111 www.mass.gov/d.ia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lel?ibly Name (Business/Organization/Individual): V'4-A ftOi t,16- a. C_ r2.6. A. Mr- DDI?Ct1,C6TLYZ 'A-VQ/J W1 1(�r`(✓ . Address: 2 �5J O A V_ 9cC, l � 1�G (ho City/State/Zip: Pr_, (2�12CDt6.E, i KA OZ-Gel Phone# -72I - 87(�) I Are you an employer? Check the appropriate box: Type of project(required): 1. — I am an employer with 10 . 4. — I am a general contractor and I 6. — New Construction Employees(full and/or part-time)* have hired the sub-contractors 2. �- I am a sole proprietor or partner.. listed on the attached sheet. I Remodeling Ship and have.no employees These sub-contractors have 8• — Demolition Working for me in any capacity. workers' comp.insurance. 9. — Building Addition [No workers'comp, insurance 5. — We are a corporation and its 10. — Electrical repairs or additions required.] officers have exercised their 3. — I am a homeowner doing all work right of exemption per MG[, 1 is Plumbing repairs or additions myself. [No workers'comp. C. 152, ' 1(4),and we have no 12. — Roof repairs insurance required.]H employees. [No workers' 13. — Other comp. insurance.required.l •Any applicant that checks box Nl must also fill out the section below showing their workers'compensation policy information. H Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. I Contractors that check this box must attaeh an additional sheet showing the name of the sub-contractors and their workers' I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:__ ect/V qL&5-, Gj � Q Policy#or Self-ins.Lic. #: L.3 /..to"';�- Expiration Date: Job Site Address: _ City/State/Zip: _ Attach a copy of the workers'compensation policy declaration page(showing the policy number,and expiration date), Failure to secure coverage as required under Section 25A of MGL C. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do hereby c y and r the pa' s and penalties of perjury that the information provided above is true and correct. Signature: —7 Dam. Phone#: l I ZL,2 Official use only. Do not write in this area,to be completed by city of 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#• b 3 Client#:55302 MAHOLD ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 1 9/007/207/2011 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 pollcy(ies)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 CONT Rogers&Gray Ins. Plymouth NAMVCT PHONE LAIC,NoExt: No 508 747-4323 A/c 341 Court Street E MAIL P.O.Box 3700 ADDRESS: Plymouth,MA 02361-3700 INSURERS AFFORDING COVERAGE NAICIf INSURER A:Selective Insurance Co.of S.C. INSURED M&A Holding Co Inc.dba INSURER B:Technology Insurance Company The Dorchester Awning Company INSURER C:Safety Insurance Company P.O.Box 385 INSURER D: Pembroke,MA 02359 INSURER E: INSURER F: OVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 ADDLSUBR LTR TYPE OF INSURANCE IN WV POLICY NUMBER POLICY EFF MM/DDY EXP LIMITS A GENERAL LIABILITY 51850321 9/08/2011 09/08/2012 EDApCMHq�OEC7CURRRRENCE $1-000-000 X COMMERCIAL GENERAL LIABILITY PREMISES RENTEDoccurrnce $100 000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $10000 PERSONAL&ADV INJURY $1 00,000 GENERAL AGGREGATE s3,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3,000,000 POLICY X PRO X LOC $ C AUTOMOBILE LIABILITY COM0039567 9/08/2011 09/08/2012 CIND EeaccidentSINGLELIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED AUTOS X AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOSX AtOJTNOSPer accident NON-OWNED PROPERTY DAMAGE $ X rive Oth Car $ A X UMBRELLA LIAR X OCCUR S1850321 9/08/2011 09/08/201 EACH OCCURRENCE s5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE s5,000,000 DED X RETENTION$O � � $ B WORKERS COMPENSATION TWC3292239 9/07/2011 09/07/201 X WC STATU-IORY LIMITS OTH- AND EMPLOYERS'LIABILITY OFFICER/MEMBEREXCLUDED?ECUTIVEa N/A E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) If E.L.DISEASE-EA EMPE $1,000,000 yes,describe under LOYE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,0001000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If mora space is required) Certificate holder is additional insured and Waiver of Subrogation applies when required by written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - 1986-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S71054/M71052 SM 3 Massachusetts - Department of Public Safety Board of Building Regulations and Standards ( ow truction Super�i.or License: CS-095315 tit.t IS ��.. MARK C LAMP'90N 3 GREEN LEAF D�I��E''��`- DUXBURY Expiration Commissioner 03/27/2014 NORTH T.-Own of 2 t E . I, ndover No. i44-*- h ver, Mass, �u-Q. `2� COC.IICKl WICK A. S U BOARD OF HEALTH Food/Kitchen PERMIT Septic System 1_ THIS CERTIFIES THAT v ` N � �` ��r`cam f��,(/ f�+�/� - 111 BUILDING INSPECTOR ...........................................................!...... �K:..T�f:`G.L..... r........................... v i Foundation has permission to erect ....... buildings onI.. ...... . ... 3..................... Rough to be occupied as ........x....2:..... ...........!:.--.....4.... ..... ... 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 CONSTRUCTI TART Rough 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. SEE REVERSE SIDE PITCH BAR & RIDGE BEAM o FRAMING TO BE 1"x2" 16GA. I GALVANIZED STEEL TUBING. n I n PERIMETER SUPPORT — FRAMING TO BE 2"x2"x I T' — I 0 Y4" H.S.S. GALVANIZED STEEL TUBING. 12"H. PERIMETER TRUSS A - FRAMING AND ANGLED Ill / EXISTING IENTRANCE I I o BRACING TO BE 1"X1" 16GA. I I\ DOOR / I GALVANIZED STEEL TUBING. 4"x4"xY4" H.S.S. GALV. STEEL CANOPY STANCHIONS, TO BE SET IN CONCRETE FOOTINGS, (TYP. OF 4). L EXISTING CONCRETE SIDEWALK, TO REMAIN. 14"dia. x 4'-0" SONOTUBES (TYP.) 10'-8" ZN OF Mess oma' JOHN W_ 9C'yG CANOPY FRAMING DESIGNED TO COMPLY OUEEN N WITH MA. STATE BUILDING CODE, 8TH U STRUCTURAL 28017 EDITION, SECTION 780CMR PARAGRAPH � yFc,'sT ERS° Q 3105.0 AWNINGS & CANOPIES. FRONT ELEVATION 7-t3-lZ SCALE: 3js" = V-0" The Dorchester Awning Company PROPOSED AWNING FOR 7%231 2 230 Oak Street FPRESCOTT SCOTT STREET,NORTH ANDOVER,MA 01845 No�o P.O.Box 385 Tel. 781-826-9001 °""'0" ""I Pembroke,MA 02359 Fax;781-826-1628 HOUSE NURSING HOME S k—' I .iww t a 4 r 4 \ f ff 12 —0 I I I -1"x2" HEADER RAIL, ATTACHED TO o I BUILDING BRICK FACE WITH 3 Y2" 1 EXPANSION ANCHORS AND Z-CLIPS. O I �� III PERIMETER SUPPORT FRAMING TO o I II l BE 2"x2"xY4" H.S.S. GALVANIZED 1 I II I STEEL TUBING. II I II I WELD TOP & BOTTOM CHORDS I II I TO COLUMNS (TYP.) I II CANOPY STANCHIONS TO BE o I {I I rl II 4%4"A4" H.S.S. GALVANIZED I II i STEEL TUBING. II I II 14"x4"xY4" M.S.S. GALV. STEEL I I I I CANOPY STANCHIONS, TO BE SET IN f I I CONCRETE FOOTINGS, (TYP. OF 4). - - --I U I WELDED 6"x6"x3/8" o BASEPLATE (TYP.) TL-I 14 dla. x 4'-0" 6'-0'f 5°-10" SONOTUBES (TYP.) CANOPY FRAMING DESIGNED TO COMPLY `Ix OF Mgrs WITH MA. STATE BUILDING CODE, 8TH oma' JOHN W. 9�y EDITION, SECTION 780CMR PARAGRAPH o STRUCTURAL QUEEN Ln 3105.0 AWNINGS & CANOPIES. 28011 ELEVATION 9 S/��sTER�G�� SCALE: 3/8" = 1'-0" 7-i3-[x The Qorchest®r Awning Company PROPOSED AWNING FOR 7/23/12 PRESCOTT STREET,NORTH ANDOVER,MA 01845 normo 230 Oak Street r�np P.O.Box 385 lel: 781-826-9001 AvHume.. Pembroke,MA 02359 Fax:781-826-1628 PRESCOTT HOUSE NURSING HOME S k—2 ~2 as PITCH BAR & RIDGE BEAM FRAMING TO BE 1"x2" 16GA. O GALVANIZED STEEL TUBING. I f PERIMETER SUPPORT 1"X1" 16GA. GALVANIZED STEEL TUBING FRAMING TO BE 2"x2"xY4" AT ANGLED AND VERTICAL SUPPORT O H.S.S. GALVANIZED BRACING AND PERIMETER TRUSS. - STEEL TUBING. r TYPICAL CENTER TRUSS SECTION SCALE: %" = 1'-0" CANOPY FRAMING DESIGNED TO COMPLY WITH MA, STATE BUILDING CODE, 8TH EDITION, SECTION 780CMR PARAGRAPH 3105.0 AWNINGS & CANOPIES. PITCH BAR & RIDGE BEAM FRAMING TO BE 1"x2" 16GA. o GALVANIZED STEEL TUBING. 1 i� �N OF Mks s oma' JOHN W. 9�'y QUEENm Nv 1"X1" 16GA. GALVANIZED STEEL TUBING a STRUCTURAL AT ANGLED AND VERTICAL SUPPORT -,s 2$��t e BRACING AND PERIMETER TRUSS. �S$�0 AL E� 7_ END TRUSS SECTION SCALE: %" = 1'-0" &T� PROPOSED AWNING FOR 7/23/1 2 The Dorchester Awning Company 140 PRESCOTT STREET,NORTH ANDOVER,MA 01845 230 Oak Street NOTED aa.m4 Kumar P.O.Box 385 Tei: 781-826-9001 Pembroke,MA 02359 Fax:781-826-1628 PRESCOTT HOUSE NURSING HOME S k-3 ~3 M 4 i AWNING NOTES : 1. TYPICAL CANOPY STRUCTURE FRAMING TO BE HEAVY DUTY GALVANIZED STEEL TUBING, FY=50,000 PSI: RAIL SIZES: 2"x2"A" H.S.S. FOR SUPPORT TRUSS 1"x2" 16GA. FOR HEADER RAIL AND PITCH BARS 1"x1" 16GA. FOR PERIMETER TRUSS AND PITCH SUPPORT BARS 4"x4"A4" H.S.S. GALV. TUBING FOR CANOPY STANCHIONS. 2. AWNING FASTENERS TO BE STAINLESS STEEL. 3. AWNING FRAME TO BE WELDED AT CONTACT SURFACES OR CONNECTIONS WITH A Y8" CONTINUOUS FILLET WELD. ALL WELD SEAMS TO BE GROUND SMOOTH PRIOR TO FABRIC ATTACHMENT. CONNECTIONS TO CANOPY STANCHIONS TO BE WITH WELDED BASEPLATES. 4. ALL FABRIC DESIGN, CAPACITY AND CONNECTIONS ARE BY DORCHESTER AWNING COMPANY. 5. FABRIC COVERING TO BE FIRE RETARDANT ACRYLIC AWNING MATERIAL, SUNBRELLA FIRESIST, FOREST GREEN #82003. 6. IT IS RECOMMENDED THAT THE FABRIC BE REMOVED FOR ALL WIND SPEEDS ANTICIPATED OVER 60MPH AND FOR ANY HEAVY OR EXCESSIVE BUILD-UP OF ICE OR SNOW. 7. CAPACITY OF THE EXISTING STRUCTURE TO SUPPORT THE CANOPY LOADS AND CAPACITY OF THE SOIL TO SUPPORT THE APPLIED LOADINGS IS NOT THE RESPONSIBILITY OF THE CERTIFYING ENGINEER. 1"x2" 11 GALV. STEEL FRAME TEK SCREW ATTACHMENT TO ZH OF AWNING FRAME, SIDES AND � BOTTOM �o� JOHN QUE=EN m 00 J_"Z" CLIP STRUCTURAL { 28011 3 Y2" LAG BOLTS CSD WOOD s��NAI�� FRAMING LOCATIONS ATTACHMENT DETAIL SCALE: 1 Y2" = 1'-0" .�,. PROPOSED AWNING FOR 7/23/1 2 The Dorchester Awning Company 140 PRESCOTT STREET,NORTH ANDOVER,MA 01845 t4Waa 230 Oak Street P.O.Box 385 Tel: 781-826-9001 Pembroke,MA 02359 Fax:781-826-1628 PRESCOTT HOUSE NURSING HOME S k-4 Aut 4 a 4 ,.,�, �','i .�.Edi:•'r`A'Urn .�'�/� 4 .n ]p� m ,�y�y, f �� t.Tom'. ♦ �'S N � �1• '�:. ,'}�l��r�t ,/ V�.• r �" � ^,�..�;'^ rte,. q4�T�t � F�;w.'+�r'�n��i..:•l. � �_b sr ^ ; r I +iXj ,.cab'•,«'�f '�-'� .��,:r �1 'G �,• •� ��Y/�1 �f •' �r-"'i �. ��:.Ao. fieri,Sig.+ �7. 7 '"' � +Q'A�• '"��; a t.. � • i'• 1 `• .�' Q fir '•►.:� ,, r ? L E 41. Ilk Ot At i