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HomeMy WebLinkAboutBuilding Permit #376 - 351 HOLT ROAD 11/13/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: r Date Received Date Issued: // /3 D IMPORTANT: Applicant must complete all items on this page LOCATION :35 t t � " '�J Print PROPERTY OWNER _ � �A i l e f( �'�!'n --t460* "1d0 Print MAP NO: -0 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 Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: �d v Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: Qlt c c�- b'E r\1 xo CONTRACTOR Name: Phone:(Cry)4 -55�0 Address: Supervisor's Construction License: " O Exp. Date: q 0110 Home Improvement License: N t A- Exp. Date: ARCHITECT/ENGINEER 1 Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. i Total Project Cost: $ 3 �J i cS FEE: $ f ` Check No.: t o $ a` Receipt No.: ',e2 29 a/ NOTE: Persons contracting with unregistered contractors do not have access to t e guaranty fund � nature of A ent/Owner - -- �, - -a "y - g g Signature_of contractor., _— -- -- r Building Department e filled out for the appropriate The following is a list of the required forms to b ppriate permit to be obtained.p 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: Doc.Building Permit Revised 2008 L 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 - Date ........._..................................................._.—.._.._......................................... Doc:.Building Permit Revised 2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPO7Tanning/Massage/Body Public Sewer ArtSwimming PoolsWell acco 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 924 Main Street Fire Department signature/date COMMENTS Location=/ HO /f No. Date 11 !-r , NORTH TOWN OF NORTH ANDOVER i Certificate of Occupancy $ s„CHUs<� Building/Frame Permit Fee $ 7 ! /'/96 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # / 2G6L � Building Inspector tAORTH To of Andover . 0 __ No. 0 over, Mass. COCHICHEWICK of?ATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System //4/ BUILDING INSPECTOR /V 67��2 e-7 THIS CERTIFIES THAT......................... ........ ;2 0 0(/ ........................................................... .......................... ........ Foundation has permission to erect........................................ .buildings on .....3 ......... .................................... Rough 'aAf Chimney to be occupied as............ ...... ... ......... provided that the person accepting this permit shall in every respect conform*r*m to the terms of the" n 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 UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR 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. ACORQ. CERTIFICATE OF LIABILITY INSURANCEDA 2/zg/2(110 E(MWDp2!28/20 $YYY ) PRODUCER LOCKTON COMPANIES,LLC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 5847 SAN FELIPE,SUITE 320 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOUSTON TX 77057 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 866-260-3538 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFOB jgMMUE NAIC tF INSURED DELTA ROOFING HOLDINGS.A TECTA AMERICA COMPANY,LL INSURERA: Arch ln&Mgcc Companv7��� 11150 1307658 DELTA HOLDINGS,A TECTA AMERICA COMPANY,LLC INSURER B: Illinois National Insurance Company 23817 DELTA ROOFING,A TECTA AMERICA COMPANY,LLC INSURER C: 2 STERLING ROAD,UNIT#1 NORTH BILLERICA MA 01862 INSURER D: INSURER E: COVERAGES DELRO01 AR THISCERTIFICATE OE WSUtt1WGEDOES-T.- OT CONSTITUTE A CONTRACT a ETWEEN THE ISSUING INSURER AUTNORIRED REPRESENTATIVE OR PRODUCER ANO THE CERTIFICATE HOLDER. 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 MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS EOF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. (NSRDO POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIQO/YY DATE MMlODJYY LIMITS GENERAL LIABILITY EACHOCCURRENCE 2,00000 A X COMMERCIAL GENERAL LIABILITY 41PKG2244100 2/28/2009 2/28/2010 PMGETOER N owuIenca S 1,000,000 CLAIMS MADE �OCCUR MED EXP(Arty one person) S 10,000 X XCU INCL/BRD FM PROP PERSONAL d AOV INJURY S 1,000,000 X POL.AGG.520,000,000 GENERAL AGGREGATE $ 4.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 4,000.OU0 POLICY X pECT X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO 41PKG2244100(AOS) 2/28/2009 2/28/2010 (Ea accident) S 2,000,000 A X ALLOWNEDAUTOS 41CAB2244200(MA) 2/28/2009 2/28/2010 SCHEDULED AUTOS (Perpp IanS XXXXXXX ( ensan) X HIREDAUTOS X NON-OWNEDAUTOS BeracciODILY accident) $ XXXXXXX (Per aolsdent) X AUTO PHYSICAL DAMAG X DED/COLL$100,000 PROPERTY DAMAGE N $(Per accident) XXXXXXX GARAGE LIABILITY AUTO ONLY-EAACCIQENT $ XXXXXXX ANY AUTO NOT APPLICABLE EA ACC $OTHER THAN XXXXXXX AUTO ONLY: AGG S XXXXXXX EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S 5,000,00o.. B X OCCUR CLAIMS MADE BE 489 1107 2/28/2009 2/28/2010 AGGREGATE s 5,000,000 OEQUCTIBLE UMBRELLA $ XXXXXXX FORM HX RETENTION $10,000 $ XXXXXXX S XXXXXXX A WORKERS COMPENSATION AND 41 WC12244000 /28/2010X WC STATU- OTH- EMPLOYERS'LIABILITY 2/28/2009 2TO Y L MIT. ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEREXCLUDED? C- II yyes,describe under NO E.L.DISEASE-EA EMPLOYEE $ 1,000,000 SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $ 11000,000 DESCRIPTION Of OPERATIONS 1 LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS CANCELLATION; 30 DAYS AS NOTED BELOW EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT, CERTIFICATE HOLDER CANCELLATION 10494266 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DELTA ROOFING,LLC DATE THEREOF.THE 48SUINO INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 2 STERLING ROAD,UNIT 91 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL NORTH BILLERICA MAO 1862 IMPOSE NO OBLIGATION OR LUIBILrry OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES AUTHORIZED REP ENTATIVE ACORD 25/2001106 F 1 or 9ueatlonan 0ardin fl this ceAiticate,eontan Iha number UstaO In ths'PmduCar saedgn show and opmay the client coda VELRopt•, Q ACO CORPORATION 1988 Purchase Order THIS Solo Cu Operating Corporation O ALLSHIPPING AND BILL 508#MUST APPEAR bate Rev Page Cup p g p 5085187 11-NOV-09 0 1 1700 Old Deerfield Road Payment Terms Freight Terms Ship Via Highland Park,IL 60035 Immediate United States Buyer: Rev Buyer: Buyer Phone: Fax: SHIP TO: ------> 351 Holt Road Vendor: 116485 North Andover,MA 01845 TECTA AMERICA CORP United States 5215 OLD ORCHARD RD STE 880 SKOKIE,IL 60077 United States Contact: VINCE VITEK Bili To: Box 3001 Accounts Payable 1700 Old Deerfield Rd Highland Park,IL 60035 United States Line Item/Descrlption Due Date Quantity UOM Unit Price Ext. Price Tax 1 Quote November 10,2009; Roof Work 23-DEC-09 1.00 Lot 310925. 310,925.00 N on Old and New Warehouse Sections at Nortn Andover Facility.Firestone TPO Roof System..60 membrane,20 year warranty. Payment Terms 30%down,progress payments based upon project completion. o SHIP TO: Address at top of page Line Item/Description Due Date Quantity UOM Unit Price Ext. Price Tax 2. Deck and Insulation Replacement 23-DEC-09 1.00 Lot 14075 14,075.00 N Allowance Payment Terms 30%down,progress payments based upon project completion. o SHIP TO: Address at top of page Total 325,000.00 USD This order is subject to the attached terms and conditions of purchase. Acceptance of this order constitutes acceptance of such standard terms and conditions. Purchase Order THIS PO#f MUST APPEAR PO# Date Rev Page Solo Cup Operating Corporation ON ALL SHIPPING AND BILL 5085187 11-NOV-09 0 2 1700 Old Deerfield Road Payment Terms Freight Terms Ship Via Highland Park,IL 60035 Immediate United States Buyer: Rev Buyer: Buyer Phone: Fax: SHIP TO: ------> 351 Holt Road Vendor: 116485 North Andover,MA 01845 TECTA AMERICA CORP 5215 OLD ORCHARD RD STE 880 United States SKOKIE,IL 60077 United States Contact: VINCE V1TEK Bill To: Box 3001 Accounts Payable 1700 Old Deerfield Rd Highland Park,IL 60035 United States TERMS AND CONDITIONS 1.This Purchase Order shall be governed by the Uniform Commercial Code and other applicable laws of the state where Purchaser's facility ordering the goods or services is located which are effective and in force on the date hereof and without regard to the conflict of laws and/or provisions thereof. Whenever a term is defined by the Universal Commercial Code(UCC)and is used on this Purchase Order,the definition contained in the UCC of such state is to control. 2.No obligation arising under this Purchase Order shall be assigned,in whole or in part,without the written consent of a duly authorized representative of the non-assigning party. 3.All warranties contained in the UCC,including without limitation,the warranties of merchantability and fitness for a particular purpose,shall be applicable to the goods supplied hereunder,and said goods will conform to any specifications,drawings,samples or other descriptions furnished to the Purchaser by the Seller or specified by the Purchaser. Seller warrants that all services contracted to be rendered hereunder will be rendered In workmanlike manner and will be of a quality and standard acceptable in the trade. All warranties shall survive delivery and shall not be deemed waived either by reason of purchaser's acceptance of said goods or services,or by payment for them,and Seller shall indemnify and hold harmless Purchaser from any loss,damage or expense that Purchaser may suffer from breach of this warranty. 4.No terms or conditions in addition to or different from those contained in this Purchase Order shall be binding upon Purchaser. Any such terms or conditions are to be construed only as proposals for additions to this Purchase Order and will not become part of this Purchase Order unless expressly agreed to by Purchaser in writing. Acceptance of this Purchase Order must be limited to the terms and conditions contained herein. Delivery to Purchaser of the merchandise orders,without Purchaser having cancelled this Purchase Order or Seller having given Purchaser written notice of Seller's acceptance hereof, shall constitute full acceptance by the Seller of this Purchase Order and of the terms and conditions contained herein,in no event shall the Purchaser's acceptance and/or use of goods or services delivered hereunder constitute acceptance by the Purchaser of any terms or conditions in addition to or different from those provided herein. 5.No waiver,alteration or modification of any of the provisions hereof shall be binding unless in writing and signed by a duly authorized representative of the Purchaser. 6.Seller agrees to fully Indemnify and hold harmless the purchaser,its agents and employees,from any and all liability,claims,demands,costs and expenses, Including attorney's fees,from claims of infringement by the goods of any patent,trademark or copyrights,or because of any claim of adulteration or other defective condition in any manner involving the goods,or because of any act or failure to act by Seller arising out of the services performed or to be performed by Seller,or any claim thereof,provided prompt written notice be given to the Seller of the bringing of any claim,lawsuit or action. 7'In the event Seller is likely to be delayed because of any failure to obtain information and/or approvals from Purchaser,Seller shall so advise Purchaser promptly in writing. 8.All material and workmanship shall be subject to inspection by Purchaser,before and after delivery. The Purchaser may require Seller to replace rejected material,or Purchaser may accept any materials that conform to Seller's.warranties and upon discovery of materials not conforming may reject or keep and rework any such matedais. 9.The invalidity in whole or in part of any condition of this Purchase Order shall not effect the validity of the other conditions. 10.Seller shall not use Buyer's name or the placement of this Purchase Order for sales or publicity purposes and agrees to treat all data regarding this Purchase Order and its contents in confidence. 11.In the event of any conflict between terms typewritten on the face of this Purchase Order and those printed on the reverse side,the typewritten terms on the face shall control. 12.Seller warrants that the material supplied herein to Buyer,Is not presently classified as hazardous waste under applicable federal,state and local law. Seller agrees to provide a complete Material Safety Data Sheet(MSDS)in compliance with 29 CFR 1910.1200(g)listing all the chemical substances contained in the material if an acceptable MSDS has not already been provided to Buyer,Seller further agrees to provide appropriate labeling on the material supplied in conformance with 29 CFR 1910.1200(f). Seller agrees to indemnify and hold harmless Buyer from any and all liability,claims,demands,costs,fines,penalties and expenses including attorneys fees if the material supplied herein is later classified as hazardous waste and Seller does not then promptly notify Buyer of such fact. Seller shall not be responsible to Buyer if Seller's material is mixed with any other material. This order is subject to the attached terms and conditions of purchase. Acceptance of this order constitutes acceptance of such standard terms and conditions.