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HomeMy WebLinkAboutBuilding Permit #Exception - 36 WEYLAND CIRCLE 5/1/2018 O� 00 DT 6'gti BUILDING PERMIT a TOWN OF NORTH ANDOVER I o APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received �9q Date Issued: 9SSACHu IMPORTANT: Applicant must complete all items on this page a LOCATION n dndou-P� 4 Print = 4 PROPERTY OWNERQ Print MAPINO PARCEL: ZONING DISTRICT: Hist6`ricUstrict eyes no _ 3 ,o T- 5 Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building '$.One family ❑Addition ❑ Two or more family ❑ Industrial )LAIteration-b4Se-fX&Lf No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other El ❑We �tlands ❑„Watershed`Distdct ❑ Septic ❑Well _'STI ❑Water/Sewer ` IfISfO-110-fi60 OP A7 Identification Please Type or Print Clearly) OWNER: Name: Tas on ArPhone: Address: 3b 60C /0/)U C2 irc& /7 -a-1-00V el—1 /`Ilq- 04?Ys— CO Name:0!har�� . 0 9 Phone:lF Io SS r� +�t- Line- f=►rr- roeEh6LdLQ- Address. , Iffao T' �3 o� S' ��r aog n Rt�dyv�; rr� o 9qS"* Supervisor's Construction License s. Exp 'Date: 3 c2J 00 f3 Horne",Improvement License: m Ex 5Date: r ARCHITECT/ENGINEER /) /01 Phone: Address: IReg. 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: $ 31706)0 • o FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ignature of Agent/Owner w Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools 11 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 ❑ ❑ COMENTS CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street FIRE DEPARTMENT - TempBumpster1 on site yes rxno - - Located at 124 Main Street Fire Department signature/date t " 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 - Date i Doc.Building Permit Revised 2012 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 o Building Permit Application o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work L3 Engineering Affidavits for Engineered products II! NOTE: All dumpster permits require sign off from Fire Department prior t issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application Li 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) Li 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 Li 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 o 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 2.2007 5C �coo�8 commonwealth o;Massachusetts Department of Public Safety License:SC-210048 sofinkler cortra><or cliARLIE ROBGERS 4 ALDERSGA�G MA 119864 i4oRTH READ CA, Expiration: c1-�^� Dili5120'iS rnt sioner j an Ll ACOIR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYY`) 02/10/2017 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(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 CT NAME Chris Gregory Gregory Insurance Agency,Ltd PHONE E ; (978)356-0491 FAX(AICNo): (978)356-5227 Po Box 625 E-MAIL ADDRESS: Chris@gregoryinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Ipswich MA 01938 INSURERA: CITATION INSURANCE COMPANY 40274 INSURED INSURER B: Admiral FRONTLINE FIRE PROTECTION INSURER C: Liberty Mutual 1820 Turnpike Street#209 INSURER D: INSURER E, North Andover MA 01845-6483 INSURER F: COVERAGES 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 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. LTR TN SR !UD—DL SUER PMM/IDDY/YEFF YYY MMID EXP LIMITS TYPE OF INSURANCE INS POLICY NUMBER X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1000000 CLAIMS MADE OCCUR PREMISES Ea occurrenceS 50000 MED EXP(Any one person) $ 5000 B CA000026269-01 01/26/2017 01/26/2018 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2000000 RPOLICY�X JECT --LOC PRODUCTS-COMPIOPAGG S 2000000 XXOTHER: S AUTOMOBILE LIABILITY CO BINED ANGLE LIMIT Ea acadent S 1000000 X ANY AUTO BODILY INJURY(Perperson) S A ALL OWNED �/ SCHEDULED AUTOS X AUTOS BBQC41 09/25/2016 09/25/2017 BODILY INJURY(Per accident) S X HIRED AUTOS X q�NOSwNED PROPERTY DAMAGE $ (Par. er accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE S 4,000,000 B X EXCESS UAB CLAIMS-MADE GX000000302-01 01/26/2017 01/26/2018 AGGREGATE $ 4,000,000 DED RETENTIONS IS WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STATUTE ERH ANY C OFFICER/MEMBER EXCLUDED?UDEED ECUTIVE NIA E.L.EACH ACCIDENT $ 1000000 (Mantlatory in NH) 804579 01 02/15/2017 02/15/2018 If yes,describe under E.L.DISEASE-EA EMPLOYE $ 1000000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more space Is required) Sprinkler System Installation:Service,Repair&Inspection 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 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD FRONT- LINE FIRE PROTECTION, LLC Proposal To: Keith Hery Hhh Pro Services 731 Winter Street North Andover, Ma P:978 968 9889 Hhhproservices@gmail.com FROM:Charlie Rodgers Front-Line Fire Protection, LLC 1820 Turnpike Street,Suite 209 North Andover, MA 01845 P:978 655 7002 F: 978 824 2557 C: 978 844 9026 Charlie@Frontlinefp.com March 2 2017 RE: Fire sprinkler system modifications Scope: To add the proper fire sprinkler protection in the newly renovated basement area. This is a proposal to provide automatic fire sprinkler protection at the property known as 36 Weyland Circle,North Andover,MA. Front-Line Fire Protection, LLC will provide material, labor,taxes,and permits necessary to complete the work in a professional workmanlike manner according to the National Fire Protection Association NFPA,State and Local Codes. Included in Proposal • Permit • Design • White Semi-Recessed and Concealed sprinklers where needed • CPVC pipe and fittings • Final testing with fire department Exclusions and clarifications • Work starts at existing system • All areas to be properly heated and insulated Front-Line Fire Protection,LLC 1820 Turnpike Street,Suite 209 North Andover,Ma 01845 Phone:(978)655-7002 Fax.(978)824-2557 FRONT-LINE FIRE PROTECTION , LLC The total consideration to be paid to Front-Line Fire Protection, LLC is Three Thousand Nine Hundred Dollars{$3,900.00} Payment Terms are as follow: {$1,950.00}50%upon signed proposal {$1,950.00}50%upon completion This proposal is valid{30}Days from the date of the proposal Thank you for considering us for your fire sprinkler work, please do not hesitate to contact our office with any questions X X Authorized By Date Front-Line Fire Protection,LLC X X Print Name Print Name Front-Line Fire Protection,LLC 1820 Turnpike Street,Suite 209 North Andover,Ma 01845 Phone:(978)655-7002 Fax.(978)824-2557 FRONT-UNEF� FIR PROTECTION, LLC Fire Sprinkler System Sales,Service,Inspections&Installation Charlie Rodgers General Manager p:978.655.7002 c:978.844.9026 1820 Turnpike Street Suite 209 f:978.824.2557 North Andover,MA.01845 www.frontlinefp.com SC-210048 charlie@frontlinefp.com