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HomeMy WebLinkAboutBuilding Permit #453-2017 - 366 CANDLESTICK ROAD 10/28/2016 v �6�IV ��� BUILDING PERMIT p10RTy o�tT,eo ,6 gtio TOWN OF NORTH ANDOVER �� APPLICATION FOR PLAN EXAMINATION Permit No#: YS3' 90/7 Date Received /0- -tea/ f'o0p ","y 4� 1TED �SSAGHUS�� Date Issued: rO go/ Id IMPORTANT:Applicant must complete all items on this page 'LOCATION S(4 Cana l,¢..4�{Load Print' F ,,PROPERTY OWNER` =�onqashrtL Tern n f. n y -Print 100 Year Structure yeT' n MAP :�(� �p _PARCEL X01 -ZONING DISTRICT' " Historic Disfnct yMachine Shop.Village y TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial A Repair, replacement:.- ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑, ,fig y'\& z ❑;Floodplain t 4Wet T s-` ➢ Watershed rDlsrct �- DESCRIPTION OF WORK TO BE PERFORMED: OUr S a.Gna ; d- Seating darn a• #Ak insu.lccf._ afMi "L 4C4CA5j install insulah-d "hausk host h tx sha4 bwdi Ln; h2611 yz4, /&&Vi dl"J,a ice. t'e,�e t bows Identification- Please Type or Print Clearly OWNER: Name: _Somashrire. 'f.P.,rnnlcr+Dn Phone: 0-1y)zss—230 : Address: 861y Land J K kJ, 1004yOtte-IS : J Contractor Name: :_- Phone. Sb 39,z— Zog"1 E- A - Address: O 8o - _p "I ib041 :.Exp:.i Date: , .$17 /2019' Su` erVisor's ConstructioneLicerise Home Improvement License 182�q tot 7 ' ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1415(e'-/ . IF FEE: $ �5�-- Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the u r ty fund _. _ _ SA x �; ,i F . k �m r - ..- . � - . -1, -. --, ", , � -, "-' , , - - -- - - . -, -, . ,.-��-��.. ....,-.. - - , . - - , ,-.- - 1,, , ,-�--7�,�'-?-.";,-�;,." . .��r, ���--,-,,,-�,�---�:----�-�---�--�--� -N-11, , - -- . 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I ,.-,,- . , � I . - Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ! ❑`' Tanning/MassageBody Art ❑ Swimming Pools ❑� Well ❑ Tobacco Sales ❑ Food Packaging/Sales ` ❑._ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR-OFFICE,USE ONLY INTERDEPARTMENTAIL SIGOOP - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS - �• {- _. .. HEALTH Reviewed on Signature COMMENTS I _ 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 DEPA T NT Ternp Durnpst re o n siteyes `' '� "" no { �t Located at 1424 Main Street ' " � -F7 1 r Fire Departm.e`nt�ignature�""%da _ 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 Nio 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 Call Email Date Time Contact Name 3 Doc.Building Pennit Revised 2014 i 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 Permit Application :6 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4 Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract :r< Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) ;rr Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 6 Building Permit Application 4. 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 _ 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 NORTH own o .F.NO G No. - h ver, Mass l O • e'� 0/ COCHICHEwrcw A. ��AOR�TEO I'Pp��S S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .......... avl.............................................. BUILDING INSPECTOR lFoundation has permission to erect .......................... buildings on ..3.(*..(*....CONdle...1 1 C. IC 16' Ill; Rough to be occupied as .......14..l.4........M5 i4 C. ..p j....T........co.S.(Ole�/. K 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 CONSTRUCT N STAR Rough Service .... .. ...I . .. ............................!In.............. 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. IE 60 Shownmut Road,Unit 2 1 Canton,MA 020211339-602.6335 ENGINEERING www.RISEenginaMag.com OWNER AUTHORIZATION FORM 5DX-A56' -e 6, (Owner's Name owner of the property located at: -146 (Afjk4Ijb " (Pro rt Addre"'71 / A q a� a�' (Property Address) hereby authorize , (Subcontractor an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property.This form is only valid with a signed contract. Ther Permit will be secured by the insulation contractor,at no additional cost. It is the homeowner's responsibility to dose out this permit by contacting their municipality at the completion of this work. �C Owner's Signature ( ( f0hilaolb Date &Me i AL Federal In#0644O362S RBE Engineering Ri contractor Reglstretlon No 8186 MA.Contractor RegW atlon No 120979 DMISE CT Contractor Roghetrafian No 44 56awmut Road,t':antun,h3A ENGINEERING' CONTRACT (481)78&3700 FAX(401)784-3710 Rage 1 PROGRAM W. C0iRhACT0 ErMREO afro RETWMEN RISE CMA-HES 87ba7MUNG AFM TNG CUSTOMER fOR WORK AS nESCar2Et311AW cU$TOMER DATA ctlWf WOPK ORDER rw') Somashree Templeton , (978)258-2307 10/0112016 439530 35002 c,s atseveCe aTnLCT3"' 'I + SILUNG MMT _ 366 Candlestick Road k 366 Candlestick Road Sr9N3CE CITY SPATE.ZtP f Ct - OLLtN8 CM,$TATS.zF � -_�• North Andover,MA 0184 North Andover,MA 01845 t JOB DES CR1MON HEALTH&SAI ETY:Wcatherizauon work cannot proceed until mechanicul ventilation that will provide(1)cfm(cubic feet per minuta)of continuous air flow has been installed in you home. 50.00 AIR SEAL NG:Provide labor and materials to seal areas of your home againstwastefisl,err s air leap e. 'Phis ward:will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be loft with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home wdn include caulks,foams and other products. Primwy areas for scaling include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) This will require(12)working hours.A reduction in cubic feet per minute(cfm)of air infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door anWor combustion safety annlysis will be conducted by dw sub-contractor to ensure the safety of the indoor air quality. $1,020.00 ATR SEAUNG ADDER: (2)woo king hours. 5170.00 DUCT SEALING Provide labor and materials to seal beating and/or cooling ducts within designated unheated areas. This work will be paformed at the rate of 575 per man per hour,which includes materials. (4)working hours. $300.00 DAkff-JWG:Provide labor and materials to install a 12"layer ofR-38 unfaced fiberglass bates to(50)square feet for damming Purposes. $102.50 ATTIC FLAT:Provide labor and materials to install a 5"layer ofR-I S Class i Cellulose added to(1532)square feet of open attic space. $2,216.72 ATTIC ACCESS:Provide labor and materials to insulate the back of(l)attic hatch with 2"rigid The ruuc board.Weatherstrip the perimeter. $60.00 ATTIC ACCP.SS:Provide labor and materials to make(I) access opening from cmc attic area to another by cutting a passage through sheathing. This access will be I:ft open as it is between two common unheated non frrewallel attic areas. $31.31 ATTIC ACCESS:Provide labor and materials to install(1) easily moved,insulating cover for the attic access folding stair. A small flat surface of plywood will be created around the opening within the attic. This will allow the coven's integral weather- stripping to restrict air leakage. $237.65 Federal ID 905440M RISE Engineering Rl contractor Regletrattoo No 8186 MA Cordradw Regletraaon No 12x676 RISECT Contractor Registration No ENGINEERING (01) Shawmat Rand,Canton,MA CONTRACT CONT®�P (101)7844= FAX(491)784.3718 B® Page 2 PROGRAM nwCUUMermerrarra9 awe CMA AES emonamwoANDUM CaIpT MFOR VWM AS BEUXV oueroeerR Now DATA — — etasrrs vim OWN Sotnaslu+ee Temper (978)258-2307 10/01/2016 439530 35002 $Etta 91FMW MM MWEV 366 Candlestick Road 366 Candlestick Road North Andover,MA 01845 North Andcrvw,MA 01845 JOB DESCREMON VENTU AITON.Provido labor and materials to install(2)iuSWMd exhaust hose to costing bathroom fan(s). $lao.00 V$NT7 7 0N:Provide labor and mst fbh to iaatall ventilation chutes in(118)rafter bays to maintain air flow $236.00 RISE Eafnecring W'H apply all appiic Wr,eligible 1110e1ritives to this oxnttaOL You will omit'be billed the Net amount for eligible m easanas,Columbia Ors offers 75%incentive,not to exceed 52,000 per cateader year,and an bwand a of 100%for the Air Sealing measures up to the first$680 and an additional$340 ifswings ate justified by the auditor. For the safer and health ofyour homda indoor air quality,wa wM be conducting a blow door dioros0c offt available air Dow In your home both bd=Bae work is beim.and aft die wedbedwUm work is comhft we wail aim conduct a fA assessment eftha combustion aft ofyow beaftsystem and water hem Tads hes avahea 0fS90 sad is at no ootst m yon. Total BROVable mon inoeadve is$3,11& NO-00 Total: $4,884,18 Program Incentive: $3,110.00 Customer Total: $1,454.18 wEA=IM rMMWTOFUM MBERVEW-COMPLEMWACCOFAUMVAMABOVESPBMRONTWNS,FORTHEStateOF *"One Thousand Four Hundred Fifty-Four i 181100 Dollars 51,464.18 UM FEft GUIPBUM ANDAPPROVALUT ME bra.CtWOW MMS TD iteWr"O Wan ait•ULL.al.w=j OF Is ML as CICROW MMOLYWMNY VWAMOALM=A"MSOCAV&SMMVMeMROIPMWr*WCW R=om GUAPJWS" 9 M M (WfMCM 900MUL Mi.AWCOWntA=MROMiR TM D0 NOT SIGN THIS CONTRACT W THERE/ARE ANY BLANx spACEs —— ••.- AarrNCRQl�p ptpNAT{NiE•RMB Olm'r6t0:aAOCflPMNCB_ _ _ _ t�J (� /�� 91WM THm COUTPACrMAY a6VOMPAM BY Us IF nor CIaCUM YA7r@r DATROFACOWrAM 3 /j ACCOTANCHOPCONM=-"MAOMPRXAU48PMgCAylaMA DCCNWIgMAFM DAY& BATmFACTORY TO Ue AND ARB HEREBY ACCaPVM YOUARS AU"10RIUDTO DO IMVMIX An RPlM87aO,PAYMENTU"BS m"AB ounRWAaWa MILLCITY-1 AGOULD ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE F 7//19/219/2016 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 terns 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 License#AGR8150 NOME CT Clark Insurance PHONE FAX One Sundial Ave Suite 302N A/c No Ext):(603)622-2855 pIC No):(603)622-2854 Manchester,NH 03102 ADDRESS;agould@clarkinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Arbella Mutual Insurance Co 17000 INSURED INSURER a:AMGuard Ins Co 43290 Mill City Energy INSURER C: 106 Joseph St INSURERD: PO Box 6411 Manchester,NH 03102 INSURER E: 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. iLTR TYPE OF INSURANCE IND WVD POLICY NUMBER ADDLSUBR MMIDDY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR8500065735 04/29/2016 04/2912017 p ERER MISES Ea occurrence $ 300,000 GE TO RENTEU MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 ❑PRO POLICY JECT F-1LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea aBBIINdE�D SINGLE LIMIT $ 1,000,000 A X ANY AUTO 1020050919 04/29/2016 04/29/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED P BODILY INJURY(Per accident) $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per acddent $ X UMBRELLA LIAB X IOCCUR EACH OCCURRENCE $ 1,000,00 A EXCESS LIAB CLAIMS-MADE 4600065736 04/29/2016 04/29/2017 AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y f N X MIWC791896 04/29/2016 04/29/2017 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? N❑ N/A _ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached N more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover MA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St. ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE l ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD The Commonwealth ofMassachusetts Department of Industrial Accidents ~, 1 Congress Street,Suite 100 Boston,DIA 02114-2417 www.massgov/dia Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lmibly Business/Organization Name:MITI City Energy Address:PO Box 6411 City/State/Zip:Manchester,NH 03108 Phone 4:603-391-7923 Are you an employer?Check the appropriate box: Business Type(required): I-E) 1 am a employer with 12 employees(full and/ 5. ❑Retail or part-time).* 6. L_.lRestaurant/Bar/Eating Establishment 2.0 1 am a sole proprietor or partnership and have no 7. []Office and/or Sales(incl.real estate,auto;etc.) employees working for me in any capacity. [lo workers'comp.insurance required] 8. Q Non-profit 3Z We are a corporation and its officers have exercised 9. 0 Entertainment their right of exemption per c. .152,§1(4),and we have I0.❑Manufacturing eno employees.(No workers'comp.insurance required]* 11.0 Health Care 4.Q Ware anon-profit organization,staffed by volunteers, with no employees.[No workers'comp.insurancereq.] 12. Other I _w___, 'Any applicant that checks box#i trust alsofill out the section below showing their workers'compensation policy information. •s tf the corporate officers have exempted themselves,but the corporation has other employees;a workers'compensation policy is required and such an organization should check box#ri. I am an employer that is providing workers'compensation insuraarce for my employees. Below is the policy h!fornuation. Insurance Company Name:Clark Insurance Insurer's Address:One Sundial Avenue Suite 302N City/State/Zip: Manchester, NH 03102 Policy#or Self--ins.Lic.#MIWC791896 Expiration Date:4128/2017 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 S'T'OP WORK ORDFR 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 cert,u ins and penalties of perjury that the information provider(above is true acrd correct. Signature- Date. Phone#:603-396.7520 Official use only. Do not►vrite in dais area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityffown Clerk 4.Licensing Board 5.Selectmen's Office 6.Other Contact Person: Phone#: www.mass.govidia Massachusetts Department of Public Safety Construction Supervisor 'r Board of Building Regulations and Standards Restricted to: Unrestricted-Buildings of any use group which contain License:CS410O41 less than 35,004 cubic feet(991 cubic meters)of Construction Supervisor enclosed space. MICHAEL JOY 106 JOSEPH STREET MANCHESTER NH 03102 _ Failure to possess a current edition of the Massachusetts -^ Expiration: State Buildirg Cade is cause for revocation of this license. Commissioner 0810712019 DPS Licensing inforrnationvisir WWW.MASS.QOVlDPS Jpr `t rfpvmr.:nrmrre�ll> �"'ff+zT3tterfr rwrll License or registration valid for individul use only. gltiirc of t:nozamtr rttlttirs&Sn` ess tte8alitioa !HQ1gIE pNPRQVEMENT CONTRACTOR before the expiration date If found return W. egistratiarr. 182782 rYpe� office of Consumer Afrairs and Business Regulation Experotlonr Tf7t2t3f7 LLC 10 Park Pia aSuite 5190 Boston.,MA 02116 M!L1.' iTY ENERGY,LLC. MICHAEL JOY' COS JOSEPH STREET MANCHESTER,NH 03102 /Va lia4rrvrcrrraay IN itAnut s' are.