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HomeMy WebLinkAboutBuilding Permit #712-15 - 4 High Street Suite 155 3/12/2015�31atkls - Pq BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAM INATION,°;,. v; Permit No#: 7,,- rJ Date:Received'­ Date Issued: IMPORTANT: Applicant must complete"all items on;thispage LOCATION. PROPERTY OWNER. Print 100 Year Structure yes no MAP 1_ PARCEL: 69 ZONING DISTRICT: __,,Historic District a no Machine Shop Village no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial * Alteration No. of units: X Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District V El Water/Sewer__ DESCRIPTION OF WORK TO BE PERFORMED: u11d OvG- Z/9h dab,- Identific tion - Please Type or Print Clearly OWNER: Name: -IN 0 d-rG •,a-Q'V CL. C.- tk Phone: Address: - V 19 v o SSI ' 4 (S N-6 ILQ It %S � bs C`� 2- t 4- _.,.. _ f CSS 1 ._ ie p%&,i W µ Contractor Name: Phone: 1, t Sq'L— Address: ru t -t T 3 ti l'3 .. . l c 140 0 V,r� Supervisor's Construction License:..0-- .._ .�,v `., �- _-x.rxp.. Date: Home Improvement License:.,. k. Exp. Date, V' ARCHITECT/ENGINEER q ►4 q 14 VL C K t qV 47V rl"--( Phone:-CkIg - S( $ - 9' 13 `i'' Address: JNMfJ 022: (. Peg..No:`:: , t (i U C� FEE SCHEDULE. BULD/NG PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED'COST BASED ON $125.00 PER S.F. xx _ Total Project Cost: $ FES':;. $ Check No.: Receipt. No.: ; 2��� NOTE: Persons contracting with unregistered contractors do not have:access to the guaranty fund nature of Plans Submitted ❑ 1 ,s'' ;11. v ) Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature b 0 • Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes 4. Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Du Located at 124!Main Street Fire Department signature/date ,COMMENTS Locatea IJu4 vsgooa bireet 477.7 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 Call Emaik Date Time Contact Name Doc.Building Permit Revised 2014 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 ❑ 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/Cross Section/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 Doe: Building Permit Revised 2014 Location No. ! }2-- Date »I i Check # e TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $�3.'D Foundation Permit Fee $ Other Permit Fee $ TOTAL$ 2-. k3 Building Inspector "GRIN 1 0� .�• y1Ho • � .F r �7S ACN�St4 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 712-15 on 3/12/2015_Date: March 20, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED ON 4 High Street — Suite 155 —1St floor MAY BE OCCUPIED AS a tenant expansion — Calamar IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG LLC, West Mill LLC 4 High Street North Andover, MA 01845 Building Inspector Fee: Prepaid $100.00 Receipt: 28559 Check: 2044 140 1: id O 0 = :doom O V'y O Q. as o� o 0 Y L� C N O a) 7 .0. yr - . E fAO C o V i � J � a • cc 0= a) c 0,0 Q Fmmoo a� z �0� - y c o c off L Q Q d d L � lo c = Q i i cc a Q ai 5 � y .V m w O 'a+�+ O O M •2 41 N C •B.t O uml w N = + �63 Q 0 LU E v � •__ o v 0-0 � o C0 m > U)y -0O t 0 .� CLOC) F. 2 Z G co Z W w X H LLI W/� M WIM O w :a O 0 m '••� C tel: O U H • Z O LUJ w Y o o Z N O = 0 AI i i W Q N •� m m aF•-� O �+ d v O o CL a CL tm Q O a Aw _v J � .2 —j O W O o o ui u cc z 2 LLz O Val H Z H Z u O W a Z a In Z Z ? � c Q m m J m _ c J Q uj LA. V N N d W ® Y Y O 0 ? N Y D -E - ro \ �p h0 bD D to :3i O v Z Qj� C v O LL N N O LL L \C V O d' LL O N d' (n O C or LL CD N N 0 = :doom O V'y O Q. as o� o 0 Y L� C N O a) 7 .0. yr - . E fAO C o V i � J � a • cc 0= a) c 0,0 Q Fmmoo a� z �0� - y c o c off L Q Q d d L � lo c = Q i i cc a Q ai 5 � y .V m w O 'a+�+ O O M •2 41 N C •B.t O uml w N = + �63 Q 0 LU E v � •__ o v 0-0 � o C0 m > U)y -0O t 0 .� CLOC) F. 2 Z G co Z W w X H LLI W/� M WIM O w :a O 0 m '••� C tel: O U H • Z O LUJ w Y o o Z N O = 0 AI i i W Q N •� m m aF•-� O �+ d v O o CL a CL tm Q O a Aw _v J � .2 —j O W O otNoerMr; . o 49 3,SSgCIN15t4 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 712-15 on 3/12/2015_Date: March 20, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED ON 4 High Street — Suite 155 — 1St floor MAY BE OCCUPIED AS a tenant expansion — Calamar IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG LLC, West Mill LLC 4 High Street v ' North Andover, -MA 01845 Building Inspector Fee: Prepaid $100.00 Receipt: 28559 Check: 2044 3?.fie. �• '•�oL i 't! One �V4•� �BS.�CHUSt4 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 712-15 on 3/12/2015_Date: March 20, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED ON 4 High Street — Suite 155 —1St floor MAY BE OCCUPIED AS a tenant expansion — Calamar IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG LLC, West Mill LLC 4 High Street North Andover, MA 01845 Building Inspector Fee: Prepaid $100.00 Receipt: 28559 Check: 2044 141 O LU S 0 O O Q m O O LL E a Ln Q N In O a H ? Z m c i c O O LL to :3-0 O d' T L U _ m LL Ooc a N Z Z J a txo_ 7 O d' co C I.L a N Z u W -' W O OC U _ O N _ co O LL W CL Z Q L j O K _ ro C LL Z LLI H Q W W LL i N 7 m O Z ai N N Y O E V7 :-: O V• O 0 V 4+ : C : CL aD 0 0 0 E m air cL 0 o r a.. M ' c � 0 V i Moo. V` i 0 _ J W am a NVHLL w 3 tm o~ c g=.(D O c� CL (D O O m O d ONo .•v =C -:;ON = : EQ 0,0 0>= r=n t'0= moo= U .0.WW -0 kl O E O O Z O C 0 0.- 0 �+ 0 0 a �. a� Q 0M r- v J � �C- O =z O 0 cn ca C c CL _N 0 O W CL U) z 0 m U FF Z �-- �_ .E CoC G Z O co CLLLI Z U O x Z �U) w az m � O 0 N O t O Z O Q O kl O E O O Z O C 0 0.- 0 �+ 0 0 a �. a� Q 0M r- v J � �C- O =z O 0 cn ca C c CL _N 0 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction, Supervisor License: CS-06r:6334r ter ti IQERAN'T WHELAN'- 31 RICHMOND ST � ° WEYMOUTH MA 021 8 1j r )' w Expiration Commissioner 09/26/2015 A�Ro® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 3/3/2015 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 DUPONT INSURANCE AGENCY INC 18 COPELAND ST QUINCY, MA 02169 NCONTACT AME: PHONE FAX Ext: AIC No: E-MAINo,L ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance 23035 EACH OCCURRENCE $ INSURED X CONTRACTING LLC INSURER B: 31 RICHMOND STREET INSURER C: INSURER D: WEYMOUTH MA 02188 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 23677622 REVISION NUMBER: THIS IS TOCERTIFY 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. INSR LTR TYPE OF INSURANCE ADDL I D SUBR POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-1OCCURPREMISES AUTHORIZED REPRESENTATIVE 4,f . �,g� LQcw Y( Liberty Mutual Fire Insurance EACH OCCURRENCE $ Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO F__] LOC JECT OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG S $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON --OWNED HIREDAUTOSAUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑Y (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WC2-31 S-601698-015 2/17/2015 2/17/2016 STATUTE OERH E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYE $ 100000 E.L. DISEASE - POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates, only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION CROWNINSHIELD MGMT CORP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 CROWNINSHIELD STREET ACCORDANCE WITH THE POLICY PROVISIONS. PEABODY MA 01960 AUTHORIZED REPRESENTATIVE 4,f . �,g� LQcw Y( Liberty Mutual Fire Insurance © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 23677622 CLIENT CODE: 1644469 Lucy Garfield 3/3/2015 10:19:07 AM (EST) Page 1 of 1 JK Contracting LLC 31 Richmond Street Weymouth, MA 02188 Name / Address RCG LLC Seth Zeren, Calamar Extension, 4 High St, N.Andover, Mass 01845 SvIT% 155, Quote Date Quote # 3/5/2015 105 Rep Project Description Qty Total Plans and Permits 220.00 Cut wall and frame opening into existing space, M&L 450.00 Insulation; Insulate walls 400.00 Electrical & Lighting 3,885.00 Tel/data 2,090.00 Interior Walls, Drywall 700.00 Tape, prime ,paint, including piping and ductwork 2,500.00 Carpet and base 1,469.61 Final Clean 100.00 Supervision 1,181.46 Thank you for the opportunity to bid this work. Total $12,996.07 OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER =•, ` CONSTRICTION CONTROL ta,.ewitt PROJECT NUMBER: 1406002.19 PROJECT TITLE: Suite 155 PROJECT LOCATION: 4 High Street, Suite 155, North Andover NAME OF BUILDING: West Mill NATURE OF PROJECT: IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I. Lioda $. Smiley REGISTRATION NO. 10080 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ❑ FIRE PROTECTION ❑ ARCHITECTURAL R STRUCTURAL ❑ MECHANICAL ❑ ELECTRICAL ❑ OTHER (SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 115.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, If the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 118.2.2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. 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