Loading...
HomeMy WebLinkAboutBuilding Permit #576-13 - 49 ORCHARD HILL ROAD 2/26/2013 OR Fj BUILDING PERMIT e�o0 TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: tLJ�j / Date Received '� zo �' Date Issued: Lx� 9SSAC NUs�tArgo �y IMPORTANT: Applicant must complete all items on this page LOCATION C,'_ Ltt,_� c l / Print PROPERTY OWNER � a0 �7cw.4�tljf-; Print . y MAP NO: PARCEL/.��'C' ZONING DISTRICT:. Historic District ye!�' no Machine Shop Village ye"k no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Ind trial ration No. of units: ommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic Well n Floodplain ; Wetlands P Watershed District Water/Sewer A G(jF(-LJC/ Y-0 C?/ Y'i C!7'\ !A© reer Pi -�-bv C9 P eAt /00 '-� � � fZ'l'r s►„�� �C�C9/vl.� / W r�ti/ GCc�vGS�/CG Chi•.� rc->S Identification Please Type or Print Clearly) OWNER: Name: (V&"-v- tfl,d Phone: y(9r —(?C4'- Z,0&0 Address: CONTRACTOR Name: +=t Phone:_ 1-f--3 -Eal i �, � f' e z't�/"•`"4..C.�r C �-'1 c !'"ti 'i�"rl ti tri ��, Address: _ .. .gip G- Z LCt_ G q t Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: 6/'0 l -`f 6 t —__5 31,0 Address: `?.r I'�t;s��ge�-- ;, �t�, Reg. No. cl'76 -7 A FEE SCHEDULE.,BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $_ 6 7 6 FEE: $ 00 4 Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund signature of Signature of contractor . v 1 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LQCATION Print, PROPERTY OWNER Print 100 Year Old'Structure yes, n0 MAP NO': 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 p Septic ❑Well ❑ Floodplain ❑.Wetlands 0 WatershedDistrict D Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: _ Phone: Address: Supervisor's Construction Licenser _Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor. Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ „ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Flans ❑ 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 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 - I Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW TbwL ]Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster onsite yes no Located at-124.Mair"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, roast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G m1n.$100-$1000 fine DOTES and DATA—(For department use B Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The fol owing 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 u Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work u Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan a Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products MOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) u Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report Li Engineering Affidavits for Engineered products VOTE: 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: Doc.Building Permit Revised 2012 Location //9 (OR& 11 K e No.-676 -1-3 Date (O/l3 • ' TOWN OF NORTH ANDOVER e ® Certificate of Occupancy $ �� Building/Frame Permit Fee $ . "� Foundation Permit Fee $ Other Permit Fee TOTAL $ c Check 26174 Building Inspector Enter construction cost for fee cal- North Andover Fee Cakulation Construction Cost $ 409676.00 m $ - $ 488.11 Plumbing Fee $ 61.01 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 61.01 Total fees collected $ 710.14 49 Orchard Hill Road 576-13 on 2/26/2013 Traininq rooms remodel ACORP. . CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 02/12/2013 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(les)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 CONTACT — NAME: Troy, Pires & Allen, LLC PHONE401.431.9200 AA/C:No Exit): (A/C,No),401.431.9201 Shove Insurance 376 Newport Avenue ADDRESS: INSURERS)AFFORDING COVERAGE NAIC q East Providence, RI 02916 INSURER A: Selective Ins Co of Southeast 39926 INSURED The RHODE ISLAND CASE CONSTRUCTION Co. INSURER B: Beacon Mutual Insurance Co 24017 dba Case Construction Co INSURER C: 22S WAMPANOAG TRL INSURER D: RIVERSIDE, RI 02915-2211 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2012 case updated 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 TYPE OF INSURANCE INSR WVD. POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS GENERALLIABILITY S 175458 02/08/2013 02/08/2014 EACH OCCURRENCE $ 1,000,00( X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 100,00( CLAIMS-MADE OCCUR A MED EXP(Any one person) $ 5 00 + PERSONAL&ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:POLICY PPRODUCTS-COMP/OP AGG $ 3,000,000 RO- JECT LOC AUTOMOBILE LIABILITY - S 1754582 02/08201,.3 02/08/2014 Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED AUTOS Per accident $ ' $ C UMBRELLALIAB accuR S 175458 .02/08/2013 02/08/2014 EACH OCCURRENCE A EXCESS LIAR $ " 5-000,0-00 CLAIMS-MADE DED RETENTION$ AGGREGATE $ -5,000,000 MP X $ WORKERS YERS'LSA LION 23705 10/01/2012 10/01/2013 AND EMPLOYERS'LIABILITY Y/N' TORY LIMITS ER . .,.,; �,• B OFFICER/MEM ERANY /EXCLU EV D?ECUTIE[:] N/A E.L.EACH ACCIDENT $ S00,000 (Mandatory In NII II under E.L.DISEASE-EA EMPLOYEE $ 500,000 yes, __DESCRIPTIO describe unIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,OO _F DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space Is required) 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 For. Information Purposes Only Sandra Gross uth/S 1G ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD U Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License- CS-073715 EDWARD J MCD 9PTALU.,l i � , 3171 DIAMOND CUMBERLAND RI 028 " Expiration Commissioner 08/20/2014 Unrestricted-Buildings of any use group which j contain less than 35,000 cubic feet(991m)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS SE ' ONST CTION COMPANY 225 WAMPA TRAIL,EAST PROVIDENCE,RHODE ISLAND 02915 TEL: (401)434-6511 • FAX: (401)438-9559 EMAIL: CASECONSTRUCTION@VERIZON.NET November 28, 2012 AAA Southern New England Merrimack Valley Division 49 Orchard Hill Road North Andover, MA 01845 Attn: Edward Hart Re: Training Area Proposal-Revised North Andover Dear Ed, We are pleased to submit our revised preliminary budget proposal in the amount of Forty Thousand Six Hundred Seventy-Six Dollars ($40,676.00) to create a new Training Area per the memo and preliminary sketch dated September 12, 2012 and per your email dated November 6, 2012. Thank you for the opportunity to submit this proposal and please don't hesitate to contact me if any of the above requires-clarification. Very truly, CASE CONSTRUCTION COMPANY P�"h9 Frank N. Gustafson II President FNG/kj Cc: Steve Manty, AAA-Providence � NORTF•/ n of � .. � E :...,,. 6 n over Tow _ O •�'- •�• wry No. iT h ver, Mass, 3 �A-O� COCNIC(WICK y�� y�p04ATED 0'4�,`�5 S U BOARD OF HEALTH LD Food/Kitchen Septic System PERMIT T BUILDING INSPECTOR THIS CERTIFIES THAT .. • 1 Q Jk.....�o................... ..`... ........................... ........... . r 1 Foundation has permission to erect buildings on ..'C�..... ••••••••••••••••• •11�•••• `•�......••• .......................... Rough to be occupied as A. New �f? tl . ... '�4..........DiliAY, S••• ••••••••••••••• 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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR qrUNLESS CONSTRUCTAON ST TS Rough Service ..........P......... ................................................... 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