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HomeMy WebLinkAboutBuilding Permit #52 - 49 ORCHARD HILL ROAD 7/20/2007BUILDING PERMIT TOWN OF NORTH ANDOVER nooi 1GAT-1nnt FOR PLAN EXAMINATION Permit NO: Date Issued: . IMPORTANT: A LOCA Date Received -Q must all items on this page 1 Ili It PROPERTY OWNER AAX W-24 t A # Cy,'. Print MAP NO: �4 PARCEL: ZONING t-ISTRICT:1- Hist ric District Machine Shop Vit yes. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial X Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic b Floodplain_ .. oiWetlands tee, ❑ Watershed District _Q,Well' u Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: REty1flJENr 7,> R-C9Uk1t,£ 3to' u (.o' e_-rtwZ or- R001= AtitD t�s�u� � oa► (ACXp aY Fl (LE . 4t40 REIN/toVE; A-*aD REPLACE 4Z LF DF U &A -L PAcr t -CL Acts D l N Su Vkrt o til Identification Please Type U�Le int Clearly) OWNER: Name: PcP�� �I1ER.RtMA�c..t� Y .10c•Phone: 9�18`io��'g2�D Address: 41 0V,(Aktzt,7,> P i w (0#kt> ---------- CONTRACTOR Name:. uz-r t f� Ate► Su> 4 IJ C_ . -� phone: _T Address: 4S &+,s't , J)tx\16 " 4kfAFepT'CAv 0°-Xe+t Supervisor's Construction License: CS 2q -J Exp. Date: It ` o Home Improvement License: Exp. Date: ARCHITECT/ENGINEER TED Phone: _78I- BZI0-133(09 Address: 1,93 CDWIM 1btA RV. 0 4kPNEt� 14A 0233°1. Reg. No. 2909 3 FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TUTAL is [IMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 331 g 2D FEE: $ 40-1. 04 Check No.: C29 691a Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund AA - - Signature of"Agent/Owner Signature of contractor 1� t /_/z Plans Submitted ❑ 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 COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ O DATE REJECTED DATE APPROVED FE DATE REJECTED DATE APPROVED ❑ ❑ Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster tri $ite yes no Located at 124 Main Street �, . Fire Department signatureldate. � , COMMENTS` Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. 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 Doc.Building Permit Revised 2007 1 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 o 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location__, / No. Date/J 4,14 �oRTM TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ cNust`� Building/Frame Permit Fee $fJ t Foundation Permit Fee $ — Other Permit Fee $ TOTAL $ Check # ! 7� /, Building Inspector ., ��~ � ✓,ie �r�m�nzoouueciltl �aGaaoac/uiaefla j BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 092994 Birthdate: 11/19/1972 Expires: 11/19/2009 Tr. no: 92994 Restricted: 00 KEITH A WENTWORTH JENNIFER DRIVE c �� CGHESTER, NH 03036 Commissioner 05/30/2007 23:28 7818268399 PAGE 01 /� Ted Greenlaw P.j--. 183 Columbia Rd. Hanover, MA. 02339 tel# 781-826-8369 fax #781-826- 8399 E -Mail tecl reenla.w e c7� alcom May 28, 2007 Keith Wentworth Dutton&Garfield 43 Gigante Drive Hampstead, NH 0384I RE: AAA Merrimack valley 49 Qrcbard Hi i l Road No. Andover, Ma On May 24, 20071 met with. you, and the certified welding inspictor From Miller Engineering & Testing, tests were performed that demonstrated that the welds in concern, Which were broken at some time, have been re -welded with welds that are proper in, so far as placement of the welds. With this, I can say that the 3/16 fillet that 2" lore are proper, and sufficient, at each of the two joints. g The inspector reviewed the welds of the two angles that are pres�nt where the lattice is bent, he approved the duality of these welds, therefore this is sufficient as is. At this point the shoring can be removed permanently. Respe ull ed rcenlaw P.LC. ,,4 k I MILLER ENGINEERING &TESTING INC. -MANCHESTER NH ;603) 668.wia NCPTHBOROUGH, MA (508) 393-2607 BOSTON, MA (617) 269-8829 FAX. (603) $68.8641 FAX, (508) 3938490 FAX, (617) 269-8837 PROJECT: AAA ME1 RIMACK VALLEY PROJECT NO; 07.817.MA DATE. MAGNETIC PARTICLE F'IELO REPORT TO: Mtttdn1'&7Gatfield, Znc.JOB NO• 07.817.MA SPECIFICATION: 43 Gigante Drive Fampstead, NH 03841 LAB NO: ASTM E709 ATTN: Keith Wentworth PO#: No indications allowed. El THIS IS TO CERTIFY THAT WE HAVE THIS DATE INSPECTED THE FOLLOW7NG; YES NO QUANITY PART DESCRIPTION Truss joist - top cord - Ray 8 INSPECTION STATUS 3 Welds E to F - The welds were found The three welds were Magnetic acceptable with both R CJ Particle and Eddy Current inspected methods of inspection. M ❑ per above specification: ACID ETCH ❑ El RESIDUAL 1-MIWILAIIUN OF UUMYLIANCE WE CERTIFY THAT THE PARTS/MATERIALS HAVE BEEN TESTED iN ACCORDANCE WITH THE ABOVE SPECIFICATION. THE PARTSIMATERIAL LISTED HAVE NOT COME IN CONTACT WITH MERCURY DURING TESTING. /4(7 METHOD OF TESTING ❑ ZYGLO (FLUORESCENT PENETRANT) M MAGNA FLUX (MAGNETIC PARTICLE) �:; _. .; ❑ SPOT CHECK (VISUAL DYE PENET ItA) Q MAGNAdLb. (FLUORESCkNT NIAGIYE [C �" ..... PARTICLE),'-.. TIME PENETRANT DIRECTION OF FIELD -CIRCULAR DC YOKE REMOVER, PARTICLE SUSPENSION --- MATERIAL __i Gray Powder DEVELOPER 2 Directions LONGITUDrNAL AMP TURNS inn/TnOIA VVA Rn:OT L007./t7./9n YES NO PLATED ❑ 91 WET ❑ SURFACE STANDARDS C ❑ DRY R CJ STAMPED ❑ 91 CONTINUOUS M ❑ ACID ETCH ❑ El RESIDUAL ❑ THE ABOVE PARTS HAVE BEEN CAREFULLY INSPECTED William Metcalf BY THE METHOD INDICATED. THIS REPORT IS LIMITED TO DEFECTS OF THE TYPE ASNT Level II WHICH CAN BE LOCATED BY THIS METHOD PREPARED BY: inn/TnOIA VVA Rn:OT L007./t7./9n MILLER ENGINEERING & TESTING INC. MANCHESTER, NH :603) 668.66016 NCa HSOROUGH. MA (5081393-2607 BOSTON. MA (617) 269-8829 FAX. (603) 668.8641 FAX. (5081393-8490 FAX (61 71 269.8837 PROJECT: AAA MERRIMACK VALLEYPROJECT NO: 07.817.MA� PATE: 524-07 MAGNETIC PARTICLE FIELD REPORT TO: button & Garfield, Inc. JOB NO: 07.817.MA SPECIFICATION: 43 Gigante Drive LAB NO: ASTM E709 Hampstead, Nil 03841 No indications allowed ATTN: Keith Wentworth FO#' THIS IS TO CERTIFY THAT WE HAVE THIS DATE INSPECTED'THE FQLLQ%MG: YES QUANITY FART DESCRIPTION INSPECTION STATUS Welds - On added Truss joits - Bay 8 -- G -I;' angle Welded angle pieces - Bent tubes. The welds were found ® The welds were Magnetic Particle acceptable with both ® R NJ and Eddy Current inspected per methods of inspection. M .above specification. M M � CERTIFICATION OF COMPLIANCE WE CERTIFY THAT THE PARTS/MATERIALS HAVE BEEN TESTED IN ACCORDANCE WITH THE ABOVE SPECIFICATION_ THE PARTS/MATMAL LISTED HAVE NOT COME IN CONTACT WITH MERCURY DURING I ES"T 140. METHOD OF TESTING ❑ ZYGLO (FLUORESCENT PENETRANT) ® MAGNA FLUX (MAGNETIC PARTICLE) ❑ SPOT CHECK (VISUAL DYE. PENETRANT P ❑:= MAGNAGrLt7,'(FL UORESCENT MAGNET C' PARTICLE; TIME PENETRANT DIRECTION OF FIELD -CIRCULAR BG YOKE REMOVER PARTICLE SUSPENSION MATERIAL _ 'Gray Powder DEVELOPER LONGITUDINAL 2 Directions AMP TURNS THE ABOVE PARTS HAVE BEEN CAREFULLY INSPECTED BY THE METHOD INDICATED. THIS REPORT IS LIMITED TO DEFECTS OF THE TYPE WHICH CAN BE LOCATED BY THIS METHOD Z00z PREPARED BY: BT11 Metcalf Riad OC:60 LOOZ/OC/90 YES NO PLATED p WET p SURFACE STANDARDS ® DRY ® R NJ STAMPED O M CONTINUOUS M M � ACID ETCH ❑ ® RESIDUAL 0 THE ABOVE PARTS HAVE BEEN CAREFULLY INSPECTED BY THE METHOD INDICATED. THIS REPORT IS LIMITED TO DEFECTS OF THE TYPE WHICH CAN BE LOCATED BY THIS METHOD Z00z PREPARED BY: BT11 Metcalf Riad OC:60 LOOZ/OC/90 The Commonwealth of Massachusetts 77 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 V 5� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name (Business/Organization/Individual): i.iV ITOO U:a�1sj�,D,1 (JL Address: 4-3 61 &kNm 'D9_-l1J6 City/State/Zip: PZ7 OS541 Phone #: (003-329-5300 Are you an employer? Check the appropriate box: I. ❑ I am a employer with 4. Dfl I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have workers' comp. insurance. 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions ILEI Plumbing repairs or additions 12.X Roof repairs 131R Other WAIL prENO2S -tiny appucant tnat cnecks box It I must also till out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /-i C iq 'D l Policy # or Self -ins. Lic. #: IAC no15 Expiration Date: Job Site Address: 49 O K RY.I_'.) N1 LL TZ _1�> City/State/Zip: U0 - AiNogyet2 ,MA 018`15' 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 STOP WORK ORDER 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. Ido hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Phone #: i003- 3Zq-5300 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # 1910-7 Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: i 13•CO JUL 10, LOOT TO- LUTTGII & GrIRrICLL f R• ROJC RUJI"ILOW iF0040 f'IyGC• CEJ !2 Q ACORD- CERTIFICATE OF LIABILITY INSURANCE OP ID 7 MOORE-1 DATE ID 07/18/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LTR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brown & Brown Empire State HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 500 Plum Street, Ste. 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Syracuse NY 13204 Phone: 315-474-3374 Fax:315-474-7039 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Harleysville Worcester Ins Co INSURER B: *American Home Group Moore Metal Systems Northeast Inc. INSURER C' PO BOX 237 Hampton Falls NH 03844 INSURER D: INSURER E: 02/06/08 l,U V t KAIa tJ 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MM/DDlYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR MPASJ8544 02/06/08 02/06/09 PREMIsES(Eaoccurence) $ 250,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY M PEQ LOC A AUTOMOBILE X LIABILITY ANY AUTO BA8J8544 02/06/07 02/06/08 COMBINED SINGLE LIMIT $ 1000 (Ea accident) r r000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) X X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 A X OCCUR ❑CLAIMSMADE BE8J8544 02/06/07 02/06/08 AGGREGATE $1x000'000 HDEDUCTIBLE $ X RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE WC6846166 04/01/07 04/01/08 TORY LIMITS ER E.L EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? If yes, descnbe under E . DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE- POLICY LIMIT $500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Named as Additional Insured- AAA Merrimack Valley v�i� awry nvw�� UANI.tLLA I IUN DUTTONG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Dutton & Garfield Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Mr Keith Wentworth VP 43 Gigante Drive IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Hampstead NH 03841 REPRESENTATIVES. 1108) © ACORD CORPORATION 1511 & IL Dutton a Garfield, Inc. April 18, 2007 CONTRACTORS AAA MERRIMACK VALLEY 49 Orchard Hill Road North Andover, MA 01845 Attn: Mr. Thomas M. O'Neil Re: Building Insulation Repairs Dear Tom: Per your request, we are pleased to submit a proposal based in the amount of: $33,920.00. Our proposal includes the following hems of work: Furnish all materials, equipment and labor to: 1. Remove and replace approximately 2,250 SF of Butler MR -24 painted roof panel and insulation. 2. Remove approximately 675 SF of Butler Stylwall metal panel and insulation. 3. Replace insulation and re -install existing metal wall panels. Thank you for allowing Dutton & Garfield, Inc, to provide this quote. State sales tax is included. Based on the attached terms and conditions. Please feet free to call me with any questions. Sincerely, 4d, , - Keith A. Wentworth Project Manager 43 Gigante Drive • Hampstead, NH 03841 BUTLER m BUILDER www.duttongarfield.com Tel: (603) 329-5300 Fax: (603) 329-5368 9 O b F; 0 W tv x O w v V) U � W 00 -o p w x O a4 U is co C w W p a: m G w a W W u2 V) G u. O 0 w G w � G c� co O cn 4 Y C'm Sm f. 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