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HomeMy WebLinkAboutBuilding Permit #215-15 - 790 TURNPIKE STREET 8/28/2014 BUILDING PERMITof "°oTH qti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o - Permit No#: Date ReceivedrED 4 �gSSACHUs���y Date Issued: IMPORTANT:Applicant must complete all items on this page LQCATIQNUV- I .� - -- — ___ . ,Pin Y ._- 1 PROPERTY OWNER Print 100 Year Structure ayes MA r PARCELt? .ZONING DISTRICT HistoriclDistrict yes Machine Shop V'i_Ilage• yes (n 61) TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial *XRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑.Septic Well 4 ,' E,Floodplain Weflands qT wet e-rshed�Distnct ,4 ❑'WaterlSewer - �, . • � `. m DESCRIPTION OF W RK TO BE PE FOMED Q ij 4 An �X (y� tification- Please Type o Print Clearly y OWNER: Name: �� Phone: -&D Address: Contractor Name: ImoPhone:, `- Q �- ., 4 g Address-: �� u v Supervisor=s sConstructlon License 'Home Improvement Licen'se:. - _ 'Exp Date: _ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.•$12.00 PER$1000:00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. +' Total Project Cost: $ Qqa -a-71-, ( FEE: $ �� Check No.: Receipt No.: Z. NOTE: Persons contracting with unregistered contractors Flo not have access to th Iguaran Signature of Agent/Qwner - Signature of contra ter__-- a i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL i 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 I i 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 H4. Osgood Street FIRE DEPARTMENT Temp Dumpster:on site yesr- 1ocated at 124M air!-Street Fire'Department signature/date. i 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 I NOTES and DATA — (For department use) i I ❑ Notified for pickup Call Email I 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 d 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 o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster p ter permits require sign off from Fire Department prior to issuance of Bldg Permit ; New Construction (Single and Two Family) Li Building Permit Application Li Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit Li 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 o 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:Building Permit Revised 2014 Location'--19() 4 e- ',A 'fit No. Date T 1 � -I i • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ . Building/Frame Permit Fee $rj .; Foundation Permit Fee $ r. Other Permit Fee TOTAL $ Check I 27962 Building Inspector F NORTH Town of t EAndover _ - .:�. Y ......... No. 7A h ver, Mass, o Am�, -,4 4 -2t�� K[ 1_ '7d AOR�ITEO N4P,`'�y S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT i�S ........P 111j.ees�04 ..................................... BUILDING INSPECTOR ... ....... ��� .... ...TIAro. �1� S• Foundation has permission to erect .......................... buildings on .... ............... g 0 Rough to be occupied as .. . .*...a ..Vi.N.. .. ... .! e1�►.... ....................... Chimney provided that the person acc ting this permit sh I 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 CONSTRUCTIO S Rough Service ................... . .... ...... .................... 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. 1.iF,J /Ftmen 14 1t.b:jc.S-Of'l v' R.^-.'y'11�sF:,..r•j EI:'tCl �':r.-ilCic^LTJ 1 censer CS-071919 L JAMES SM TR NN'Sla 12 CH `P AN K M _ GARANrER MA 01440 c at to 07/ :'n tlr�r=sslor:e= -r � MMERCli11: �f , T-L,-INPUSTRIAL 1 . a j rCON' S V I : F 51 , L-N—' .C , F; rACIL=1 n'F_5 MAIN'I' NANCF &`TpF-pAp5?1..� t t y Scope-o#, r f ti > PAugUst 27,2014 r v r' x x` page 1 of.5 1 o , ,✓ s 4- 10 c �. Mr. Tom Beauregard, KS Parthe�sLl.0 r t ° 130•New Bost on,Street ✓ 3 t _ ` ^t- 1 'Woburn, MA 01801 zl RE: Vinyl/Aluminum-Clad\Exterior.Trim'and Soffit �` 7.90-800 Turnpike Street' We.hereby submit_specificatlon.and estimates t&.provide labor, materials and equipment.to,.install, (M approximately 660'+1-'linear feet pf,vinyl and or aluminum exterior trim„at the subjectlocation as follows: { �1. At,the subject buildings,�along thee xterior wood fascia; soffit and frieze, secure loose and t disconnected,pieces as rnay,be required'. Prepare thetisurfaces ready to receive new vinyLand aluminum } trim: T - 2. At thdfrieze molding,-site,fabricate and install.018”aluminum coil stock in a'�size and configuration,that mimics the existing profiler Install the fabrication,and set each'section*ith.a minimum- g ,'/2",lap joint over the molding,,extending,.up 4" minirrium'and secure with vinyl adhesive and non-corrosive nails,and or screws.Over he coil stock,,furnish and,install-'16'`long`extruded polyurethanefoam derail \. � trim,detail to match the existing as'close as possible. Secure andrfill resulting,holes as per z , / o manufacturer's instructions. ,' t 3. At existing"soffit panel, furnish and install Mastic Triple4'vinyl soffit panel or,equal'`Cut and fit s / the soffit into;the existing wood-sections and secure with .vinyl adhesive and�non-corrosive{nails.and-or, 0, screws. ' } \ 4. -.At the two par fascia tr m, site fabricate and install.018"`aluminum coil stock in.a size and 4 •^r`> configuration that`mirrilcsthe existing profile as.close' -Provide 1"'wide,receiver with '/?:-hem „� _ ' for soffit panel end closure. Install the fabrication and set\each section with a mmlmum '/2" lap joint over 1 'll the trim and:secure with vinyl adhesive and non-corrosive nails and or screws. s A- , II{ 2 fig_, All workmanship will conform-to standards and practices of the trades. All,debris,caused from work in r progress shalhbe remoeed by Falcon.Services Inc. Any-existing damage'or other unacceptable`, r condition's, hidden-pe otherwise'not-readily visible, shall'be repaired and,cir replaced_ upon written change order,`above and beyond this contract. h z _ We wil,furnish materials equipment andrlabor.to c r q p a ry out the above for thertotal`sum of:,/" I t Twenty-Nine Thousand Two Hundred Twenty Sevenrpollars arid,00/1001 $29,227.00, Due and,payableas follows:due,when complete^ _ \ Authorized Signature:,' All materials shall co�ifomi to industry standards.All work to be oom eted in a �' r ✓ - - ^ - protessional'manner according to standard practices.Any anftje on�or deviation from the above specifications invoMn9 extra costs will be exectited only u�pn writleri orders,and r ti r f + will become an extra'charge over and above the estimate.AII'agreements contingent upon. ( �; C�, '; 'Z e , \ strikes,.accidents or delays beyond our control.Ow`nerto&any fire,tornado and other rF' f 1 necessary insurance.Oar workers,are fully covered by Wo*er's compensation Insurance. ` L. James Shetrawski,.President e- THIS.PROPOSAL MAY BE WITHDRAWN BY us IF NOT ACCEPTED-WITHIN 30 DAYS _ \• ' \ ACCEPTANCE OF PROPOSAL: The above prices,specifications and conditions are satisfactory•and are,hereby accepted.-You ry are authorized to,do the`workl as specified.'Payment will be made'as outlined above.' 0- Y , 113-MAPLE 5ftl�T'�CAAR19 , MA 01440 -!34 LVYAN WAY_ftt;, MA,01) 2 l HO' : 9i8-630-4922 'Ax: 9�8-632-6511 • 'AI coNs�r vlcl;slNc:c�M s 'he Co mmonwealti o,fffassa0usefts - �e�ai'�nel2�o,f.I•�tt��c,���t�l.Acczc�e�ts 6`00 Washington Street ' Hostoa,MA 02111 r immassgovIdliz 'Fork,ex,q,comp ematxonInsurance Affilavit:J�u�Sder���Go��°ac�oz��/�Iec���czansl�'X�b�x�� AD-pWant--fiformatlon .'Z ase Przn ) itbX a7 e(BusinesslOzganiationnndz`vi�izal�: Eal (OoSefv' 1t` F Ad&ess: - ci /S tatOOT: O.nr (o j t)- (l Q a .Arepontars employer?Cheek the appropriatebom Type ofyroject(regpfred): �. d Z ant a general.conttracox and I am a employer with 4. €. New cbnstrrzctzon. employees( zlland(arpar�time).T have,Mdthe sub-contractors 2.El I am a sole propxietor or partner- listed on.the attached sheet.T 7. �(Remodeling ship and lavano.employees These su7�-contractorshave 8. Demolition working forme in any capacity. workers'comp,insurance. 9. []Building addition [No workers'comp.insurance 5. ❑we are a corporation and its 10.0 Rlectricalrepairs or additions mquited.] officers have exereised.therr 3.El Z am a homeowner doing all work right of exemption perMOL 11..[]Plumbingrepairs or additions myseL coworkers'comp. c.152,§1.(4),andwehaveno 12-ElRoof xepairs insnrancerecp�ired.�i employees.WOworkexs' 1s.0 Other comp.insurance,logaked j �Avyapplicancthaicheckshox#�imuscalsa�Ilduitheseetionbel6vrshowing�teirworkers'compensation.policyinformafion. '� • i Homeowners who submifthis atfidagitmdicatingiiiey ire doing allwork and then hire outside oontractors muss suT�mi�anew afddagitindica�hg such. Contcacfarstheyche�kthisbo mustattachedanaddiiionatsheetshowingthenameotthosuh-contractorsandthokworkers'comp.poRryinfozmation. _r aln an emvfoy�&thai is p�avidijtg workelg'eoinpe�a�atia�insr��araee fog pit ffaTf ees .Bcl w is Me paliey r ndjobffi`e ire,foa�xnatio�z. . Insum eo Companywame:. amencao MtMuffinal policy's or Selr"ins.ii'ic.#'��(`l�� �-I Q� � � Expixatzon.Date' .. City/State/zip: 11 1 I .Attach a copy of t aworkers,compensationjpollcy ileclaratimz page(showiug.Me policy mmmher anal expkatloa date). 1:'aiime,to secure coverage as regrtiredundex Section 25A ofMOL c.152 cart leadto the imposition of oxhihalVenalties of fuze-up to$1,500.00 and/or ones-pear 11nptzsgmentz as well as oWipenaltzes i a th e fotm of a STOP.•W'OPX ORDER and a fine ofup to$250.00 a day against the vioXator. Be advised that a copy ofthis statementmay he foxwardedto the Office oz• investigations of the DIA.fox insurance coverage verification. X,10 Hereby car. ' ride tiie .aing antipenaldeg of perfury tliattlte lnforrnation provid,-d above ig tare anti correet, � Si atare: Date' Thone g.- - OjfyciaZ us,-manly, vo not write in this area,to be completed by city or town ofeial. City or Town: Permit/Liceose 0 Issuing.Authcrity(circle one): Z.Board ofJ ealtlo 2.BuRd ugDepartmeiek 3.CHyffoym Clerk 4.Blectricallopector a Numbhagbspector f.Other _ _ FALCO-1 OP ID: PL CERTIFICATE OF LIABILITY INSURANCE 1 DAT 0810DD/YYYY) 08/05/14 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 978-443-6530 RM"E:ACT McGlynn,Clinton&Hall Insurance Agencies 978-443-0263 PHONE FAX No): 365 Boston Post Road Ste E-MAIL Sudbury,MA 01776 ADDRESS: Lawrence L.McGlynn,CP1A,AAI INSURERS AFFORDING COVERAGE NAIC# INSURERA:Arch Specialtf SpecialIns.Co. INSURED Falcon Services Inc. INSURERB:Torus National Insurance ID 588035 INSURER C:American International Group 113 Maple Street Gardner,MA 01440 INSURER D:Travelers Insurance INSURER E: INSURER F: COVEiiZES; - 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_ rLTR ADDL SUB POLICY EFF POLICY EXP TYPE OF INSURANCE -Ma POLICY NUMBER MM/DD/YYYY MM/DD LIMITS GENERAL LLIABILITY EACH OCCURRENCE $ 1,000,0001 X COMMERCIAL GENERAL LIABILITY ACP00001730004/01/14 04/01/15 DAA MISES(E.occurrence) $ 100100 CLAIMS MADE I OCCUR MED EXP(Any one person) $ 5,00 X DED 2500 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG is 2,000,000 POLICY M PRO LOC Is AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,000 D ANY AUTO BABE469929 08/14/14 08114/15 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident)',Ss AUTOS AUTOS X HIREDAUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 B EXCESS LIAB CLAIMS-MADE 7200TJ140ALI 04/01/14 04/01/15 AGGREGATE $ 5,000,00 DED RETENTION$ $ WORKERS COMPENSATION X I WC STATU I OTH- AND EMPLOYERS'LIABILITY ,RY ER C ANY PROPRIETOR/PARTNERiEXECl1TIVE YINC005590133 04/01/14 04/01/15 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION KSPARTN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE KS PARTNERS, LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 130 NEW BOSTON STREET WOBURN,MA 01801 AUTHORIZED REPRESENTATIVE Lawrence L.McGlynn, CPIA,AAI ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD