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HomeMy WebLinkAboutBuilding Permit #116-16 - 999 OSGOOD STREET 7/28/2015 INORT1� BUILDING PERMIT 3206 S<.to A. hb.6 TOWN OF NORTH ANDOVER40"' APPLICATION FOR PLAN EXAMINATION ; s -- y Permit NO: Date Received �;`�:.� Date Issued: O IMPORTANT: Applicant must complete all items on this page LOCATION OS CiU ac( S�. fP�.nt PROPERTY OWNER �L /?A I"2 (tel I'C o Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no- Machine o-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 ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer ►S Is en t F1--"'e 1�ed+J- k.- be iii S A/1 e/ 0/1 Identification Please Type or Print Clearly) OWNER: Name: Phone: ''774?- Address: '774?-Address: S Q �� /Va�f� /������- /'1/� 6,lS-ysT CONTRACTOR Name: 17iM Phone: 978- � 37 97So %Ii Br-s Pte•fi� !?c,ef� Address: j/ It C J'S&! f P1l.(e- Ulll�f D G`jC/AJ1arW it,A)- Supervisor's Construction icense: Exp. Date: Home Improvement License: Exp. Date: R. 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 a.F Total Project Cost: $ L] FEE: $ 4 30. ad Check No, ! 15 D_ Receipt No.:� NOTE: Persons contracting with unregistered contractors do not have access to the uaran'ty fund ignature of Agent/Owner Signature of contractor J -- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ ;-5tamped Plans ❑ TYPE OF SEWERAGE DISPOSAL e Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ " Well ❑ ❑ Tobacco Sales Food Packaging/Sales ❑ Tg Private(septic tank,etc. ❑ Permanent Dwnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on ( Si nature 4 COMMENTS -HEALTH Reviewed on Signature COMMENTS ZoningBoard ofA Appeals:NN als:Var►ance, petition No: Zoning Decision/receipt submitted yes „ Planning Board Decision: Comments Conservation Decision: Comments Wafter &In Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: FIRE DD PA r.. _�y' - Located 384 Osgood Street ` R�TMENT F °Ternp`Durnp0 �ster on site�,iyes i - ,Located at 124 Main Streetk LFF ra Department ire t& Tyrl [ 'CN®MMENTS: '`",=ri�n.� i:{{rl .,b.,a ti�+rry, "•,s ,:a ::�.� � •i v f����� A ..�. .1:� .. 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 DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine w NOTES and DATA— (For department use) ® Notified for pickup Call Email Date Time Contact Name I 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 4. Building Permit Application Workers Comp Affidavit :rE Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work i Engineering Affidavits for Engineered products OTE: 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 OTE: 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 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 Doc:Building Permit Revised 2014 Location ' A No.I t Date • TOWN OF NORTH ANDOVER .m Certificate of Occupancy- $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ s TOTAL $ Check#� k Ing Inspector 29114 NORTH Town of ,� ndover 0 . . h ver, Mass, co I CNIWCK y1' 4�RATED S U BOARD OF HEALTH RM IT T 4- Food/Kitchen PE>' Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ............. ... ...C.�sr.. .W..!��.��ii�.............. .....r.LL.�......................................... has permission to erect .......... buildings on Q Foundation :1• ......a ad.....isr........... Rough 5 k.�. to be occupied as ... ... ...... ......T............ .........T6!!! ' ...................................... Chimney 'b provided that the person accepting this permit shall in every respect conform to the terms of the application Final y. 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 .Y r' E VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final ` PERMIT EXPIRES IN 6 MONT S ELECTRICAL INSPECTOR UNLESS CONSTRU N TS 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. i Smoke Det. Status: Reservation 11 Cushing PI Unit D Contract#: 5597 Chelmsford, MA 01824 www.twinbrospartyrentals.com Event Beg: Sat 8/1/2015 8:00AM Tents '* Tables * CkMm 978-337-9730 Phone Event End: Sat 8/1/201511:OOPM 070-337-0730 I Operator: Tim us omer50 Jeannie Grico 978-655-7455 Phone 999 Osgood St. North Andover, MA 01845 Ordered By: Jeannie Salesman: Justin Delivery and Pickup Delivery : Sat 8/ 1/2015 7:OOAM -8:30AM Contact: Pickup Date: Sat 8/ 1/2015 5:30PM Phone: Used at Address: 999 Osgood St. ; North Andover, MA 01845 Qty Items Rented Each Price 1 15xl5Ft.High Peak Frame Tent White $209.00 $209.00 Tent can be set up on grass,pavement,or a patio and requires an area of 16'x16'for installation purposes.If being set up on pavement or where we can't stake into the ground,make sure water barrels are on your order so we can anchor it down. 4 50 Gallon Water Barrel. $12.00 $48.00 6 6 Foot Banquet Table $8.00 $48.00 1 Delivery Green Zone $50.00 $50.00 1 Multi Rental Discount ($11.00) ($11.00) Discount 1 1Permit Fee $100.001 $100.00 I Delivery is normally scheduled two weeks prior to your rental date. Payments made on this contract: Rental/Sale Paid $50.00 7/9/2015 4:12PM Credit Card Amex x)=-xxxxx-42015 Auth:286505 Total $50.00 Rental Contract Rental: $294:00 Payment is due in full at time of delivery.We accept cash,or check at time of delivery.Checks can be made payable to Twin Bros Party Rentals.If paying by credit card please call at least 24 hours prior to your scheduled delivery date,so we can process your credit card.We will be giving you a courtesy call half an hour before we arrive for delivery and set-upl Sales: $100.00 Delivery Charge: $50.00 Subtotal: $444.00 Sales Tax: $24.62 Total: $468.62 Paid: $50.00 Amount Due: $418.62 Modification# 8 Printed On Tue 7/28/2015 9:29:48AM Software by Point-of-Rental Systems www.pointof-rental.com Contract-Params.rpt(1) � D - - I m V 1J OUMPSTERS 28� EXIST. 12" HDPE 35.0+ vrF 5 v+F Ih S L- 8, _0015 L=9' S=0.033 es l EXIST 2" 14 EXIST. C8#3 p EX/ST. OCS#2 RIM=128.51 . p INV OUT=125.41 R/M=129.0 \ h� EXIST. NO AIL SNF `� EX/ST. 12 HDP _ _ _ _ IN /N=123.7 9' L=25TS=0.034 D EXIST. 12" HDPE" /j�V OUT=124.7 �1� SNOW/SAL T SIGN AROE ZONE l IRIM= /ST. DMH#1 L=26' S=0.045- (TYP.) 32 + NON_pIS wAIER 9 127.51 ,w Sj0R1 � ,� vINV =12751 I EX/ST�DMH -� EXIST. WETLAND R/ 128.2 EXIST. S'TC#2 ❑ RULES SIGN (TYP.) ROM F V. OUT=125.11 , RIM=128..3 `r° (EMERGENCY �cp 2-12")INV. /N=124.25 uA IL/ GATE VALVE) (12")/NV. OUT=124.0 J EX/ST. CB# 0 �� k+* Lp 28 O° RIM=127.41 6� �� \ G1 1�0. � / V, /NV OUT=12511 W op 13 0� / ovo I U APPROX.. /NF07RA 770N SYSTEM 102 s'> 100 1%4 0 molo , � SOV EXIs"Ti PR07EC7ED,:, \ ®�, '� � v 0 _ I 1ti� MA/LSOXE� _ EX/ST. .CONCRETE CURB/NG 1,30.1 WE7ZAND iRE-SOURCE; na. H. A4EASIGN (TYP.) G, r NON_ v 100' f EXIST. CONC. SIDEWALK A NE �Ff\ \ GRASS / BUFFER STURB ZONEAr I � � � SjONE STONE C'� Zm EX/ST. I o + GAS LANDSCAPE UN/75 130 = t� METERS WALL 0 o Eamon 09 #1003 ROOF DRAIN BOLLARDS � ° Q a I A.C. EXISTING BUILDING (T?) P I IZ UNI T5 N( ME7ERS EL BOX \ - 132 0 EXIST. SMH#2 c LANDSCAPE RIM= H C 0 4, /NV /N=130.72 RAMP O h WALL /NV OUT=130.62 k \ I p / ROOF DRAIN \ k I / (TYP.) j 'hIS STONE RE AL / BW=134.7 _y 1W=-138.7 >�> 734 STONE STONE > COBBLE 141.0 CONC. S/LYALK EX/ST. CONC. SIDEWALK STONE A'AMP e EX/ST. CB#1RIM=06.21 `� I INV OUT=133.41 0 U�GN GRASS �o S,0.026 S EXIST. STC#1 738_ 1M �1 vG $ RIM=140.21 MULCH MULCH) I ------ �\ °` ��Qo (2-12")INV. IN=132.90 2�/NV. OUT=132.65 \ I \\ 1PPROX. " D ��6 EX/ST. CB#2 8 PICC SEWE,Q S -' EXIST. 12' HDPE L=90 S=O.006� ,�t� H.C. RIM=137.43 I \� I p EX/ST. DMH RAMP /NV OUT=133.7 GRASS I EMERGENCY - - - ° EXIST. 12" HDPE _ ° EX/ST. SMH#1 ) 1 >� ° R/M=137.28 GA 7� VALVE) JO L=110 S=0.007 ° INV /N=129.21 APPROX. /NF/L TRA 77ON SYSTEM #1 W o ` I EXIST. OCs#1 - -��-- INV OUT=129.06 MULCH 140� �+ - - - - CD � 668 R137.14 7Z /NV. IN=132.39 \ �0 INV OUT=132.39 l �° � / I �y-938 t EXIST. SLOPED GR /1F CURB/NG 8� EXIST. SLOPED GRAN/7F CURBING i 1tf 117.6 19.9 4' # GRASS -� GRASS MUCH `�- STREET -1 e 01 f: WIDTH) Certificate of Flame Resistance REGISTERED ISSUED BY Date of Manufacture FABRIC JOHNSON.OUTDOORS INC. NUMBER BINGHAMTON, NEW YORK 13902 11/3/2014 F-140.01 Manufacturers of the Finest Tent Products Described Herein This is to certify that the products herein have been manufactured from material inherently flame retardant as here after specified by the material supplier. NAME: Jeannie Grico CITY: North Andover,MA 01845 Certification is hereby made that: The articles described on this certificate have been manufactured with an approved flame retardant chemical in compliance with California State Fire Marshal Code, NFPA-701*, Underwriters Laboratory of Canada, and have been tested in accordance with the Federal Test Method Specifications and meet or exceed the Military Flame Specifications of MIL-C-43006G. 15x15 High Peak frame Tent,CAN/ULC-S108 Description of item certified: 15x15 High Peak Frame Tent Serial#017847 Flame Retardant Process Used Will Not Be Removed By Washina And Snyder Manufacturing, Inc. Manufacturer of Flame Retardant Vinvl Laminates TENT DEPARTMENT,JOHNSON OUTDOORS INC. *Large Scale Client#: 1045955 TWINBROS ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/28/2015 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(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: USI Rental Specialties CLPv"�"N Ext):888 489-7165 FAX 1616 Smith Road,Suite D E-MAIL A/c,No: 888 489-7105 Temperance, MI 48182 ADDRESS: 888 489-7165 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:St Paul Fire and Marine Ins 24767 INSURED Tim Aalerud INSURER B:Travelers Indemnity Co of CT 25682 dba:Twin Bros Party Rentals INSURER C: 11 Cushing Place Unit D INSURER D: Chelmsford, MA 01824 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 CONTRACTOR 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD MM/DD LIMITS A GENERAL LIABILITY ZPP15N8522A1547 5/01/2015 05/01/2016 EACH OCCURRENCE $1 000,000 X COMMERCIAL GENERAL LIABILITY PREMISES ERENTED occccur encs $100,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 XPOLICY PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED Per accident AUTOS AUTOS ( ) BODILY INJURY $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR L OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DE I I RETENTION$ $ B WORKERS COMPENSATION XEUB4106T24115 6/24/2015 06/24/201 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY L M TS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Inland Marine ZIM15N852671547 5/01/2015 05/01/201 Blanket: $350,000 Equipment Floater Deductible: $1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder is listed as additional insured/additional protected person or organization for general liability as per written contract. RE: 120 Main Street, North Andover, MA 01845 CERTIFICATE HOLDER CANCELLATION Jeannie Grico SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 999 Osgood Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S15877708/M14995951 LXSAH