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HomeMy WebLinkAboutMiscellaneous - 1060 OSGOOD STREET 4/30/2018 (18) Date.......�1./ � ....... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION CHU Tbis certifies that ... .......................................... has permission for tallation ............................................................................ in the buildings of ........... ....... ............ 0'tt An d o v e r^, M'a'ss. at...1660 .................................................. Fee... ...... Lic. No./ Sb....... ..................................................................... Check#1662 GAS INSPECTOR i MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY - M __ MA DATE: o Sr PERMIT# M06 JOBSITE ADDRESS_ N°iVr..__.._OWNER'S NAME TAX- OWNER ADDRESS __ Q ��_ /q�dc G 1: _ TEL:- _.. _ ._._._ Fes IF TYPE OR ' OCCUPANCY TYPE COMM IAL: EDUCATIONAL..' RESIDENTI ^, PRINT CLEARLY- NEW:- RENOVATION:: REPLACEMENT:: _= PLANS SUBMITTED: YES N0-i APPLIANCES 1 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER --- COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE _- ; - - - -- - - ---- --3 --- -- ___- =- --- " FRYOLATOR FURNACE GENERATOR GRILLE -_ ._ _ --=— —� INFRARED HEATER _ --- ---= _-- -- -- — - - LABORATORY COCKS _ MAKEUP AIR UNIT ' OVEN fi POOL HEATER = ROOM lSPACE HEATER ROOF TOP UNIT TEST ---_- - ---- ---- - ---- - --�;--- --�.-- -- ---;- - - __ __ UNIT HEATER UNVENTED ROOM HEATER f iiWATER HEATER OTHER INSURANCE COVERAGE I have a current liabil' insurance policy or its.substantial equivalent which meets the requirements of MGL.Ch.142 YES 1. NO -_ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY- OTHER TYPE INDEMNITY BOND j - OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement CHECK ONE ONLY: OWNER ° .. AGENT, -. SIGNATURE GENT:_SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information l have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance'viiffi all Pertirlent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General taws. PLUMBER-GASFiTTER NAME:Kevin Scott LICENSE#- 13258 SIGNATURE MP MGF: JP _ JGF. ' LPGI: CORPORATION ,:# 2438 PARTNERSHIP #_ LLC __.;# COMPANY NAME:.Kevin Scott Plumbing&Heating INC. i ADDRESS P.O.Box 446 CITY _Wilmington" _ — - STATE MA ZIP 01887 .TEL.978-988-3632 FAX.978-694-9977 CELL;978.479-8966 :EMAIL kevplumbing@comcastnet I I ��1 �� a���' i i i ., �, _�,� -: OMMONWEALTH OF MASOF S PLUMBE#��:`<`€�tND t ASF ITTEA5:>>` ISSUES THE FOLLOWII. :F=1 CENSE,t_; I{8 >I> 1D AS A PLIIMING CURFv». : .:.,KEMA—N" A SCOTT n <{tVIfiI SCO',.T 't ' HTG INC -'>:- ... _ PO B0XX4k6>" W "iGTON 87-046;_: .;; 99499 ,u»COMMONWEALTH OF MSAHtSETTS>:> <'{2 PLUMBER'S>lItD OASFITTERS- ISSUESHE FQLLOW , #J <>:: f CEK SE: , T HS At AS A MASTER RLUMBERL.F`>a " <_.. ... '�_�,Ian A..SCOTT PO BOX:`446 l!iGTON MA`01887-044 `;:::» 214840 ># The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations s {+ 600 Washington Street ° = Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AvRlicant Information Please Print Legibly Name(Business/Organization/individual): 1 Address: - o L4k 4A City/State/Zip: Phone #: Are you n employer?Check tW appropriate box: Type of project(required): 1. I a employer with 1_ 4. 0 I am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance.t 9. ❑ Building addition comp.[No workers' comp.insurance P- required.] 5. ❑ We are a corporation and its 10.❑ lectrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] 'Any applicant that checks box#1 must also rill 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. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: ,S Policy#or Self-ins. Lic.#: Expiration Date: A 1 W Job Site Address: O (D O City/State/Zip: —J64 &Jvft Attach a copy of the workers'compen tion 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. I do hereby certify under the pains and penalties of perjury that the information provided ab ve is true and correct. Si ature: / Date: Phone#: yM' b Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# 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 M i Al ORE® ATE(MMfDMTYYY) CERTIFICATE OF LIABILITY INSURANCE D5/26/2015 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 poiicy(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 NCA FACT Kelly Sturtevant, CIC,CISR TGA Cross InsuraAce, Inc. PHONE ----(781)914-1000 No:(781)224-5777 401 Edgewater Place ADols.ksturtevant@tgacross.com Suite 220 INSURER(S)AFFORDING COVERAGE NAIL# Wakefield MA 01880 INSURERA:The Netherlands 124171 INSURED INSURER B Excelsior _ _ 11045 Kevin Scott Plumbing & Heating Inc. INSURERC:Peerless Ins Co 24198 PO Box 446 INSURER O: } Kevin Scott INSURER E: Wilmington MA 01887 "- -- INSURER F• I COVERAGES CERTIFICATE NUMBER:CL1552639530 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. INSR POLICY EFF POLICY EXP LTR i TYPE OF INSURANCE �DbLjSno POLICY NUMBER MM/D MMID LIMITS X COMMERCIAL GENERAL LIABILITY i ! t ( EACH OCCURRENCE S 1,000,000 A j CLAIMS MADE XjOCCUR DAMAGE TO RENTED — — I X ?{CBP3185448 i �P-REM—ISE$—(Ea-occurrenceS 300,000 5/15/2015 _ 4 5/15/2016 M � I EO tOCP(Arty one person) ,S. 15,000 PERSONAL 8 ADV INJURY S 1,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE` S — 2,000'000 ! X 1 i POLICY�jE L_J LOC ` I I PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: ( ( j C005 g AUTOMOBILE LIABILITY ( I I { i COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO I I (Ea Rd) B BODILY INJURY(Per person) S ALL OWNED 1 SCHEDULED ! ( - AUTOS X AU70S 1!»185446 5/15/2015 j 5/15/2016 BODILY IN URY(Per accident) S NON-0WNED I X I HIRED AUTOS X j AUTOS ( { PROPERTY DAMAGE S -- r—� � Per accident) j X UMBRELLA UAB OCCUR i i EXCESS LIAR L� ( )EACH OCCURRENCE 15 1,000,000 C I i CLAIMS-MADEI AGGREI GATE S 1,000,000 1 DED 1 X 1 RETENTIONS 10,000 1 CUB777929 5/15/2015 5/15/2016 ii S WORKERS COMPENSATION ,STATUTE1 I ETH E _ AND EMPLOYERS'LIABILITY Y I N j j i j C 1 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? I E.L. ,�)N I A!1 I LE.L.EACH ACCIDENT S 500 000 (Mandatory In NH) I { j WC3185445 ( 5/15/2015 1 5/15/2016 E.L.DISEASE-EA EMPLOYE S 500,000 es,describe under i I` + Ij __ DIf ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 II I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) " r CERTIFICATE� HOLDERCANCELLATIONCANCELLATION Qwy� J ' `A`J�f SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE iii THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORMED REPRESENTATIVE Thomas Gregory/SP3 IL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(2o14o1) Location moo No. �a—�`� Date `P't , • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ -- Building/Frame Permit Fee $ Foundation Permit Fee $ -•� Other Permit Fee 5; (%J $ " TOTAL $ Check# 2-tl-5 U Auilding Inspector i ,� ' F SORTH q Q .It L E D 116 �IO ti zto TOWN OF NORTH ANDOVER � CoATED"c SIGN PERMIT ACHU`-►���y DATE: June 10, 2015 I I PERMIT: 022-15 THIS CERTIFIES THAT has permission to erect three signs on 1060 Osgood Street 1- 11x120 "Hair Removal" and 1 — 11x120 "Care-Laser" and 1 directory siqn 12 inches by 30 inches "Care-Laser" provide that the person accepting this Permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section #6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED nspe for of Buildings Amount Paid:$60.00 Check 2073 Receipt 28904 SIGN PERMIT APPLICATION a 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER David Samuels Site Owner Charles Raz, Signs Now NH 603 635-2292 1060 Osgood Applicant Tel Site Address 1111 by 12011 Size of Proposed Sign Man Parcel Illumination: a) Not illuminated How attached: a) Against the wall b) Internally illuminated b) Roof c) Externally illuminated c) Ground d) Other Materials: HDU Sign Board and vinyl to match existing signs and colors . Proposed Colors: Background Dark Green Lettering Gold Border Gold Cost of Sign $1000 Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until an Photographs of building application on the appropriate form furnished by the Sign Office has been filed Material sample with the Sign Officer containing such information including photographs, plans Color sample and scale drawings, as he may require, and a permit for such erection, alteration, Site or Plot Plan (Required for all free-standing signs) or enlargement has been issued by him. Such permit shall be issued only of the Drawings of proposed sign Sign Officer determines that the sign complies or will comply with all Other, specify applicable provisions of the By-Law. Will sign overhang any public road or walkway Yes ( ) No (k) i If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: LA, `1�j Receipt # ?SS�tOq Check Revised 10.31.2006Form Sign Permit Application SIGNAT RE OF APPLICANT APPROVED BY SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER i David Samuels Site Owner Charles Raz, Signs Now NH 603 635-2292 1060 Osgood Applicant Tel Site Address 1111 by 12011 Size of Proposed Sign May Parcel Illumination: a)Not illuminated How attached: a) Against the wall b) Internally illuminated b) Roof c) Externally illuminated c) Ground d) Other Materials: HDU Sign Board and vinyl to match existing signs and colors . Proposed Colors: Background Dark Green Lettering Gold Border Gold Cost of Sign $1000 Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until an Photographs of building application on the appropriate form furnished by the Sign Office has been filed Material sample with the Sign Officer containing such information including photographs, plans Color sample and scale drawings, as he may require, and a permit for such erection, alteration, Site or Plot Plan (Required for all free-standing signs) or enlargement has been issued by him. Such permit shall be issued only of the Drawings of proposed sign Sign Officer determines that the sign complies or will comply with all Other, specify applicable provisions of the By-Law. Will sign overhang any public road or walkway Yes ( ) No !k) If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: ( � Receipt# Check# Revised 10.31.2006Fonn Sign Permit Application SIGNATURE OF APPLICANT APPROVED BY :JA E Qty:(1)Single-Sided 11"x120"Carved&Painted 1.5"Sign Foam _0 a r > r t t1i r fi tii - — ..IIA. 4 � t t E � C 1 Qty:(1)Single-Sided 11"x120"Carved&Painted 1.5"Sign Foam Un � .� { __..m_. .tom-•.�. fi l i t i f I t I t III. 7. IY � a Care-Laser Hair Removal Care-Laser.FS 5.27.15 J.D. ba— s E r Qty: (2) .040 Alum Panels Decorated with Ivory & Green Vinyl CARE- LASEIR Roberts FALAFEL, Insurance CAFE & GRILL Qty: (1) Ivory & Green Vinyl Patch for Single-Sided Parking Sign LOCAL CARE-LASER DRY CLEANERS R R R Rid-All CARE-LASER Pest Control f Power Yoga n KarateEvolution j CARE-LASER Advanced Fuel Solutions 1 •• 1I cuslow Re No.: Date: Care-Laser. .27.15 ° "p"°"` Care-Laser Hair R FS 5 tomwy: Order OEM: Salesperson: J.D. � Ad*m: &Ipn OkMnelone: E•dm•te: Cly: SteIYZIP. Commenm: I` Plane: • :• i� ••' 1 1 ill �� 1 • 1� I • • • • • it• •t •tl Fax ! --I07 t Chuck Raz From: Maral Ghahramanlou <Maralg@care-laser.com> Sent: Thursday, June 04, 2015 1:06 PM To: Chuck Raz Subject: FW: For Dr. Samuels approval See below Thank you! Sorry again about my confusion with the dash and the hair removal Maral Ghahramanlou Vice President of Operations, MA -re Hair Removal 1060 Osgood St. North Andover, MA 01845 Mobile: (248)469-5147 Email: maralg@care-laser.com From: David Samuels [mai Ito:DrDSamuelsOaol.com] Sent: Thursday, June 04, 2015 1:06 PM To: Maral Ghahramanlou Subject: Re: For Dr. Samuels approval Approved David S.Samuels, DMD Sent from my iPhone On Jun 4,2015,at 1:03 PM, Maral Ghahramanlou<Maralg@care-laser.com>wrote: Great!Thank you Just say approved Maral Ghahramanlou Vice President of Operations, MA 1060 Osgood St. North Andover, MA 01845 Mobile: (248)469-5147 Email: maralg@care-laser.com , On Jun 4, 2015,at 12:55 PM, David Samuels<DrDSamuels@aol.com>wrote: They look great. What do you need me to do? David S.Samuels, DMD Sent from my iPhone On Jun 4, 2015, at 12:09 PM, Maral Ghahramanlou<Maralg@care-laser.com>wrote: 1 Hi Dr Samuels, Please see attached can you approve this signage so the sign company can obtain permits. Thank you Maral Ghahramanlou Vice President of Operations, MA <image001.jpg> 1060 Osgood St. North Andover, MA 01845 Mobile: (248)469-5147 Email: maralg@care-laser.com <Care Laser (Building Signs).jpg> <Care Laser (Pylon& Parking Signs).jpg> • 2 • 1 N{lRTFj . �4g4e0 ltd F� by1e 4 rt O� r NORTH.AMOVE7�R.IBM-DINGDEP"D ENT gttenF .LS ,1600 Osgood Street North A.ridover , Tel: 978-698-9545 Fax: 979-688-.9542 BUSMS,SFO"F01?TOWN CLEW DATP- 0q NAS: �. Ct,�r (, I agar 0 CA ADDRESS; Q SCA � ,®z -GDISTRICT: TYM OFDUSINESS-, �0`��,� �c �f q-Q�j ('-ye)rJ\(Q'S DUZLDI GLAYOUTPROVEDED: YES NO AVAMARLE PARKIN SPA 'M: ZONMGBY LA.W USAGE: 'ES NO BUI.DWO INMYCTOR�TGNA.TUPX BUSMSSFORMFOR MVMCLERK . i ZAO Rome Occupation(1989132) .An accessory use conducted within a dwelling by aresident who :resides in the dwelling as his principal address, which is clearly secon&y to the use-of the-bdding for living piuposes. Home occupations shall 'incIiide,"bu"t iiot'limited to the following uses; personal services such as fbxnished by an artist or instructor, but not occupation involved oath motor 'vehicle repairs, beauty parlors, animal kennels, or the conduct of retail business,or the manufacturing of goods,which impacts the residential nature of the neighborhood;` d. For use of a dwelling in any residential district or multi-family district for a home occupation,tho following conditions shall apply: a. Not more Haan a total of three (3) people may be occupation, one of whom shall be the.owzier ofthe hbpie occupation.and residing in said diwlfing; b. The use is carried on strictly withintbe principal building; c. There shall be no m-forior alterations, accessory buildings, or display which are not customary= with residential buildings; . d. Not more than twenty'five(25) percent of the cxisfhg gross floor area of iho dweMng unit. so used, not to exceed one thousand (1000) square feet; is devoted to'such use. fn connectionwith such use,there is to be kept no stock in trade, commodities or products which ocoupy space beyond these limits; e. 'There will be no display ofgoods or wares visible from the street; f The building or premises occupied spall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the ederior appearance, emissid of odor, M smoke, dust, noise, &Aufbance, or in any offier way become objectionable or detrimental to any residential use withk the neighborhood; g. Akv such building shall include no features of design.not cust6maq in buildings for residential igraature Date Chtxklaz From: Maral Ghahramanlou <Maralg@care-laser.com> Sent: Thursday, June 04, 2015 1:06 PM To: Chuck Raz Subject: FW: For Dr. Samuels approval See below Thank you! Sorry again about my confusion with the dash and the hair removal Maral Ghahramanlou Vice President of Operations, MA »% -ffo- Hair Removal 1060 Osgood St. North Andover, MA 01845 Mobile: (248)469-5147 Email: maralg@care-laser.com From: David Samuels [mailto:DrDSamuels@aol.com] Sent: Thursday, June 04, 2015 1:06 PM To: Maral Ghahramanlou Subject: Re: For Dr. Samuels approval Approved David S.Samuels, DMD Sent from my iPhone On Jun 4, 2015,at 1:03 PM, Maral Ghahramanlou <Maralg@care-laser.com>wrote: Great!Thank you Just say approved Maral Ghahramanlou Vice President of Operations, MA X 1060 Osgood St. North Andover, MA 01845 Mobile: (248)469-5147 Email: maralg@care-laser.com On Jun 4, 2015,at 12:55 PM, David Samuels<DrDSamuels@aol.com>wrote: They look great. What do you need me to do? David S. Samuels, DMD Sent from my iPhone On Jun 4, 2015, at 12:09 PM, Maral Ghahramanlou<Maralg@care-laser.com>wrote: i 1 Hi Dr Samuels, Please see attached can you approve this signage so the sign company can obtain permits. Thank you Maral Ghahramanlou Vice President of Operations, MA <image001.jpg> 1060 Osgood St. North Andover, MA 01845 Mobile: (248)469-5147 Email: maralg@care-laser.com <Care Laser (Building Signs).jpg> <Care Laser (Pylon & Parking Signs).jpg> 2