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HomeMy WebLinkAboutMiscellaneous - 39 Water StreetLocation No. v Date 4�9Z e�6-V' �� TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Fra.me Permit Fee Foundation Permit Fee n+k— D-4 Cnn Check 31003 Commonwealth of Massachusetts Date :—.216 �/% Estimated rob Cost: Plans Submitted: YES NO Business License # c / 7 Sheet Metal Permit Business Information: Name: 5 Street: Wl ft e City/Town: Telephone: Permit # Permit Fee: $ Plans Reviewed: YES NO �4- Applicant License Property Owner / rob Location Information: Name: ` G44 Al GA Street: City/Town: /✓ Telephone: %79 Z dZ - , L06 6 Photo I.D. required / Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family Multi -family Condo / Townhouses Cpmmercial:Office Retail Industrial Educational Institutional Building Cubic Footage: under 35,000 cu. ft. ',�' over 35,000 cu. ft. Sheet metal w to be completed: New Work: Renovation: HVAC Metal Roofing Kitchen -Exhaust System Chimney / Vents Provide brief description of work to be clone: INSURANCE COVERAGE: I have a current Iiabilif insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes ❑ No ❑ If you have checked Yes, indicate th pe of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent I Signature of Owner or Owner's Agent By checking this box[], 1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Date Date By Title aityTrown 'ermit # =ee $ nspector Signature of Permit Approval Progress Inspections Comments Final Inspection Type of License: ❑ Master ❑ Master -Restricted ❑Joumeyperson ❑Jo urneyp erso n -Restricted Comments Signature of Licensee License Number: Check at www.mass.gov/dpi t' INSURANCE COVERAGE: I have a current Iiabilif insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes ❑ No ❑ If you have checked Yes, indicate th pe of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent I Signature of Owner or Owner's Agent By checking this box[], 1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Date Date By Title aityTrown 'ermit # =ee $ nspector Signature of Permit Approval Progress Inspections Comments Final Inspection Type of License: ❑ Master ❑ Master -Restricted ❑Joumeyperson ❑Jo urneyp erso n -Restricted Comments Signature of Licensee License Number: Check at www.mass.gov/dpi c9 Sheet Metal Commercial Guidelines / Life Safety / Cxztical Systems inspection Checklist Ybs No , NIA, Set of stamped engineering documents and detailed description of mechanical system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper joumeyperson-to-apprentice ratios .Fire dampers with access doorproperly installed and checked for operation . . Smoke and combination fire / smoke dampers with access doors properly installed - actuator checked for proper operation (May also be verified by fire department during fire alarm testing) Duct smoke detectors with access doors properly located (May also be verified by fire department during fire alarm testing) Smoke / atrium exhaust systems installed and operation verified (May also be verified by fire department during fire alarm. testing) Stair pressurization systems installed (where required) and operation verified (May also be verified by fire department during fire alarm testing) _ Grease / kitchen hood exhaust system installed with all seams and connections welded airtight with properly located cl.eanouts. Proper clE2, anees, fire rated enclosures and pressure testing required: , _:, SF*° �c ke�,..atsstalir Orli z quxred `on equipment and Duct penetrations in fire anfla6rs fisealed Metal roofing systems installed watertight using proper materials and fasteners Flexible duct reins installed 6'-0" maximum length Ductwork installed using proper hanger spacing, hanger stock, threaded rod and angle iron Ductwork / plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining Volume dampers installed for each supply air branch duct New/clean - properly sized filters installed (finial inspection) T, ef;nrr anri PsIn-nni-n cr rennif ramnZete (final sim-off) Sheet Metal Residential Guidelines I Thmection Checklist Yes No N/A Detailed description and sketch of sheet metal system to be installed has been provided All workers performing sheet metal work onsite has valid Massachusetts sheet metal license All sheet metal work being performed with proper journeyperson-to- apprentice ratios Equipment sized per heating / cooling load calculations Duct work sized per manual "D" calculations Bath / shower rooms contain mechanical exhaust fan vented outdoors 'Electric dryer exhaust properly installed maximum total run 35'-0", maximum flexible run T-0" Flexible duct runs installed 14'-0" maximum Iength Volume dampers installed for each supply air branch duct Ductwork installed using proper gauges and hangers Ductwork/ plenum connections sealed substantially airtight Ductwork insulated by means of external covering or internal lining New/clean - properly sized filter installed (final inspection) Testing and Balancing report complete (final sign -off) .I TOTATEM-01 LCARUSO Ac°oRo� CERTIFICATE OF LIABILITY INSURANCE �..� DATE(MM/DONYYY) 9/28/2016 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: Af 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 Salem Five Insurance Services, LLC 445 Main Street Woburn, MA 01801 - - CONTACT NAME: PHONE FAX A/c No.Ex<:(781) 933-3100 A/C No: (781) 933-9048 E-MAIL insurance.services@salemfive.com - 'INSURER(S) AFFORDING COVERAGE MAIC q INSURERA':.OhiO Security Insurance C.O. _ INSURED .', =! .: ., _ ; c , .. _. •• :• Total Temperature Control Inc ,.-.INSURERC:.. .. 39: West Water Street ': • Wakefield, MA 01880 .. .. _..-... INSURER B: American Fire &Casualty.: Co - 24066 A .. .. .. INSURER D '.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:ABOVEFMTHE .POLICY PERIQDr- INDICATED: NOTWITHSTANDING ANY REQUIREMENT, .TERM!,Ok' ICONDITION'OF',ANY.CONTRACT OR OTHER DOCUMENT."WITH RESPECT.TO WHICH -THIS, 'CERTIFICATE-MAY`SE tISSUEDaOR1MAY PERTAIN', THE INSURANCE AFFORDED BY.kTHE POLICIES DESCRIBED- HEREIN IS-SUBJECT:'TOALL THE TERMS E=XCLUSIONS AND CONDITIONS ORSUCH POLICIES. LIMITS SHOWN:MAY HAVE BEEN REDU.CED.BY PAID CLAIMS. INSR -LTR : - ' . -' �" - _.TYPE OF INSURANCE Y, INSD WVD. �. POLICY.,NUMBER -.' POLICY EFF - MM/DD POLICY EXP : MMIDD/YYYY , a; LIMITS ',.. A X COMMERCIAL'GENERAL LIABILITY, •t n / EACH OCCURRENCE $ '. -1,000,000 CLAIMS -MADE T OCCUR z BKSS6291199.. 09/18/2016 09/.18/2017 PREMISES Ea occurrence $ ? 100,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 ` ' GEN L AGGREGATE LIMIT APPLIES�PER GENERAL AGGREGATE.-- $ >' 2,000,000. X, POLICY +*' jE LTOCtlt �' t - •.PRODUCTS `COMP/OP AGG.. $ 2,OO.OyOOO ,. OTHER $... AUTOMOBILE LIABILITY - COMBINED 'SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) '$ B ANY AUTO BAA56291199 09/18/2016 09/18/2017 ALL OWNED .X SCHEDULED - BODILY INJURY (Pec accident) $ 'AUTOS AUTOS PROPERTY DAMAGE $ Per accident NON -OWNED X X HIRED AUTOS " AUTOS-_, P _ _ _ .� A.- w,}XS�'� EACH OCCURRENCE.• 1,000,000 EXCESS uABa CI AIMS MADE ' US056291199 09/18/2016 09/18/2017 AGGREGATE $ 1,000,000 " .. � ;DEDF ,X;;RETENTION$ 10,000. $ ` WORKERS'COMPENSATION - - --=• ,-. ., -° ER ' .OTH • X S - STATUTE " ER . -A! • AND EMPLOYERS LIABILITY, ANY PROPRIETOR/PARTNER/EXECUTIVE YIN . OFFICERIMEMBER EXCLUDED? a 'N / A - - XWS56201199 ' t -: : 'x .-:09/18/2016 - -" _. 09/18/2017. "E.L': EACH ACCIDENT• $ .1,000,000 -E:L. DISEASE- EA EMPLOYE $ 1,000,000 (Mandatory In NH) •'`-.. -.. _.:: .. - _-.. '-' If yes, describe under ._ -• DESCRIPT.IONOF.OPERATIONSbelow - ---' _ `"'- '�:•'. �•- -• E.L. DISEASE- P.OLICYLIMIT �$,:�..,•. .. -1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /.VEHICLES• (ACORD 101; Additional Remarks Schedule, maybe attached If more space:Is.requlred) :::-• g �: ,., _ :;, • - ...- C`COTICI!`ATF LJAI 111=0 L , CAMRFI I "ATIAM © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION' DATE: THEREOF, NOTICE WILL BE DELIVERED IN of Boston City _ . +'.'r.. ACCORDANCE WITH THE POLICY. PROVISIONS. 1010 Mass Ave Boston, MA 02118 AUTHORIZED REPRESENTATIVE - n / © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD m w I