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HomeMy WebLinkAboutMiscellaneous - 733 TURNPIKE STREET 4/30/2018 (17)�" - �� W v ER ** ! r F- C) O Q N co L a) O N W ti pC LL H y i U O. W F-L) 1V ° t .7 O 1 *** W m H 0 c N U a) L 0 4- c O U) N U) m 0 U ) o E o 0 o 0) c ocy� (n a) 0 Q N c a) •C a) m a) L a) f'7 '� J X ' 00 m E cu L cn U L '= c — E Q O (D o U) N Fn ,L .r cn O C) O a) > Q C: 0 *k Co c (n : 0 C: a) m 0 O "0 v (1) o 4-- vi In Q O N O 00 > X 0 M c c 0 Q a) I cO c 0 z .- (D U) N O O O U U 0 O) 1 Q~ O c� ) N C: a) ►-, () L I— 0c0 MfA to O c CV) L L CY a) 75 qD) ,6 0 > 0 w F- m w a w c U Z m U) O W o U Z C' J J J J Z W H Z F- C) O Q N co L a) O N W ti pC LL H y i U O. W F-L) I Q Q o W m H ) o E o 0 o 0) c ocy� (n a) 0 Q N c a) •C a) m a) L a) f'7 '� J X ' 00 m E cu L cn U L '= c — E Q O (D o U) N Fn ,L .r cn O C) O a) > Q C: 0 *k Co c (n : 0 C: a) m 0 O "0 v (1) o 4-- vi In Q O N O 00 > X 0 M c c 0 Q a) I cO c 0 z .- (D U) N O O O U U 0 O) 1 Q~ O c� ) N C: a) ►-, () L I— 0c0 MfA to O c CV) L L CY a) 75 qD) ,6 0 > 0 w F- m w a w c U Z m U) O W o U Z C' J J J J Z W H Z Location :7) .�& No. Date Check #P 3 5 � -f %J TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ '~ TOTAL $ Building Inspector cis tr rA ,Oj 9 boa' -a aA a]@ v .a�ppeda;� }••0 O 02 -log 0 catrA 00 C 00 G K—) c —Fan • M � "_u o CL 4 o cCL O m z CA tr rA ,Oj 9 boa' -a aA a]@ v .a�ppeda;� }••0 O 02 -log 0 catrA 00 C 00 G K—) S 9 10/10/15 Alyssa Cohen Dottie's Delight's DC 733 Turnpike St N Andover MA 01845 Dear Alyssa: As discussed, this letter gives approval to install a hanging sign under the overhang in front of the doors to your shop at Jasmine Plaza. The sign shall be similar in size and style to the attached design. Thanks Dotglas R Locke Turnpike Flagship LLC 359 Main St Suite 220 Haverhill MA 01830 978-337-9367 CC Sign Tech Inc. #/ Date................ ...................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......... 64. ?..... (�.��.4.A..... /e :. ........... :..................... has permission to perform .... '... fj�...4ve....................................................................... wiring in the building of........... /t�.. /... °.,��....... hh-A /.f ........................................ at ...... .?..��..�......... 1../„�.✓..i'. P1. ke.........�.... �... ..... ...... ..... . No hAn, over, Mass. Fee i Lic. No. ham-'` ' Check it ELEc � CAL INSPECTOR o ?3� � 2 �f� t* is C. /� //�� ►r �/�j Official Use Only OEMCom»wnwaa/ o� //Ia isacad ® Permit No. - - a[Jepartmerct o��ire �eruices Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev.1/071 leave blank) APPLICATION FOR PERMIT T0. PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT RV INK OR TYPE ALL INFO TIO Date: City or Town of: Qwnif To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) I Urf) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes (� Purpose of Building I No ❑ (Check Appropriate Box) Utility Authorization No. Existing Service ;OU Amps /Q / Volts Overhead ❑ Overhead ❑ New Service Amps / Volts Number of Feeders and Ampacity C,) t�( Location and Nature of Proposed Electrical Work: L/ IT Undgrd ❑ Undgrd ❑ No. of Meters No. of Meters MQ lite 00 0 e`r .-.Jr, /L crrd!m Com letion 0 the Aliowin table ma be waived b t/te In ector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans o. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above o In -El Swimming Pool rnd. rnd. 15Ba-0' o Emergency Lighting ttery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Detection and No. of Switches No. of Gas Burners Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices Heat Pump umber ons KW No. of Self -Contained No. of Waste Disposers Totals:r _ _ Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal ❑ Other Local ❑ Connection No. of Dryers Heating Appliances KW Security stems:- No. of Devices or Equivalent No. of WaterKW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Te ecommunicationsiring• No. of Devices or E uivalent OTHER: h 1 W' Attach additional detail f desired, or as required by t e nspector of Tres. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cov rage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains acrd penalties of perjury, that flee information on this application is true and completes FIRM NAME: P4A1U 77� CJf-C+f1L LIC. NO.:.,2/0'?J Licensee: Signature _ LIC. NO.: (Ifapplicable, enter "exempt" in,,he I'cense ber,line.) Bus. Tel. No., 978` %Sr Address: % / c1t9SSC LJ'tC-irt1$ Diva Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. * By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent Owner/Agent PERMIT FEE: S ZJ Signature Telephone No. W% � 11 i Is 1• E.Ljp,tmt 382 Date. .!. ........ TOWN OF NORTH ANDOVER PERMIT FOR MECHANICAL INSTALLATION t � This certifies that t : �' ' �' }C .. '........ • . F has permission for mechanical installation CICL . �. in the buildings of .. I�c � S „ ► :? � , '�" 11, k; . at .?...�...,. �. f.'.�; , �.�.�- .... ?� ....... , North Andover, Mass. Fee...:..... Lic. NO `I ... ......................... . I''1r GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Commonwealth of Massachusetts Sheet Metal Permit Date I� Estimated Job Cost: / Plans Submitted: YES V NO Business License # Business Information: W Name: 7�Eek �)ul. " ') Street: ... City/Town: 30�40)1-114 w 6Telephone: (61 2- � 4 Permit # b Permit Fee: $ Plans Reviewed: YES NO Applicant License # 2-5 2A Property Owner / Job Location Information: Name: Street: _ ) �-0 - City/Town: Alv 01H, q J Telephone: Photo I.D. required / Copy of Photo I.D. attached: YES NO Building Type: Residential: 1-2 family Multi -family Condo / Townhouses Comm ercial:Office Retail Industrial Educational Institutional Building Cubic Footage: under 35,000 cu. ft. —Z over 35,000 cu. ft. Sheet metal work to be completed: New Work: Renovation: s HVAC Metal Roofmg Kitchen -Exhaust System Chimney / Vents Provide brief description of work to be done: INSURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch.112 Yes 6o ❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance' policy V Other type of indemnity F1 Bond ❑ OWNER'S INSURANC 'WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts Gene I Laws, a4� that my_sigdature on this permit application waives this requirement. Check One Only Owner U/ Agent ❑ of Own tr or Owner's Agent By checking this box0, I 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 Progress Inspections Comments a Final Inspection Date Comments Type of License: By ❑ Master Title ❑ Master -Restricted City/Town ❑Journeyperson Sig ature of Licensee Permit # D ourneyperson-Restricted License Number: Fee $ ❑ Check at www.mass.gov/dpi Inspector Signature of Permit Approval 4.: Sheet Metal Commercial Guidelines / Life Safety / Critical Systems Inspection Checklist Yes No N/A., 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 journeyperson-to-apprentice ratios Fire dampers with access door properly 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 cleanouts. Proper cle2l`ances, fire rated enclosures and pressure testing required. installeti =hr'li required oir equipment and d?=, ti . "'•4• — — a% : Duct penetrations in fire's atcrali:r and floors sealed Metal roofing systems installed watertight using proper materials and fasteners Flexible duct runs 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 (final inspection) Testing and Balancing report complete (final sign -off) Sheet Metal Residential Guidelines / Inspection 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 joumeyperson-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 8'-0" Flexible duct runs installed 14'-0" maximum length 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) N The Commonwealth of Massa chusetts M (Department of IndustrialAccidents I Congress Street, Suite 100 Boston, M4 02114-2017 t yrs www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name Address: City/State/Zip: hA A 0 2 t Z-) Phone #: A.re y an employer? Check the appropriate box: Type of project (required): 1. am a employer with _employees (fiill and/or part-time).* 7. E] New construction 2. ❑ I am a sole proprietor or partnership and have no employees working for me in 8. E] Remodeling any capacity. [No workers' comp. insurance required.] 9. ❑ Demolition 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t ❑ 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers' compensation insurance or are sole 11. ❑ Electrical repairs or additions proprietors with no employees. 12.E] Plumbing repairs or additions 5. I am a general contractor and I have hired the sub -contractors listed on the attached sheet. ❑ � 13. [] Roof repairs These sub -contractors have employees and have workers' comp. insurance.$ 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 14. ❑ Other 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who subniif this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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-coniraciors 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. .�. f 7— Insurance Insurance Company Name: Policy # or Self -ins. Lie. #.. 2 Expiration Date: V Job Site Address: � ` l��- City/State/Zip:Q Attach a copy of the workers' compensate n policy declaration page (showing the policy number and expiratio date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-yimprisonment, as well afivil penalties in the --form of a STOP WORK ORDER and a fine of up to $250.00 a day against th violator. Apy of this sement a forwarded to the Office of Investigations of the DIA for insurance coverage verifi atic \ 1 C I do hereby cert ui r tli �insaltles ofpeijury that the information provided a ovj�e is rue an rcorrect. Cio-nnfiira• Date: 1 v 1 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Issuing Authority (circle one): 1. Board of Health 2. Building Department 6. Other Permit/License # 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of liire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill- out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and -phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents foi• confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia Date: September 3, 2015 For: Subcontract Agreement Dottie's Delights 733 Turnpike Street North Andover, MA Contractor: Dan Bernatas Construction Services 3 Foundry Street Amherst, NH 03031 Subcontractor: Eagle Food Service Equipment and Supplies 163 Old Colony Ave. Unit B South Boston, MA 02127 Project: Dottie's Delights 733 Turnpike Street, Unit 7 North Andover, MA Work to 'be preformed: <� Construct and install kitchen hood exhaust fan and make-up air per plans and (�{specifications by BLW Engineers, 311 Great Road, Littleton, MA, plans M-1 through M- l 6, dated July 31, 2015. Work to include labor and materials, permits and exhaust and make-up, hood, ductwork, -se rials sul system, and all work necessary to make a fully functioning system as shown on drawings. Work by others: Line voltage, gas connection, carpentry. Work to be preformed for the sum of $17,531.25 Dan Bernatas Dan Bernatas Construction Services/, Wesley Huang Eagle Food Service Equipment If- EAKIT-1 OP ID: LL ,acoRL7° CERTIFICATE OF LIABILITY INSURANCE `—^"'� DATE 10/07/207/20 15 6 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 Richard Soo Hoo Insurance 1148 Washington St, Suite 1 Boston, MA 02118-2108 CONTACT Richard Soo Hoo NAME: A/CONNo Ext : 617-338-8168 A/c Nol: 617-338-1148 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Insurance EACH OCCURRENCE $ INSURED Eagle Kitchen Supply, Inc. 163 Old Colony Ave. Boston, MA 02111 INSURER B INSURER C : INSURER D: LAGGREGATELIMITAPPLIESPER: POLICY ❑ J RECT LOCPRODUCTS M'OTHER: INSURER E: - COMP/OP AGG $ 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 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 LTR OF INSURANCE L ADDTYPE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYW LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR 120 Main Street North Andover, MA 01845 / �� EACH OCCURRENCE $ qTE PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ LAGGREGATELIMITAPPLIESPER: POLICY ❑ J RECT LOCPRODUCTS M'OTHER: GENERAL AGGREGATE $ - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT $ Ea accld.n BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per acc dent UMBRELLA LIAB EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, be under DESCRIPTION OF OPERATIONS below N / A UB -2A79297-8-15 06/07/2015 - 06/07/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Hood/Exhaust installation: 733 Turnpike St. North Andover, MA 01845 CERTIFICATE HOLDER CANCELLATION TONOAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. North Andover Town Hall AUTHORIZED REPRESENTATIVE 120 Main Street North Andover, MA 01845 / �� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD A I a