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Home My WebLink AboutWelding Permit - Permits - 100 WILLOW STREET 10/15/2019 1 _ LJ�G �0/l9?/j920�9iflLP.f�ili(if2 r��l��G�fil'IrLl�1P� Application for Standard Permit FP-006 Return completed application to: 41 (Rev.1.2018) Permit Number; DIG SAFE NUMBER City or Town: North Andover Start Date: Date:10/15/19 In accordance with the provisions of M.G.L.Chapter 148, as provided in Section 1 OA -application is hereby made by SL Chasse Steel QQ3-8H-34aQ (Full Name of Person,Fimi or Corporation) (Phone Number) of 8 Christine Dr,Hudson NH (Address:Street or P.O.Box,City or Town,Zip Code) for permission to(state clearly purpose for which permit is requested) Perform cutting and/or welding at the address listed below. All applicable portions of 527 CMR 1.00 Ch 41 and NFPA 51 B codes and/or standards must be foltowed.A 4 hr fire details]may be req'd by NAFD Proper extinguisher and/or hose must be provided by Co.performing vlork.Fire protection curtains,mats and/or blankets to be used if necessary Name of Competent Operator(if applicable) Cert. No. Date Issued-rejected 10/15/19 By * (Signature of Applicant) Date of expiration 1 Oil 8/19 Fee $50 Amount Paid$ $50 _�-------------------------------------------------------------- 1` :A -s C '/W 60�I 2092� 2 O�UI/�C?rJQl il?�U�P a ti`� wL��CJO(.If�IL Q� v d F P-006 (Rev.1..2018) PERMIT City or Town: North Andover EDIGSAFEUMBER Date: 10/15/19 Permit Number(if applicable): In accordance with the provisions of M.G.L. Chapter 148,as provided in 10A this permit is granted to SL Chasse Steel (Full Name of Person,Firm or Corporation) for Perform culling andler welding at the address listed below.All%York must be done in accordance w1527 MAR 1 Ch 41 and NFPA 5113,FAIR.4 hrffre detaii[s)may be re4d by NAFD. Restrictions: All applicabte portions of 527 CWIR 1.00 Ch 41 and NFPA 51 B codes and/or standards must be followed. at JAFCO, 100 Willow St., warehouse area (Street and A or Describe Location for Adequate Idenlificalion) Fee Paid$ $50 This ermit will expire on 10/18/19 Signature of Official Granting Permit: Title FPO 0411 / This permit must be conspicuously posted upon the premises 'his is to certify that This is to certify that This is to certify that Danial Fuller Dave Gagne George Marble Has successfully completed Has successfully completed Hot Work Safety Certificate Program. Has successfully completed Hot Work Safety Cer:tiftate Program. as required by the local Authority Having Jurisdiction, Ifo t Work Safety Certificate Program, as required by the local Authonty Having Jurisdiction. as required by the City Of Boston 4�1111ft June 22,2018 May 17,2018 IF IN Certificate number 9188468 Wedoesday,October 11,2017 Certificate number 8107 182 L*J L Director. Education and Development NFPA certificate number:5&59 1 NFPA` Direc:cr.Education and Development NFF* j This is to certify that This is to certify that This is to certify that Doniel Conning Darren Cushman Ed Martin Has successfully completed Has successfully completed Has successfully completed Not Work Safety Certificate Program, Hot Work Safety Certificate Program, Hot Work Safety Certificate Program, as required by the local Authority Having Jurisdiction. as required by the local Authority Having Jurisdiction_ asrequired by the City of Boston May 22,2018 June 25,2018 Wedwesday,October 11, 2017 Certificate number:8136478 Certificate number. 5315732 LW Certificate number: 98357 NFPA Director, Education and Development NF Director,Education and Development 14F This is to certify that This is to certify that This is to certify that Corey Fearnley Danny Barrows Dave LaBranche Has successfully completed Has successfully completed Has successfully completed Not Work Safety Certificate Program, Hot Work Safety Certificate Program, Not Work Safety Certificate Program. as required by the local Authority Having Jurisdiction- as required by the local Authority Having jurisdiction- as required by the local Authority Having Junsdiction. May 17,2018 Junre 2Z 2018 May 22,2018 Certificate number.6930554 S CeTtificate number 0841749 U Certificate number 6187426 OJ L "F NFPA Director, F Director,Education and Development ra Director. Education and Development Education and Development This is to certify that This is to certify that This is to certify that Justin Ennis Mark Staid Michael Swanson Has successfully completed Has successfully completed Hot Work Safety Certificate Program, Has successfully completed Hot Work Safety Certificate Program, as required by the local Authority Having Jurisdiction_ Hot Work Safety Certificate Proyrum, as required by the City of Boston May 7,2018 as required by the City of Boston Wednesday,October 11,2017 Certificate number. 1697942 Wednesday,October 11,2017 LA Certificate number: 9828 FP Director,Education and DevelopmentNFPk Certificate number: 87226 P #` This is to certify that This is to certify that This is to certify that Joe Jackson Kyle Johnson Michael Nee,per Has successfully completed Has successfully completed Has successfully completed Hot Work Safety Certificate Program, Hat Work safety Certificate Program, Hot Work Safety Certificate Program, as required by the local Authority Having Jurisdiction_ as required by the local Authority Having Jurisdiction. as required by the local Authority Having Jurisdiction. November 26,2018 � June 21,2018 February 4,2019 Certificate number. 6040950 Certificate number 2605612 �$ Certificate number: 7266265 ei Director, Education and Development Director, Education and Devetopntent Director, Education and Development NF T m ts to certify that This is to certify that This is to certify that Kris Karafelis Matthew Hurst Jeremy offer[ Has successfully completed Has successfully completed Has successfully completed Hart Work Safety Certificate Program, Hot Work Safety Certificate Fragrant. Plot Work Safety Certificate Pro yrum, as required by the local Authority Haling Jurisdiction_ as required by Ise local Authority Having Jurisdiction. as required by the City of Boston May 16,2018 May 21.2018 Wednesday,October 11, 2017 Certificate number 0299379 Certificate number-8005897 Certificate number: 23529 P Director_ Education and Development Director Education and Development NF This is to certify that This is to certify that This is to certify that Russell Scholtz Shane Campbell Tim Walker Has successfully completed Has successfully completed Has successfully completed Hot Work Safety Certificate Program, Hot Work Safety Certificate Program, Hot Work Safety Certificate Program. as required by the local Authority Having Jurisdiction. as required by the local Authority Having Jurisdiction. as required by the toil Authorty Having Jurisdiction. September 18,2018 November 21, 2018 May 16,2018 Certificate number:6963427 Certificate number:0236507 Certificate number:4172676 LO Director, Education and Development 14FPX Director. Education and Development Director,Education and Development NFPA This is to certify that This is to terms tie. I This is to certify that Rodney Stuart Sean Cullman Tim Kean Has successfully completed Has successfi0v completed Has successfully completed Heat Work Safety Certificate Program, Hot Work Safety Certificate Program- Hot Fork Safety Certificate Program, as required by the local Authority Having Jurisdiction, 11 as requite by the local AuthoTfty Haves Ju;�sd tcm 11 as required by the local Authority Having Jurisdiction_ May 17,2018 1.it y 19,2018 May 17, 2018 Certificate number:7278409 LO Cen-rficate mumt 7563405 - Certificate number:9964819 I a ,Education and Development ��Director D Education and Ceveto�r€ � � Directo€.Ilttttucaor�and tesrelopra�est€ This is to certify that This is to certify that Patrick Chapman Scott Rosebush This is to certify that Mars hall arshaf Has successfully completed Has successfully completed Hot Work Safety Certificate Program, Heat Work Safety Certificate Program. Has successfully completed as required by the local Authority Having Jurisdiction. as required by the 3ocal Auftrity l-laving Jurisdiction. Heat work Safety Certificate pro from, May 5, 2019 .Terse 15,2018 as required by the City of Boston Certificate number:0268220 jo Certificate number:0716738LOJ wedraesday,October 11,2017 NFPA_ Certificate number: 51985KFPA Director, Education and Development Director. Education anti Deve oprrent This is to certify that Wayde Strickland Has successfully completed Hot Work Safety Certificate Program. as required by Lhe local Authority Having Jurisdiction_ June25,2018 Certificate number*4568912 L Director.Education and Devellopi This is to certify that This is to certify that Tyler Spring Zac Audet Has successfully completed Has successfully completed Hot Work Safety Certificate Program. Hot Work Safety Certificate Program, as required by the local Authority Having Jurisdiction. as required by the local Authority Having Jurisdiction_ May17,2018 April 20,2018 Certificate number.3698597 Certificate number 6199286 no 7 Director,Education and Development 14FPk -Director,Education and Development MF This is to certify that Ths 4's to certify mat Anthony Scrivani 1 Wayne Dixon Has successfully completed Has successl%[Iby completted Hot Work Safety Certificate Program, Hot Work Safety Certificate Program. as required by the local Authority Having Jurisdiction. as required by the local Aumority HavLng Jurisdi'n'o-r January 29,2019 s June 29.2018 Certificate number: 1140611 Cenificate number 7016527 L J Director, Education and Development NFPAI sentNFPA Director,Education a.-.d Devel CUSTOMIZED J A-',4"R CO I SOLUTIONS FOODSERVICE To:The Town of North Andover Re: 100 Willow Street Date:10/1S/19 Re:Welding,etc. This letter istogive approval toSL Chasse to use weld ing/brazingthat's goingto have to be doneto make utilityconnections at100WiIlowStreet,North Andover,MA. Thank Y ; Matthew Ferro lafco Foods, Inc. r�» ri ht Flood Consulting 2019 TYP ll O d L4 x 4 x ALL SIDES 3 W Q N Of Uj (TYPICAL) L4 x 4 x '/4" ¢ a x 0'-6" LONG z SADDLE (TYPICAL) RQQF OPENING 0 L OPENING FOR DUCT WORK STEEL JOIST COORDINATE STEEL JOIST SEE PLAN FOR SIZE SIZE & LOCATION SEE PLAN FOR SIZE W/ MECHANICAL CONTRACTOR COORDINATE SIZE W/ MECHANICAL CONTRACTOR TYPICAL ROOF PENETRATION FRAMING DETAIL SCALE: NONE PROJECT. .JAFCO FC PROJECT NUMBER: 1906 PROJECT LOCATION: NORTH ANDOVER, MA F L • • TITLE: RTU/EVAP SUPPORT SCALE: N.T.S. Structural Engineering 07.30.19 DRAWN: SRF 56 Lourel Drive TEL: (978) 562-5499 Hudson, MA 01749 FAX: (978) 562-6246 -NCE: - SKS-1 ...................... ....... . Coa ri h€ Flood Consult;F141 2019 PANEL POINT q JOIST PANEL POINT LOAD > 100. LSS STEEL ANGLE EACH SIDE > 5 OF JOIST TO MATCH JOIST WEB AT EACH POINT LOAD (TYPICAL) 5 STEEL JOIST SEE PLAN q PANEL POINT FOR SIZE - � JOIST PANEL POINT LOAD > 100. LBS NOTE: 1. THE TRADE CONTRACTOR REQUIRING SUPPORT FOR THE HUNG OR SUPERIMPOSED LOAD SHALL BE RESPONSIBLE FOR FURNISHING AND INSTALLING THE REQUIRED ANGLES AT THE DIRECTION OF THE GENERAL CONTRACTOR. TYPICAL BAR JOIST REINFORCEMENT DETAIL SCALE: NONE PROJECT: JAFCO FC PROJECT NUMBER: 1906 PROJECT LOCATION: NORTH ANDOVER, MA TITLE: RTU/EVAP SUPPORT SCALE: N.T.S. Structural Engineering DATE: 07.3019 DRAWN: SRF 56 Laurel Drive TEL: (978) 562-6499 Hudson, MA 01749 FAX: (978) 562-6246 DWG REFERENCE: - SKS--2 ® DATE(MWDDA YYY) ACC>R to CERTIFICATE OF LIABILITY INSURANCE 10/16/2019 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 have ADDITIONAL INSURED provisions or 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 Insurance Services LLC PHONE FAX 3 Executive Park Drive, Suite 300 (A/C,No.Et):855-874-0123 (Arc,No); Bedford NH 03110 E-MAILD SS: _..._ INSURER(S)AFFORDING COVERAGE NAIC# _INSURER A:Massachusetts Bay Insurance Company 22306 INSURED SLCHASSE INSURERB:AllmeriCa Financial Benefit 41840 S.L.Chasse Welding&Fabricating, Inc. INSURERC:North River Insurance Company 21105 8 Christine Drive Hudson NH 03051 INSURERD:Granite Slate WC Manufacturers Trust 23809 INSURERE:Hanover Insurance Company 22292 INSURERP: COVERAGES CERTIFICATE NUMBER:1454463722 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 ADDLY. XP TYPEOFINSURANCE INSD SUER POLICYNUMBER MWDDPOLICYEFF MMJ nY1YYYY LIMITS LTR WVD A X COMMERCIAL GENERAL LIABILITY Y Y ZDV920607208 W112019 7/112020 EACHOCCURRENCE $1,000,000 DAMAGE YO-R-FITT—ED CLAIMS-MADE I ..1 OCCUR PREMISES(Fa occurrence)-- $100,000 X Contractual Uah MED EXP(My,one person) $10,0()0 _ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 ^ PRO- POLICY JECT F LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: u S B AUTOMOBILE LIABILITY Y Y AWV921323808 7/112019 7/112020 Ea Ea and SINGLE LIMIT $1,000,000 LccWent JX ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY IWURY(Per acadenl) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per acadant _ $ C X UMBRELLALIAB X OCCUR Y Y 5821123491 711/2019 7/112020 EACH OCCURRENCE S 10,000,000 EXCESS LIAB CLAIMS- DE AGGREGATE $20,000,000 DED I XVRETENTION$ $W D WORKERS COMPENSATION WC0120191001533-3AStates:NH 1/112019 111/2020 X PEATUTE ORH" AND EMPLOYERS`LiABILiTY ANYPROPRIETORIPARTNERIEXECUTIVE YIN NIA E.L.EACH ACCIDENT $1,000,000 OFNCERWEMBEREXCLUDED7 �� (Mandatary In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS bolow E.L.DISEASE-POLICY LIMIT $1,000,000 E Leas9dlRented IHV920607406 7/112019 7/1/2020 $160.000 A Stored Material ZDV920607208 7/1/2019 7/1/2020 $276,600 Special Form DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached If more space Is required) WC Informat(on:WC5315387912018-3A:MA-Eff Date:12l0412018 Exp Date:121041201 9;Limits:$5001$5001$500,Company,LM Insurance Corp. Blanket as Required by A Written Contract:Addit(onal Insured&Products Completed Operations Coverage,Primary&Non-Contfibutory,Waiver Of Right To Recover From Others Per Farms Attached To The Policies. 19-327 JAFCO 1 Gourmet Specialty Foods CIVIC Design-Build Inc.,owner,and all other parties required by contract,are named as Additional Insureds with respect to Project as required by written Contract, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CMC Design-Build Inc. 859 Willard Street Suite 300 Quincy MA 02169 AUTHORIZED REPRESENTATIVE 540W AW O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD I