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Home My WebLink AboutBuilding Permit # 7/16/2015 s NpnvN q Q 9° `V Me BUILDING PERMIT �r a6,. . �•, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received " °+,�. .m-r q' Permit N®• °AAT60 �p$SACHIS Date Issued: IMPORTANT: A221icant must com fete all items on this page l LOCATIOW �° �Y7/ rid t9� r f , PROPERTY1 CiWNER'a { 1 r v s FARCELZONING D1STR1CTr Historic,Distnct yes no Machih'6`,Shop Village=' yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential 0 New Building 0 One family U Addition 0 Two or more family 0 Industrial ,CCIteration No. of units: 0 Commercial 'Cl-Repair, replacement 0 Assessory Bldg 0 Others: 0 Demolition 0 Other DhS�rptl'C'�;�D Weil `% I�rFloodplain , ,D Wetlands,., JCI°;Watershed District;, ro, Identification Please Type or Print Clearly) OWNER: Name: Lo Phone: Address: "'b"OfrITRAName Bone ✓.? ( , r Address r- e„ lit Supervisor s Construction Licensery .� Exp. Date: '`great Jai` Pkrr art /rry Home'Irrtprovement i,tcense Eitp: Date F. ARCHITECTf�1 G NEER�_� �> C�/'� 7t"C'� Phone: res t 'c��1, .a C' OCs2 Reg, No. — 51� Add s. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESriMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ N— FEE: $ Check No.: ` / .. Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund .166nature of AgentlOwne ignature of contractor Town of 1 0Andover ® to No. b14 ;.rA, - Zy C"01 �,KE h . ver, ass, �o V coc«�c«ewic� S V BOARD OF HEALTH Food/Kitchen PER..MIT T Law Septic System .dl ..... THIS CERTIFIES THAT IX . ......� � ..,,,R,,,,,,,,C,V,A`�. _..... BUILDING INSPECTOR has permission to erect .......................... buildings on ........sis.... f . ...... ................ Foundation /� ' - I Rough to be occupied as ..........`... vkICA. .......fes. r........................................................... Chimney provided that the perso cepting this permit shall in every respect conform to the terms of the application Final 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough �A Final PERMIT EXPIRES I 6 MON HS ELECTRICAL INSPECTOR UNLESS CONSTRP TS Rough Service..... ................................ Final x BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz7 Rough Islay 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. Smoke Det. Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 01 edition of the Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: MERRIMACK COLLEGE—CUSHING HALL Date: 07-09-15 Property Address: 315 TURNPIKE ST.—N. ANDOVER,MA. Project: Check(x, )one or both as applicable: New construction X Existing Construction Project description:Interior renovations to first floor classroom I Charles Cochran MA Registration Number: 6559 Expiration date: 08-31-2015,1 am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: X Entire Project X Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a 'Final Construction Control Document'. S,X&AAA414, eDA 14 LES CHAR Enter in the space to the right a"wet"or 11 A 0 electronic signature and seal: COChiRAN `4 4 No.65519 A WESTFORD MA A �4/ Phone number: 978-399-0240 Email: ---1—+--+s.com Building Official Use Only Building Official Name: Permit No.: Date: Trial Version 10 09 2012 PIMENTEL MENEM= July 13, 2015 Merrimack College 315 Turnpike Street North Andover, MA 01845 Attention: Felipe Schwarz Re: Cushing Hall CONTRACT Based upon marked up drawings, dated 07/01/15, of Cushing Hall, Pimentel Construction Co., Inc. proposes to supply labor and materials to complete the renovations of O'Reilly Hall at Merrimack College. Scope of work: • Permit • Supervision • Remove carpet • Supply and install doors as follows: 0 1 Knock down single door PM frame 0 3 Welded 3-10 x 3-10 OA borrowed lite PM frame 0 31/4" clear tempered glass 0 1 Prefinished clear maple flush door o Hardware o Frames based on 4 7/8"wall size o Wood veneer not specified, based on prefinished clear maple o Hardware not specified, based on items listed o No elevation on borrowed lite window, based on size listed • Build new wall inside conference room and cut in for two new windows • New ceiling tile and repair grid • Furnish and install carpet and v, base in two rooms, carpet based on $35.00 psy allowance installed. • Furnish labor and materials to paint per plan A1.0 Jab# 115 193 Pirnentei Constructian CO, lnc. � 231 Andover Street,wirninoton, MA 01887 * Telephone(9 78)657-9600 4 Fax (978)65%-9603 • Add 1 smoke detector • Rework two sets of electrical switches • Install two Cat5e cables Price: $21,665.05 Anthony Timentel Pimentel Construction Co., Inc. Accepted Date: 17 Excludes: Premium time Job# 115 193 Pimentel Construction Co. Inc * 231 Andover Street, Wilmington: MA 01887 Telephone (978) 637-9600& Fax(978)657-9603 The Commonwealth of Massachusetts Department of IndustrialAccidents y Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 «N 5� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Orgauization/Individual): 14( bA) Address: two/ar 1:s4- City/State/Zip: a2 �� oh '�Phone #: C,' i� 5 ��oC� Are you an employer? Check the appropriate box: Type of project(required): 1.P)am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical 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.❑ Other comp. insurance required.] *Any applicant that checks box#I must also till 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. 'Contractors 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 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. � � I��, Insurance Company Name: _ Policy#or Self-ins. Lie. #:��( P�C/ r� �� 1,7 Expiration Date: k Job Site Address: ��) �'� /y� ( 1%/ City/State/Zip: //W Attach a copy of the workers' compensation 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 above is true and correct. 1 � Ll Signature: Date: Phone#: � 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#: v®Ac IlrnnTFORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6S60UB-2EG2448-0-14) NEW-1 4 INSURER: HARTFORD UNDERWRITERS INSURANCE COMPANY NCCI CO CODE: 10456 1. INSURED: PRODUCER: PIMENTEL CONSTRUCTION CO INC EDWARD F SENNOTT INS 231 ANDOVER STREET PO BOX 457 WILMINGTON MA 01887 TOPSFIELD MA 01983 Insured is A CORPORATION Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 12-20-14 to 12-20-15 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA a B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: a Bodily Injury by Accident: $ 1000000 Each Accident Bodily Injury by Disease: $ 1000000 Policy Limit 0 Bodily Injury by Disease: $ 1000000 Each Employee N C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A m D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 0 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating �— Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 01 -13-15 AK ST ASSIGN: MA OFFICE: ORLANDO DA HTFD 05G PRODUCER: EDWARD F SENNOTT INS 2562B Cun:trucU,)n Su�,rr�ir License.: CS-012453 ANTHONY J PMENTE[, , z 16 Spencer Court- Andover MA 01830 Expirat,on Commissioner 02/27/2016