HomeMy WebLinkAboutBuilding Permit # 8/18/2015 kg, 12, 2015 10: 12AM Town of North Andover No, 5341 P. 1
BUILDING PERMIT I 0
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
'Permit Nod: Date Received 11Z.
7
Date ISSUed: �-L S ,;
IMPORTANT:Applicant must complete all iteins on this page
LOCATION
PROPERTY OWNER
1 Y
Print 1000 Year tructure yes no
MAP �,)Z PARCEL: (,()02- ZONING DISTRICT- Historit Districty no
Machine Shop Village y s no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
11 New Building 0 One family
11 Addition 0 Two or more family [I industrial
Iteration No. of units, 0 Commercial
0 Repair, replacement 0 Assessory Bldg 0 Others:
0 Demolition 0 Other
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LA I 6f 2: 0 1Z 4(2
dentil icafion- Ple se Tyne�r Print Clearly
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OWNER, Name: n- e Phone:q E6
Address'
fCfZ%C
Contractor Name'
Email:
Address,
Supervisor's Construction License: CS- Vs M) Exp, Date:..
Home improvement License.'IV Exp. Date:
ARCHITECT/ENGINEER (fnfm2,S1�'
kP one-
E A ki -0--W(2, �)Reg. No. (j
—
PEE SCHEDULE:BULDING PERIVIT.MOO PER$1000.00 OF 7HH TOTAL rSTIMATED COST BASED ON$125.00 PER SA
Total Projoet Cost: $ —FEE:
Check No,,
Receipt No.:
NOTE: Persons contracting with n7iregistered contractors do not have access to the guaranty fend
OORT}l
own o t E ndover
No. 20(P_ a0145 4 .4 �iT = -
Co' LA1[E h ver, Mass, `
COCMICNEWICN
A�4A-rEv
S tl
BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT r :57..14 //-/��� BUILDING INSPECTOR
.......��..�..7..-���`.�.��...�:�`......... ............................Via... .................
/�7 �U✓N� ('7'F S� Foundation
has permission to erect .: ....................... buildings on ..........................................................................
? Rough
tobe occupied as ................................................................................................................................... Chimney
provided that the person accepting 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 thespection,Alteration and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIO STARTS Rough
Service
..... .. ....................................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildin_z Rough
Display 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.
7r7i "-9
PIMENTEL
03MMUM
August 12, 2015
Merrimack College
315 Turnpike Street
North Andover, MA
Attn: Felipe Schwarz
Re: Ash Hall Renovation
PROPOSAL
Supply labor and material to build new unisex HC bathroom
Divide one classroom into two
Install new doors and frames
Paint all finishes
Install vinyl plank floor throughout
Replace damaged ceiling the as required
PRICE: $48,640.00
ntfiony 1Pimentef
Anthony Pim entel
Pimentel Construction Co., Inc.
Note: This proposal may be withdrawn by us if not accepted within 30 days.
Job# 115 212
Pimentel Construction Co, Inc. 4 231 Andover Street,VVilmindton, NIA 01887 o Telephone(978)657-9600 , Fax(978)657-9603
Initial Construction Control Document
w To be submitted with the building permit application by a
M offd Registered Design Professional
} �< for work per the 8th edition of the
Ver Massachusetts State Building Code, 780 CMR, Section 107.6.2
Project Title: MERRIMACK COLLEGE ASH HALL Date: 08-12-15
Property Address: 315 Turnpike St,North-Andover,MA 01845
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description: Interior renovation at the lower level for new handicap toilet,new office and classroom
I Charles Cochran MA Registration Number: 6559 Expiration date: 08-31-2015,I 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'.
PD'•�'E°D�ii�
Co��
Enter in the space to the right a"wet"or �� CHARLESA. �a
electronic signature and seal: 3 COHAN �`t
No.6559
WESTFORD
MA
Phone number: 978-399-0240 Email: a' SP rc itects.com
®►w®V
Building Official Use Only
Building Official Name: Permit No.: Date:
Trial Version 10 09 2012
Aug, 12, 2015 10: 13AM Town of North Andover No, 5341 P. 2
T-'he Comwonweaitk ofMassichusetts
Department of XnduMaLkeidents
°t o 1 Congress street)Suite 100
Boston,1{lA.02114-2017 ,
www az.gov/dia
%Beers'CompensataoulinsurariceAfffdavit:Builders/Contractors/EYgctr3icians/kliunbel's.
TOM,,RILED WtM TEE JRRTY�G AUTHORI'I Y.
A iicantWo matlon } pleagBprlut Le
N=e(Business/Orgauizat oWJndividual): �� J —�
Address:est:
l v o ref ` ec
Cityl,5tatelfip: 11� t phone#: f� r
Are an employer?Checlz&e.9pproprlafe bv
A. x: T"a of project(Tgquired):
1 in a employer wik-1 'employees(full and/orpare fine).3 7. 0 New conattuotion
m a sole proprietor orpaitnembip and Kaye no employeesworking for mo k 8. 0 ltemo delirig
any capacity.[No worlrcrs'comp-insuranco required-]
�r 9• El Dcurolifiotr
3.E]T am a lrojaeowner doing all work rnysol£[No workers'comp.insurance required.]t
10�Builditlg addition
4.01 am a homeowner and will bo hiring contractors to conduct all Work on my property-I-will
cnswo that nit contractors eitherhave workers'compensation ineuranoo ar sic axle 1l.❑Electrical repair's or additions
propirictow with no employees. 1i tj P1,=bing:tepaits or additions
5,E]Iamagoneralcontractor and Ihavolxcdthe;sub-contractorslisted onthoattached sheet. 13. Roof Te alll's
These sub•confuactoie b-4 employees and have workers'comp-insurwce.t p
6,0 We are a c arat nand its s hava Mc clued their of tion uMGL c. X4.Q ether
�P 14 9�� � cramp P
152,§1(4),and we have PQPfi ployeP.pToworkera'comp,insurance required.]
'tArry applicmit that chocks 4ox#1 must also fill out tbe aec$on below showingtheirworkers'winpewatioA policy information.
I Iiorneowmrs who submit tNsaffidavit indicating they arc doing all work andtherLhn outsido contractors must aubmit anew affidavit indicating suck
tContmetors that check thiq box uiuet-attached an additional dtcet shovring the name of the sub-cantractors arid,atate whether or not those ontities have .
employees, if the sub-eontrad6rs fin"employees,%ey iiaust proAdo their Workers'comp-policy number.
I aan ars employer triatisTir'o ldhig-workersF eompens ado n Insurance for stay elnvMygo$.'$elof4 is tTt-epoffey rated job site
it�aYmatiorr.
Insurance Company Name', C`
Pol cy#or Self-ins,Lio.#: L?xpiratio Data:
Tab Site Address: dA 1 0 4(51 a! City/State/Zip: InN
Attach a copy offhe workers'com'epa atlon•policy declaration longe(shMlug the policy number and ezclairAfiou date).
failure to secure coveitage as required imdex 901,0.152,§25A is a oximinid violation pimisliable by a fine up to$1,500.00
an/or one-year imprisoMant,as well as civil pazraltics in the form of a STOP WORK C7ZDFA and a fine of rip to$250.00 a
day against the violator.A,copy of this statement may be forwarded to tho Office of Iuvestigatians of the TM fnr insurance
coverage yeti tur�atl0n.
X do Hereby certD tdaidea the rains aardpenaltles ofperjraly that the biforrnationprovided above is true ma dcorrect
turaDate: 5
Itgge n' (— r &,7 r 9
Official arse oilly. Do-not 1prite in M&area,is be completed by city ar tawra 0)'icTal.
City or Town: 1'exmitlLicense#
Issuing.A.athority(circle one):
1.Board of Heal& 2.13ulldlugDepaxtment 3.City/Town Clerk 4.BXectriealTnspector 5.Plumbing Inspector
6,Otlrer
Contact person: phone#:
v®A
fi.-IFORD WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
TYPE AR INFORMATION PAGE WC 00 00 01 ( A)
POLICY NUMBER: (6S60UB-2E62448-0-1 4)
NEW-14
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 0GA
N
D. This policy includes these endorsements and schedules:
o 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
Unrestricted -Bu `dings of any use group which
00
contain less than 35,000 cubic feet (991M ) of
nar'� _i:t wr .r .a
enclosed space.
CS-108002 r
JASON R GONZALES 1
7 HEMLOCK LANE
BURLINGTON MA 041,0 Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For DPS Licensing information visit: www.Mass.Gov/DP5
07/23/2018
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