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Home My WebLink AboutBuilding Permit # o,ortTi- BUILDING PERMIT °+```eD °�a °� TOWN OF NORTH ANDOVER ° fn �c� APPLICATION FOR PLAN EXAMINATION -o Permit NO: C Date Received Date Issued: t s�acHus� ' IMPORTANT: Applicant must complete all items on this page 0,0111 �irnl�,�l>i 11 I�r�/rrrf✓�II / �/ ii, f•. ,i rr� r�j�/ /� 'd�" // j�llla//`ff� ��ff 1 j �l '1 �/�� /' l r J TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential Ci New Building 0 One family C Addition C1 Two or more family i l Industrial L Alteration No. of units: 11 Commercial CI Repair, replacement D Assessory Bldg r:] Others: C I Demolition n Other Se ticWell ! %% ri° ,F oodpain,l " ,r i Wetlands atersh ;d D J /i an, i,el,/ti7„yWer Add walls,doors and outlets to create two offices. Identification Please Type or Print Clearly) OWNER: Name: Merrimack College Phone: 978-837-5459 Address: 315 Turnpike Street,North Andover,MA 01845 r / / J I d JJ � � � ��1 � 1/r� / (�`.�;� (OI, ( (�I✓� ,NUJ,,/�l/ ll 1 1 I J //, Il / 1 ��% / 1 r�II r ARCHITECT/ENGINEER. Dewing Schmid Kearns Phone: 978-371-7500 Address: 30 Monument Square Suite 2005,Concord,MA 01742 Reg. No. 6938 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 18,000.00FEE: $ Check No.: '� Receipt No.: Cl V41 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund „ thORTH i own 01 ndover ® 0 No. 4o-. 2ai ��.c. h ver, Mass, I lb COCMIC.EWICK �•Q AORATEULD S � BOARD OF HEALTH t: FXMIT T Food/Kitchen Septic System THIS CERTIFIES THAT Ctm .. . BUILDING INSPECTOR has permission to erect .......................... buildings on .... .. ...... • ................ Foundation . Rough 1 to be occupied as ..... ................. Chimney provided that the person 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 Final PERMIT EXPIRES I �+T ELECTRICAL INSPECTOR UNLESS T . A ` Rough Service ............. ..... .. .........:...:....................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Qccuey Pulldln Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing all To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Initial Construction Control Document M To be submitted with the building permit application by a M , a Registered Design Professional for work per the 8`I'edition of the gybe Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Dean of Student Success Office Suite—Merrimack College Date:9/30/15 Property Address: Mendel Building, 315 Turnpike Street,North Andover,MA 01845 Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: Design of architectural interior renovation I Thomas D. Kearns MA Registration Number: 6938 Expiration date: 8/31/16 ,am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: X Architectural Structural Mechanical Fine Protection Electrical Other: for the above named project and that to the best of my knowledge, information,and belief 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 perforin 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. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. 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'. Enter in the space to the right a"wet"or `��RED ROy� electronic signature and seal QW� S D. n g STON 9 MASS Phone number: 978-371-7500 Email:tkearns@dskap.com \'F4 FM h Building Official Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, provide a description. Version 06 I 1 2013 The Commonwealth of Massachusetts PnntForm_ y Department of Industrial Accidents Office of Investigations kv I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly Name(Business/Organization/Individual):Channel Building Company Address:355 Middlesex Avenue City/State/Zip:Wilmington, MA 01887 Phone #:978-657-7300 Are you an employer?Check the appropriate box: Type of project(required): 1.2 I am a employer with 20 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 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. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 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' 131-1 Other 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 submit 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-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. Insurance Company Name:Hanover Insurance Company Policy#or Self-ins.Lic.#WHN237594 Expiration Date:1/1/2016 Job Site Address:315 Turnpike Street City/State/Zip:North Andover, MA 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 v' ator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insuyi& coverage verification. I do hereby certify uncle th paiis d enalties ofperjuty that the information provided above is true and correct Si ature: - Date• Phone#:978-657-7300 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#: Insurance Group_ WORKERS COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE POLICY 02 WORKERS COMPENSATION RENEWAL INFORMATION PAGE RENEWAL OF WHN-2375394-06 CARRIER CODE NO. 13633 Policy Number Policy Period Coverage is Provided in the Agency Code From To WHN-2375394.07 1 01/01/2015 01/01/2016 THE HANOVER INSURANCE COMPANY 3201659 ITEM 1. Named Insured and Address Agent Telephone: 413-586-5011 CHANNEL BUILDING CO INC ALEXANDER W.BORAWSKI, INC 355 MIDDLESEX AVE (RATS) WILMINGTON MA 01887 88 KING STREET,STE.A NORTHAMPTON, MA 01060 Federal ID No.042468048 Bureau File No. 000130763 SEE ATTACHED SCHEDULE OF ADDITIONAL LOCATIONS FOR OTHER WORKPLACES NOT SHOWN ABOVE. IF APPLICABLE SEE CONTINUATION OF NAMED INSURED SCHEDULE. ENTITY OF INSURED - CORPORATION ITEM 2. POLICY PERIOD- 01/01/15 TO 01/01/16 12:01 AM STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN. ---------------------------------------------------------------------------------- ITEM 3A. PART ONE OF THIS POLICY APPLIES TO THE WORKERS' COMPENSATION LAW AND ANY OCCUPATIONAL DISEASE LAW OF EACH OF THE FOLLOWING STATES- MA. -------------------------------------------------------------------- B. PART TWO OF THIS POLICY APPLIES TO EMPLOYERS' LIABILITY INSURANCE FOR WORK IN EACH STATE LISTED IN ITEM 3A: BODILY INJURY BY ACCIDENT $500,000 EACH ACCIDENT BODILY INJURY BY DISEASE $500,000 EACH EMPLOYEE BODILY INJURY BY DISEASE $500,000 POLICY LIMIT -------------------------------------------------------------------- C. PART THREE OF THIS POLICY APPLIES TO OTHER STATES INSURANCE FOR THE FOL- LOWING STATES- ALL STATES EXCEPT ND,OH,WA,WY, AND THOSE STATES SPECIFICALLY NAMED IN ITEM 3A. -------------------------------------------------------------------- D. SEE ATTACHED SCHEDULE FOR LIST OF ENDORSEMENTS AND SCHEDULES FORMING PART OF THIS POLICY. ---------------------------------------------------------------------------------- ITEM 4. THE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUALS OF RULES, CLASSIFICATIONS, RATES, AND RATING PLANS. ALL INFORMATION REQUIRED BELOW IS SUBJECT TO VERIFICATION AND CHANGE BY AUDIT. ADJUSTMENT OF PREMIUM SHALL BE MADE ANNUALLY. --------------------------------------------------------------------------- COUNTERSIGNED THIS DAY OF - - - - - - - - - - - - - - - AUTHORIZED REPRESENTATIVE BRANCH OFFICE:100 NORTH PARKWAY WORCESTER MA 01605 IF THE BILL FOR YOUR POLICY IS NOT ENCLOSED, IT WILL BE SENT TO YOU SEPARATELY. Form 331-0226(9-03) WC000001B Date Issued: ORIGINAL/INSURED Payment Type: DIRECT BILL GROUP NAME: CONTRACTOR SELECTIVE GROUP NUMBER: ZBF wrrwr+ NLIKMNNENNNNM CHANNEL BUILDING COMPARV September 29. 2D|5 Felipe Schwarz Merrimack College 315 Turnpike Street North Andover, MA 0|845 McQuade Library Offices Scope ofWork Dear Felipe: Channel Building Company is pleased to present this proposal for construction of new offices in McQuade Library as per the Al.I Proposed Plan prepared by Dewing Schmid Kearns dated 9/28/2O|5. Demolition as per plan. Furnish & Install: ° Steel stud and GWBto create 2 offices and infill doorway as per plans. " 2— 3'xT flush birch doors w/ hollow metal frame and associated hardware. ° Carpet Tiles " Paint all new and repaired vva||a, doors and frames. " Outlets and tal/clata /2\ ° Switching for existing light fixtures atnew offices. This is work, is to be competed on a Time & Materials basis. Sincaraly, |ose8� ��ukstern Project Manager JSS Middlesex Avenue 11 Wilmington, MA 01887-2163 " 978.667.7300 fax: 978.657.7788 ° vvv,vv.chxnna|bui|ding.com f u 1 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-053259 JOSEPH A GAUKSTERN 6 JUNIPER DRrl AMHERST NH 03031 4 " W Expiration Commissioner 03/03/2018 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991M )of enclosed space. 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/DPS