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Home My WebLink AboutBuilding Permit # 11/20/2015 ORyy BUILDING PERMIT TOWN OF NORTH ,ANDOVER 0 � APPLICATION FOR PLAN EXAMINATION m _ w '°aarEo Date Received `ArED ` Permit i�i6��: '�° � C Date Issued: IMPORTANT: Applicant must complete all items on this page ,rr . � l G .. I � I ,�rlrWrvar�°w� ✓ { �,,�/ ��U r!L�'.r1�J�'7 r� �I r � I ��,��/��/i U l 1 I 1 ` MI �P I r l r r / J i r //r / ,,,, , // / f ra, .1�,1 / ✓ rl /ir/ /, �//, ,; / 1,,,/ .{ / l/ 7/ �i�l/l ,/�A//��ur:r✓r.//.I�f�jrl i!I„J,�i/if,%/c,,:, „/�7//i„/U,/iiG,//��/✓,l��n, ,,,,,, ,,ori, / Fir, P„/;, gr,�r///, .ar.r// r<L TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: emolition ❑ Other r N o!' /7Y �7 �f/,vi & c 1 i '. / l/�/(ear ✓..1; / {/r ° v ',�<; ,; ., .,,r!rlr, 1, ,,�, e /, / ❑ Flood `lam / Wetlands ❑ ',Watershed'District{ // ❑ Se tic ❑&W IIs { / / f l Ir �/ !own/.. / / /i/ / r /, 1/ , gid / iN�I�1't.Vn-,V at�r/ewer,:,/,/��,✓�.:�.. ,/,r/(, � ,/r,1✓Grr�✓��,�!�,�/✓��,.✓r7,/�//�.r,,�: ,.,I� ,.r/,,.,,s/r�,/:,//,../,/ /./I/r,,✓1.,�,��r.. ✓/,,.,�,, ,,,,DESCRIPTION OF WORK TO DE PERFORMED: +J ^-... w ( Identification- Please Type or Print Clearly , 4 OWNER: Name: i 'J' 0 z" .- Phone: ' � 1 Address: ,� � t� � � � � �” A --2-- ,�/J//�///Ff //� / //r/�//11/r/� f/�{ /i,/ i� %/r i, ,,,- „/; ,,;. r,,,g,,r /;,,;,,,,�,� y, ;, / �, <✓/r/i//,l//a, %/i�i/��%�// ��/%/// / ;/;-; i%��%./i///'/��/IJl//%i,/ii rl/Gr/ ir l�//�/.�/�,/ // �x / l � „';%� ,,,,,,,:/ / r ,�r; ,r, ,,, ,,,/I /,/, ,e; fr a/,/ / �.,'�r/ f�//i/✓1/ /ir , Contractorf„Name f Phone ..r r/��rN//,.... aro / �,./.✓ /./. .r:.r/ f, %///d, /..,r /,./ /i/ ,: ..,,/. /r / ,/ //- -,/ // I / ✓. ..,. ..//�� 1 l ,„ /l 1/l. �/�! I/. Gl./ rr // /,i�,/ ,,://r a .,,d I/��/,.%�/�„. /�/ r // / r// //// ,„ l ,�jl�r'/✓^/�. � r, r/ i/ r�f� �� /, /�ii r„ ik-, U�.., / / / I, ;.,. .erl l/ ,G,'..,/„ ., .!�rl��/��l / /r� � �� 1� � !�,/-;” q//�/ I/ //! �, / ;/: /r ,,off.r//r,�� r.-,�✓ n „r l"r�/(.i/ai Ir l r /F'1r %/ / ,. ll' ��! , 711'%%�i,�/�fi /f/i�l �' v ' ,, �� I � r` ii,� � �/f�/,;:,,'r4d,, cess.,k , d l` r�� 1 �rlll ✓/��,., r”I f/ /, ir , ✓lr,��„/N/i��,.�'/�„r r! l�/'/G�i��rl��d� ��(r�;ul%r��Il%l //, I In/,,,, , , // ��r �/�r/✓ �� !� I /r, rr....,,. l ,/ ��n��..loJ"p,',� �,n, � �.r .�_ ✓� /��! i ;/ i I r/�//�/�/t'ij/ �/ fl/////��.I! ,. r l// � _ i,�,�� r � >j '� rl��l��%r,':. U I � I t //�✓ n. /f f ��/ y / /v l / � ,, ✓/ �r,r / r r,/, r/ <��,,,�i,�r/� ,, ,1, ��ii r rr,, ,�/I'/�� I,f / � �f //�, / l / r /! � Il oo/G l 1 i„� �! /// r, �/ / r //,/ /„i ru/ I „/ /, ✓, er ,/v , / / r r � r / u'!��, t , .��/�1��,�/"/, I �c � ✓ r {lit/ /r/r/ /� 1 7 i � �i/` / r � /�/ l� 1 l r/1/,. Home Im . ove ent Lice se I /-.,rl;,,l.✓ ..,�,�1: ,,.�u. .z�.w�r.,,��,�.� 1,�Ex ,Dates%��y�� //rr ARCHITECT/ENGINEER I � I � Phone: Cly Address: 16 0 " r Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ I FEE: $ � . Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guar tyfqnd _.___ —_ __,m __—.._ ham_-4.._ ______._. �i✓4 Signature_of Age`nt/Owner Signature ofcan.ractor. Arb t1ORTy Alk OW11 ofAlk 2 E - nclover Alt ® COCHlICAHE i` Ver® ` 'QA HE WICK 1' 7 ss, Smoak ATED P'PP E �`�.�� U BOARD OF HEALTH Food/Kitchen THIS CERTIFIES THAT........ ... ... Septic System ....14.111.4.s..�A... has permission to erect.... ..... .. r-ft BUILDING INSPECTOR ............... buildings on " Foundation to be occupied as .. ..... ... .... . Rough provided that the "ftqpw Person accepting this "' ' " "� ........... .0*4% p g permit shall in every respect conform to the terms of thea application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Ins ec • pp Chimney p tion,Alteration and Construction of Buildings in the Town of North Andover. VIOLATION of the Zoning or Building Regulations Voids this Permit. PLUMBING INSPECTOR Rough E I I 1 MONTHS Final UNLESS CONSTRUC "'TI TARTS ELECTRICAL INSPECTOR Rough ............ Service .L"`; .......................... BUILDING INSPECTOR Final Occupant-v P.,,, � uired to Occu Buil in GAS INSPECTOR Rough Display in a Conspicuous Place on the premises -- Do Not Lathingor Not Remove Final Wall To Be Done Until Inspected an prove the Building FIRE DEPARTMENT . ing Inspectoro Burner Street No. Smoke Det. AccorCERTIFICATELIABILITY INSURANCE ��( �3 2 i15 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 polie I ) Aust be endorsed. If SUBROGATION IS WAIVED,subject to the terns 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 endorsemen s. N PRODUCER NAME: T Maria Dupont Insurance Agency, Inc. PHONE 617 376-0795 FAx (617) 479-9121 18 Copeland Street s: me@dupontinsuranceacrency.com Quincy, MA 02169 INSURERS)AFFORDING COVERAGE NALCO INSURERA:Main Street America INSURED INSURER B: JK Contracting, LLC INSURERC: 31 Richmond Street INSURERD: Weymouth, MA 02188 INSURER E: 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, O EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID am. LNTR TYPE OF INSURANCE POLICY NUMBER M/CDK LIMITS A GMERALLABUM MPT7794M 2/10/15 2/10/16 EACH OCCURRENCE a 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERALLIABIUTY �;ISES(Eaoccurtenc $ 500 DD CLAIMS-MADE ❑X OCCUR MED EXP(Anyone person) $ 10 000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000-000 GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-OOMP)OPAGG $ 2 OOO OOO S POLICY PRO _71 LOC INGLELIMIT AUTOMOBILE LIABILITY a td E $ BODILY INJURY(Per person) $ ANYAUTO ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOSDAMAGE PRPeraPcdderd1 $ HIREDAUTOS _AUTOS $ UMBRELIAUAB OCCUR EACH OCCURRENCE S EXCESS LUU3 CLAIMS-MADE AGGREGATE $ DED RETENTION WC STATU- OTH- WORKERS COMPENSATION lID AND EMPLOYERS'LIABILITY E.L.EACH ACO DENT ANypRopROFFMCEPJMEIMBE EX�IAED? YN!A QiAardabry In NN) E.L.DISEASE-EA EMPLOYEE (fayn8s descnb NH) E.L.DISEASE-POLICY LIMIT DESG�RIPTION CF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS IVENCLES(AdachACORD 101,Additional RensrksSchedule,ifrtwrespace lsrogUred) 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. AUTHORIZED REPRESENTATIVE . Brid et McGowan ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: apedranti@crowninshield.com ',?/3./2015 7:22:03 AM PST (GMT-8) FROM: 100005-TO: T6174' •9121 Page: Z or z ® CERTIFICATE OF LIADILITY INSURANCE �� M016 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 CONSTI'T'UTE 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 poitey(ies)must be endorsed. if SUBROGATION fs 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 endorsems s. PRODUCER DUPONT INSURANCE AGENCY INC 18 COPELAND STFAX N.V. QUINCY,MA 02169 DAUB 9 AMRSIM COVERAGE "of muRERA: Liberty Mutual Fire Insurance 23035 IN JK CONTRACTING LLC • "e1R�1Cf 31 RICHMOND STREET WEYMOUTH MA 02188 URERD: INSURER E: COVERAGES CERTIFICATE NUMBER: 230=2 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. lt�R TYPE OF INSURANCE ADM sualt POLICY M �ErP E7� tan's CONMERCDAL GENERAL LMBLITY EACH OCCURRENCE $ LIPMAUR To rum I MW CLANS-MADE D OCCUR ElLacalln S MED EXP we :son S PERSONAL&ADV INJURY S GEN%AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑QCT 7 LOC PRODUCTS-COMPIOPAGG S S OTHER: AUTOMOBILE LIABLRY $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED 3 cd LED BODILY INJURY(Per edert) S AUTOS AUTOS HIRED AUTOS AUTOS S S UMBRELLA LIAR HOCCUR EACH OCCURRENCE S EXCESS LIAR CLAIAS•MADE AGGREGATE A WONJUM CO10PI3 T= -3 S-601698-016 2/17/2015 2/17/2016 SITE AMM I ICU' AND E MPLOYERa'LUMITY ANY PROPRIETORIPARTNERE ECVTNE YIN EJ.EACH ACCIDENT S 100000 OF'FICEPMEMBEREXCLUDED? a NIA (M�reensdtIy in NH) E.L.DISEASE•EA EMPLOY $ 100000 DE-141PTI�ON OF OPERATIONS bob* E.L.DISEASEPOLICY LIMIT S 600000 DESORPTION OP OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddNloml Remarks Schedule,rule be sasrhad Itra"spsee In regidrod) Workers compensation insurancea applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously Issued certificates,only as they relate to workers compensation coverage. 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. :�!+"'�'"� .• AUTfNItIZEDREPRESENTATNE LI Mutual Fire Insurance illi 019B8.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registansd marks of ACORD CERT NO.: 23677622 CLIENT CODE: 1644469 Lucy Canfield 3/3/2015 10:19:07 AM (EST) Page 1 of 1 g Massachusetts Department of Public Safety Board of Building Regulations and Standards € License: CS-066334 I Construction Supervisor KIERAN T WHELAN\ 31 RICHMOND STR i WEYMOUTH Mk 02_ = Expiration: Commissioner 09/26/2017