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HomeMy WebLinkAboutBuilding Permit # 12/10/2015 0.1 OORTH BUILDING PERMIT �t,,FD , 4- TOWN OF NORTH ANDOVER 0, APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received TED LIS Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION k Print PROPERTY OWNER (L C& — L-,\-, (�-- Print 100 Year Structure yes no MAP PARCEL: k3 ZONING ISTRICT: Historic District no Machine Shop VillageE69' no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 11 One family 11 Addition El Two or more family [I Industrial I<Alteration No. of units: 11 Commercial [I Repair, replacement 0 Assessory Bldg 11 Others: 0 Demolition 11 Other AfMhipd:1 'District' W DESCRIPTION OF WORK TO BE PERFORMED: C7) S' � Q � i TC570 Identification- Please Type or Print Clearly OWNER: Name` -,1 e a YJ PhonAFI - \, L- Address: 10 Q Contractor Name: Rou, Phone: L 1-4 –Z I Email: VC k 6Y tda-&=a YA Address:S,.j t 1, 0 9 Supervisor's Construction License:,�,- s 0 6 � 3� Exp. Date: q Home Improvement License: Exp. Dat ARCH ITECT/ENGINEER K. A -6-". Phone: OL2- i (J -(V Reg. No.1,4 Address: FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. q C) 6 0 1 - Total Project Cost: $ �q FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund rA A Wco'n t ra ctn r 7 9- -- ne qhature of��>Ykq . Ha `a a 'ii x'0+,,.0::••fie �SSgcxuSEi CERTEPETICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 714-2016 on 12/10/2015 Date: December 23, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED at 4 High Street— Suite 216 MAY BE OCCUPIED AS a tenant fit up IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG West Mill LLC 4 High Street North Andover, MA 01845 Building Inspector Fee: PrePaid$100.00 Receipt: 29804 Check : 2366 1 Uf NOR7N 9 � i 9 gOw" CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 714-2016 on 12/10/2015 Date: December 23, 2015 THIS CERTIFIES THAT THE BUILDING LOCATED at 4 High Street— Suite 216 MAY BE OCCUPIED AS a tenant fit up IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG West Mill LLC 4 High Street North Andover, MA 01845 Building Inspector Fee: PrePaid $100.00 Receipt: 29804 Check : 2366 1 FORTH' Town -ofq 1 2 E �s ® '•• nclover n O LANE h ver, S9.SS' COC HIC"t NCR - �• A0RAnD S U BOARD OF HEALTH Food/Kitchen PL; RMIT T Lu Septic System THIS CERTIFIES THAT ......... ......:...................................:............................................ BUILDING INSPECTOR has permission to erect .......................... buildings on ..'�..���.��..:.:Ss� Foundation to be occupied as ....... t.t"l� I� .� ���n &��= 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 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 EXPIRESPERMIT ®NT S ELECTRICAL INSPECTOR UNLESSI STARTS Roug C ahe,1 Z4 q,-( Service r .......... .... _.r�,.............................. .... Fina oZ�( Z.e• I BUILDING INSPECTT OR GAS INSPECTOR Occupancy Permit Required t® Occupy Building 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. t4o";a a m architecture December 22,2015 Mr. Gerald Brown Inspector of Buildings Town of North Andover 1600 Osgood Street North Andover, MA 01845 Re: West Mill tenant fit-out for 4 High Street, Suite 216 Dear Mr. Brown, The tenant fit-out for Suite 216 on the second floor of 4 High Street at West Mill in North Andover, MA,was to the best of my knowledge, belief, and understanding constructed in conformance with the construction documents issued for building permit dated December 10, 2105 Permit#714_2016 in accordance with 780 CMR Commonwealth of Massachusetts building code. During the course of construction, representatives of our office made periodic visits to the site to observe the progress of the work. Sincerely, Saam Architecture Cl Linda Smiley, Principal saam-arch.com (216) 496 3647 655 Summer St Boston MA 02210 JK Contracting LLC Proposal 31 Richmond Street Weymouth, MA 02188 Proposal Date: 12/10/2015 Proposal#: 197 Project: Bill To: David Steinbergh, Suite 216, 4 High St, N.Andover, MA 01845 Description Est. Hours/Qty. Rate Total Plans and Permits 256.00 256.00 Demo 300.00 300.00 Wall Framing 550.00 550.00 Heating &Cooling 2,500.00 2,500.00 Electrical & Lighting 1,000.00 1,000.00 Insulation 300.00 300.00 Interior Walls, Board and Tape 2,000.00 2,000.00 Painting 1,000.00 1,000.00 Floor Coverings 1,800.00 1,800.00 General Conditions 400.00 400.00 Cleanup & Restoration 100.00 100.00 Supervision 1,020.60 1,020.60 Thank you for your business. Total $11,226.60 ,.7/3/.LU10 I:LL:UJ AM &UT (C TI—tf) B'XUM: lUVUUb—TO: lbl'/-4'1.`J`JlYl ®� CERTIFICATE OF LIA1111W INSURANCE THIS CERTIFICATE*ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRIIATNELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERME AIYORDED BY THE POLICIES BELOW. THUS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INBURERM,AUTHORMM REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. BA ANT: V the emelRaft holder Is an ADDITIONAL INSURED,the polkV(Ess)Mutt be NrdonsMl. K MRMTNM E WANED,sukla t to Ow tsrew and otndBUens of the po ft,contain policies a"mquiw an oncleaomment. A stomont an this aRlllats dots not conlu rights to the I Nllmale hoEdS in Esu al such endarmou Pwwumm DUPONT INSURANCE AGENCY INC 18 COPELAND ST QUINCY,MA 0216 oar�AaE Mwr NJ CONTRACTING LLC e: 31 RICHMOND STREET WEYMOUTH MA 02188 t63fE�lE: COVERAGES CERTI IrATE NUMB REVIOM NUMBER: THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY RECIUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VMCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE IN8URANCE AFFORD®BY THE POLIC 0 DESCRIBED HEREIN 18 81XISOr TO ALL THE TERMS, EI=81ON8 AND CONDITIONS OF SUCH POLI MB.LIMITS SHOWN MAY HAVE BON REDUCED BY PAID CLAIMS. TYie OF rOfalmm oafs MtI1�IGAl OBtB3rAL LVA LITY EACH OcclttltgiCE 1 CIJIaNilAOE ocum rico I9tP ani s PlR80NAL IADV HAIRY W&AOIEI OM LIMMAPPL IS1 PIR: ODINMAGOMM70 FoucY ipm F-1 Loc PRODUcn.02~AM OTHM $ AurOMON .a WL" 94um LJwTALLWl� s AUO$ ALr= 9WILYWJRf(Pw=dd6fp { HIRIO ALM : s un.nau►uAN omt EACHocOursln6cE roacEEa uA. CIAWA 6 7 A!OEElLQrtlr'NAEaJtY YIN OFFICaItEr ltvcmAmm? MIA EL EACHACCDENT 1 1000QO r0esd61Ef/Y MMI EL DIsrAE!•K !< 1 D0000 E MEAN POLICY Ll;u;,l 6500000 0f3sals1ror6 OF OPERATU M I LOOAIW M IVMsout IAOM mt,w:wEW a...t.anon.noy r..a.r.t gn o vpm to n 4 Workers e�mpwttlOn Irntaantoa sppiits only to fhe workafs on laws d fM sols d MA This Osrtitte�ts airlals and supsned PWACuNy Msusd cwd;;; a as Q rNab to wm kMa OOmpwook n oowrraps. CERTIFICATE HOLDER CANCELLATION WOULD ANY OF TME ABOVE DBSC POLICIES BE CANCELLED BEFORE TME ElaMIM DATE THll1E0F, NCRICE MALL BE DELIVERED N ACCOIIQANCEINRMTHE POLICY PRDVIEIOW. 711}+.►rar •M• NRMOII®11ll�alriwTNa f I� �J Lberiv Mtrhrlsi Firs Insurance •1SSSOi4ACORD CORPORATION. All r%ftb rsservsd. ACORD ZS(?011101) The ACORD mm and fto an mgI•blltBd msrim of ACORD czar NO.: 23677622 CUM C=.* 1641449 way GulLeLd 33/20LI M1607 AM (rsrl rays L o: i DATE(MMIDDIYYYY) AC®R®® CERTIFICATE OF LIABILITY INSURANCE CERfIFlCATE HOLDER THIS 5 THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH THE CsubJato ERTIFICATE DOES NOT AFFIRMATIVELY RANCE EG IVELNOT CON8�,E�CONTRACT ND BETWEEOR ALTER THE N THE SSUINGFINSURER()INSURER(S), D BELOW. THIS CERTIFICATE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: ff the certifica hddr is�an"AD TIt may regllire�an endothe rsement A statemert�o this certificateAdoes not confer n' is to the the terms and cin policies onditions oft policy, certificate holder in lieu of such endorsemen s. I T Maria PRODUCER 479-9121 Dupont Insurance Agency, Inc. PHONE 617 376-0795 16 Copeland Street no s: me@du ntinsurancea en .com Quincy, MA 02169 INSURE S AFFORDING COVERAGE NAIC# INSURERA:Main Street America INSURER B: INSURED JK Contracting, LLC IISURERC: 31 Richmond Street IISURERD: Weymouth, MA 02168 NSURERE: INSURE2 F: COVERAGES CERTIFICATE NUMBER: FOR THE REVISION NUMBER: D NAMED THIS INDICATED. NOTWITHSTANDING OTWITH TANDING ANYIRE4UIREMENTES OF NTE 0 CE DBELO BEEN'SS'COND ON OF ANY CONTRACT 01 THERE JED TO THE EDOCU ENT ABOVE H RESPECT IUVVnI ALL THECHRMS, CERTIFICATEAND CONDITIONS OF SUCH POLICIES. HE INSURANCE SHOWN MAY HAVE BEEN REDUC DI BY PAID CLAIMS. EXCLUSIONS BED HEREIN IS SUBJECT TO ALL THE TER Am BR LIMITS TYPEOFINSURANCE OLICY NUMBMANY MMIDdYYYY LTR PER 2/10/15 2/10/16 EACH OCCURRENCE $ 1 ODD 000 A GENERALLIABILITY MPT7794M DAM4GETORENTED s 500 OOO X COMMERCIAL GENE PAL LIABIUTY MED E)?(Any one person) $ 10,000 CLAIMS-MADE 7x OCCUR PERSOP14L&ADVINJURY $ 1,000,000 GENERAL AGGREGATE s 2, 100 000 PRODUCTS-OOMPAOPAGG s 2,000,000 GEN'LAGGREGATE LIMIT APP UES PER $ POLICY PRO 71 LOC aaod rt $ AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ ANYAUTO BODILY INJURY(Per accident) $ ALLOWNED SCHEDULED PROPERTY DAMAGE $ AUTOS UTEDOSED eraccident HIREDAUTOS _AUTOS $ EACH OCCURRENCE $ UNBRELLALIAB OCCUR AGGREGATE $ EXCESS UAB CLAIMS-MADE DED RETENTION WC STATU- OTH- WORKERS CONRENSATION E.L.EACH ACO LENT AND EMPLOYERS'LIABILITY Y 1 N ANY pROpRIIM�EXCLNL.OED��, NIA E.L.DISEASE-EA EMPLOYE oFFICERIM#Aandebry in NH) E.L.DISEASE-POLICY LIMIT S if yyea describe under DESCRIPTION OF OPE RATIONS below DESCRIPTION OF OPERATIONS ILOCA`nONS/VEHICLESIAftachACORD1o1,AddhlonalRermeAnScf*dLde,Lfmoresp001$mgdmd) CANCELLATION CERTIFICATE HOLDER LD THE ORE SHOULD DATE THEREOF,ANY OF THE ABOVE B NOTED ICE WILL WILLIES E BE DELIVERED CELLED F IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORQFD REPRESENTATIVE Brid et McGowan ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD dame and logo are registered marks of ACORD Phone: Fax: E-Mail: apedranti@crowninshield.com f Massachusetts Department of Public Safety 110 r' Board of Building Regulations and Standards License: CS-066334 l Construction Supervisor KIERAN T WHEL.AN 31 RICHMOND STR,. WEYMOUTH MA 02 , M"^K CA— Expiration: Commissioner 09/26/2017