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HomeMy WebLinkAboutBuilding Permit #059 - One High Street 5/1/2018 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION O��tLED A.`IO * L Permit NO: Date Received Date Issued: �9SSACHus���� IMPORTANT: Applicant must complete all items on this page y 11 ^ Y I LOCATION -'' D/lJ� /-114y S;WC rz_) Print PROPERTY OWNER '111/4N$iyJAA� "MA��/!lW Y be 7- CU. Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑One family ❑Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑Repair, replacement ❑Assessory Bldg [i;,Commercial ❑Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED %i5re. Identification Please Type or Print Clearly) OWNER: Name: 144,&AlArowwiy /!W, /!IE/t/T Phone: G17 ;KS-7-3G Address: 3060 6mn+OrRzs-s L// AdXV414 0/1. CONTRACTOR Name: -,2/A A&ZY 7WL Phone: �7Y ���' 02S'& Address: •3� �LL M4A.+ J 7. a,+,-r �'fr 7,-&4S$!/�'/ /7y,/ O/ ,� Supervisor's Construction License: WA Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PER IT:$12 00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ �$� x12.00=FEE:$ Check No.: Receipt Receipt No.: Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools 11F1Tanning/Massage/Body Art ❑ g Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ % Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING&DEVELOPMENT ❑ ❑ []Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS '• DATE REJECTED"-, , •DATE APPROVED_ CONSERVATION ❑ _ ❑ COMMENTS DATE REJECTED _. DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Si2nature&Date Drivewav Permit Temp Dumpster on site yes no Fire Department signature/date Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area,sq. ft.: NOTES and DATA— For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Complianceliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Pp Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a'variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Pave.4 nf 4 LocationynC�- !4� )3 ks r ~ No. Date -L-�—k NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ �'�s'•'•° Building/Frame Permit Fee $ s�CHU Foundation Permit Fee $ Other Permit Fee $ T TOTAL $ Check # � U y 9 2 � " Building Inspector i 71. 677 457-3400 NAI HUNNEMAN MANAGEMENT PAX 6,7457-3267 & DEVELOPMENT COMPANY Lfl_ wwNnaihunneman.com 303 Congress Street Boston,MA 02210 July 19,2006 Daren Shahtanian Tour Andover Controls One High Street North Andover,MA 01845 Dear Karen, Hunneman Management&Development Company and ;he ownership of One High Street grant Tour Andover Controls the right to use the s)ace next to the pond at the end of the Dental Collaborative parking lot at One High Street,forth Andover, MA,on Thursday,August 10 and Friday,.:kugust 11 for their Company luncheon. Hunneman Management acknowledges the re ceipt of Certificates of.'Jnsurance from the only two vendors pen-pitted to use the space ,Big Top Party Renta s and Vinwood Food Services. Tour Andover Controls is responsible for all vendors tha"enter the property by their request. You are also responsible for leaving the locatio.r in the same condition and cleanliness as the property currently resides. Enjoy your luncheon. Regards, Fred Medeiros Site.Manager II REAL ESTATE: BROKERAGE •C:JNSULTTNG -APPRAISAL PROrERIT MANAGEMENT -FINANCE TOOYU TT:TZ LTOZ/9Z/ZT JUL-14-2006 FRI 03;25 PM CONSOLES INS FAX N0, P. 01 _ __... -. -- —•— ------ DATE(MMIDPrYYYY) CERTIFICATE OF LIABILITY INSURANCE RTIFICATE NCED AS A MATTER OF INFp 14 FORMATION THIS PRODUCER (978)535-7700 FAX (978)535-8800 ONLY AND CONFERS NO RIGHTS UPON THE CE N A Consol es / CFR Ins Agency LLG HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 100 Corporate Plate, Ste 110 ALTER THE COVERAGE AFFORDED BY THt=POLICIES 61ELOW Peabody, NA 01960 INSURERS AFFORDING COVERAGE NAI(# 111 ServTtes, In[. INSURER St Paul/1•ravelers 39454 INSURED inwoa F INsuRERB: Safety Insurance 3 Union Street INSURER C: American Home Insurance Company Ipswich, NA 01938 INSURER D: TruW-all Insurance Company INSURER E: NOTWITHSTANDNG CO G THE POLICIES OF INSURANCE LIS OF AN CONTRACTOR OTHER DOCUME T WITH RESPECTOT TERMS, SC CERTIFICATE D Y BE ISSUE ONS OF s CIH ANY REQUIREMENT,TERM OR CONDITION MAY POLICIES.AGGTHE REGATE LLI�MI S SHOWN MAYSY THE HA E BEEN REDUCED ED SY PAID CLAIMS.gUBdECT TO ALL INSR D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFFCTIVE PO CY EXPIRA ON LIMITS 00 /1Z/2Q06 06/12/2oQ7 000,00 GENERAL LIABILITY 6808766B390 06 D 1, GE TO RENTED 11 300,0001 X COMMFRCIAL GENERAL LIABILITY 1 MEP FXP(A^Y one person) $ 5 CLAIMS MADE X�OCCUR PERSONAL&ADV INJURY $ 1 000 00 01 A GENERAL AGGREGATF $ 21000,00 PRODUCTS-COMPIOPAGG $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER X POLICY 'EC LDS 1705833 05/07/20D6 05/07/2007 COMBINED SINGLE LIMIT 6 AUTOMOBILE LIABILITY (ED wAent) ANY AUTO BODILY INJURY 6 ALL OWNED AUTOS (Pm person) 250.00 B X SCHEDULED AUTOS BODILY INJURY $ X HIRED AUTOS (Per a0word) 500 00 X NON-OWNED AUTOS PROPERTY DAMAGF S (Por sooirkM) 100.00 AUTO ONLY•EA ACCIDENT 6 GARAGE LIABILITY OTHER THAN EA ACC S ANY AUTO AUTO ONLY, AGG $ EACH OCCURRENCE $ EXCES6NMBRELLA LIABILITY AGGREGATE S OCCUR a CLAIMS MADE S s DEDUCTIBLE 6 RETENTION s WC9300149 08/19/ZQ05 08/19/2006 X WC STATU- OTH WORKERS COMPENSATION AND E.L.EACH ACCIDENT $ 500,00 EMPLOYERS'LIABILITY F.L.DISEASE•EA EMPLOYE 6 S00.00 C OFFICEROIPMFMOER EXCLUDED ECUTIVF E.L.DISEASE-POLICY LIMIT 6 S00100 V y=tlesU be under SPECIAL PROVISIONS below Common VQ0004241 02/28/20Q6 02/x8/x007 $1►000,000 Limit Eac U quor Law liability Cause $1,000,000 Limit - Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVI6IONS C C SHOULD ANY OF THE ABOVE DESCRIBER POLICIES BE CANCELLED BEFORE THE EXpIRATIDN PATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1Q DAYS wRrMN NOTICE To THE CERTIFICATE HOLOUR NAMED TO THELEFT, SLIT FAILURE TO MAIL SUCH NOVICE SHALL IMPOSE No OBLIGATION OR LIABILITY Kl nneman OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESFNTATIVES. 303 Congress Street AUTHORIZEDRFPRESFNTATTVE Boston, MA 02201 Nicholas Consoles GATL CACORD CORPORA11ON 1981 ACORD 26(2001108) FAX: (978)933-5205 JUL-13-2006 16:33 From: To:89789335205 P.2/2 USI South Coast 7/13/2006 12:52 PM PAGE 2/003 Fax Server CERTIFICATE OF LIABILITY INSURANCEPAIR BD° n PRP R THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION URI Ruud 4eclakbs-EP ONLY AND CIOWWG NO RRiIITB UPON THE GERnMTE P.b.Bm 53310 HOEDER. THIS CERTIFICATE DOES NOT AMEND, MMD OR ALTER THE COVERAGE AFFORDED BY THE POLX= BELOW. R�I IM CA 92619,3310 !!i>A 8'rs4,9286 INOUREW AFFORONS COVERAGE SU REO INRER A: SL Paul Flm and Miring 11m once _ BObtw coOpr INSURER B: dba:Big Top Pally Renals INSURER - 36 HBbnm Wed Ung 4 _ Tewimbury.MA 01076 INSURER D: Il1OURER E. TOE POWESOFINSUAANCE LISTED BELOW HAVE BEEN 188M TO THE INSURED NAMED ABOVE FORTHEPOWCYPERIODINDrATED,NOTWRHBTANDING rRECUREMENT, TIMOR CONDITION OF ANY CONTRACT OR OTHER DO"ENT WITH REIPECDT TO WHICH THIS CERTFEATE MAY BEI MIM OR PERTAIN,THE INSURANCE AFFOSM $Y THE POLOS DESCROM HERI N D $W=TO ALL THE TERMS.OMUSIONSAND COMMONS OFSUCH IA ICIES.AGGREGATELIMNS%0NN MAY HAVEBEEN AMUCI)BY PAID aAlm. TMOF INOURANCEpA7E cENERA�LaAstutY CKDO217505 05fisms WOW VkCH OCCUfi MCE ii,pOpT Opo X =MERCK CENERALLMLOV PWEDAMAAftc V* 5100600 cLMM Kne 0 oxuR MED EXP Om ani Pi5 000 _ PERSWALBAOVINLURY t1$0 000 0MRALAGGREGATE EZ OQD GENl.AGcwGATI:L"A' PRMU CTs-=MW AW t7 0 000 X PWQy Fl FIRM Loc AVT DILE LwBBm CL118INED sN0.E LINT i ANYAutO tE■■pddw) ALL DINNED AU108 904EMAMAIROB (owr INJURY i P�1 w NpN.pNR1ED AUT08 (PC i � ;AMW-Z i &VMW UABUff AUTO ONLY.EAACCIDENT i ANrN1TO MER%M EAACC i AuroaNLY: me : ■[G[DB LLABILIIY EACR OCCURRENCE f Cloctm 17 CLMNSMME AOCJ NATF i S DEDUMBLE -- NETFNTWN 6 i wORID;R CONOMWONAND rvGaTAT� °i" EMM,dTlR81JABIl.OY ELEAOHAWMENT i ELDIBEABE-EAEMPLOYM i P.L.DWEAGE-POUMM i OTHER 008C1 I'M OP DPMLATNriB C"TIONSIVENX3 EME =lK t$ADDED BY 9ROORG M IM PECIAL PROVIMONS Proof of cavarage. a Opt 10 dabs rw0w of cwwdlMkm for nonpayment. CENTIFICA-M MO MR C`.ANCEU AMOK i MOULD A"CFTH EMM DIMMED MUCEWE CMICELLED BEFCIM THE WOMEN Hun an DATE MIREOP,THE I C.MAR R WILL ENDEAVOR To.M3r_DlATBwRDT[N m congrwa 8t" NOME TME CERTIPN;ILIE HOLDERNAMEDYOTHELEPr,BUTPMLURE TOOOSDSMALL Boston,MA 02MV IMPOlEWOOD LIGAIMORLL401LRYCFANTENDUPONTHI1XI RER.ITBAMNTSGR REPREMWATNEG 7 2"RlB711 of 2 9=740321M3045M LRGJG 0 AIGORD CORPORATION tW Big Top Party Rental 36.Hillman Street,Unit#4 .. Tewksbury,MA 01876 TEL: (978)858-0250 FAX:(978)-85870029 wWw.bigtoppartyrental.com "Invite us to your next party!" RENTAL CONTRACT - EQUIPMENT & LABOR Agreement made on 3/ ���`20015 for RIV20 between Big Top Party Rental, hereafter called "Lessor" and the following person and/or company hereafter called the "Lessee." Lessee: .,,, ,.,.�.. - ��*��t;f�)�; Home Phone#: - Cell#: Work#: , . .,A Other 1 Other#: X Qty t Description Price Amount h 1t �l�t�s• �atf' ��.�m..'i� ��'r�in'�:>k' .lt,'3s1.� .l,�ar.���_fi�.� �,�e���,t.1�4,' ,3mloglet. = 1e. DE'POSI1T F0-,HECK ❑CREDI Lt" �+ CASH._, .tin � t > ; 't Jicc#: 1.00 2,50.0-� i Tag Off W61, Amount:$ `' ' 1410.00 20.06 a. ^^;50G (£ tx 'u'iiio.t NewBalance:5 -J 64.0 .s � t L=bo C kite.(R.a-crk lxjith Wfus) :�.r.(30 tT A ndove,7;MA 0.;0fl 50.0 v' r Special Instructions: Setup' t �� f "Yg 10. � 'ttf' xt , . t.n h !a:.e Subtotal c An .I I zip ky IC-00. Ran w e aii r�:l.�_�: �. Sales Tax �� � .. Total r Delivery on or around: ti3 a' for use on 1J75fl Recovery on or around: ;? . j 1�, Sales Person Delivery Address: ' ,, First time renting from us: ids Equipment to be used on: ;;-SMS -� Delivery Address is off of: Waif'si Kfiil.Cl.} A deposit or pre-payment of$ is.required prior to installation of rental equipment. This deposit is necessary to assure availability. This amount will be deducted from your balance at delivery. COD-All final balances must be paid on or before delivery unless otherwise stated in this agreement. Lessee shall be responsible for reasonable care of rental items for rental period.Lessee is responsible for safety of items for rental period, RENTAL PERIOD:TIME OF DELIVERY TO TIME OF PICKUP. Please read front&back of contract,sign date&return the white copy to the above address as soon as possible with deposit to assure availability. Availability not guaranteed until receipt of signed contract with deposit is returned. In the event of a scheduling conflict,the first returned contract with deposit will be honored.please enclose directions to every site. We need 3�eks notice on all cancellations or order adjustments. ep C ustomer igna�ure) (Date) t (Big TPrtaty ReyA) (Date) White-Please sign and return with deposit Y low-Customer Pink-Office Copy a IMPORTANT DOCUMEISTo � a� rtif-leto of V lan-te �lst � Y, REGISTRATION ISSUED B. � Date of a�2�Qacture 151 APPLICAi(ON �i� � NUMBER _ __.____._•____ _.___.__�__ ! � I ! Qrder Number rr�� m .! t � EVANSVELLE, INDIANA 47725 I ;S�b�9 �- MU) F140.1 F MANUFACTURERS OF THE FINISHED F rTENT PRODUCTS DESCRIBED HEREINEO 5 (S This is to certify that the materials described have been flame-retardant treated 0 (or are inherently noninflammable} and were supplied to: I C� 28530D y BIG TOP PARTY RENTAL � ...r qo ygo CA S 36 HILLMAN ST UNIT#4 TEWKSBURY MA 01876 5 5 5 Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshal Code. All fabric has been tested and passes NEPA 701-99, CPAs 84, ULC 109. r 4 �� The method of the FR chemical application is- 1 inj: Description of item certified: 12 m R CF.NTI RY MATE EXPANDABLE END fR 5 CU S Flame Retardant Process used Will Not Be Removed By 5 Washing And Is Effective For The Life Of The Fabric CDN OD. C� TENT DEPARTMENT-ANCHOR INDUSTRIES INC. ti4 zPr�elePc.f3cPel�rJ�1-2Pcnr�`Pr P�P�c�i�PrJ��Pr.Pr��PcP�Pr J�cPr�rl��PrJ�cPrPr.�fzPcPrJcPcJ� ^r•PrJ��rJ�r�rJ"�rrJ r�eluu'�clr���r l�r.PcP�!u-c,`cPr r1cPfs O IMPORCF M+,AT Di"3CUMENTAMP-MEMS of Is a: REMSTRATION M t !N-I APPLICATION LIE., P. M NUMBER N� F_'�'fAtVSVILLE, I=MCAIAMA 47725 Tent Identification I'I-tul MANUFACTURERS ti.!r FINISHE f14235C.3t Lr) 0 lu U) M artiiy that the materials descdbed h4ft, befm flMe-MlardanI treated jor are inherently noninflarnmable) and were suppljo tea: S' 00 285300 BIG TOP PARTY RENTAL 36 HILLMAN ST UNIT#4 TEWKSBURY NIA '876 AM Certification is hereby made that: .2 The articles described on this Certificate have leen, treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California r:ire Marshal Code. All fabric has been tested and' passes NFPA 701-99, CPAI 84, ULC 109. Serial # 8 108 9'5(1.1 Description of item certified: CENTURY MATE EXPANDABLE-MIDDLE IL Flame Retardant Process Used Will Not Be Removed By N 5J Washing And Is Effective For The Life Of The Fabric 0" -VEDAt EVEN TIS DIIASION-ANCHOR INDUST.91E5 INC, &R M [] cPcJ�PEPcPrJzcP r�cltJtPr PrJrFr.Prlt IMPORTANT Q O C U 111 E N T�PrJr��l�PrlcPc P�P�P�PcILJ�r r1cP @] N - Coarti ic.te of ��Vi�ulc Resi t _ - c �i REGISTRATION ISSUED ay I Date of M�anVicture iS APPLICATIONI :ri co NUMBER .�_s i F fri ` EVANSVILLE. INDIANA 47725 -, m =; i Order Number f i � [U u r 382619 M 611 F14U.1 MANUFACTURERS OF THE FINISHED 1 cJ En TENT PRODUCTS DESCRIBED HEREIN m This is to certify that the materials described have been flame-retardant treated S 0 (or are inherently noninflammable) and were supplied to: NS sa 2e5300 a foAid BIG TOP PARTY RENTAL 5 36 HILLMAN ST 5 TEW SBURY MA 01876 5 5 S Certification is hereby made that: NJ 0 The articles described on this Certificate have been treated with a flame-retardant approved INchemical and that the application of said chemical was done in conformance with California 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99. CPA[ 84, ULC 109. Cr The method of the FR chemical application is. �! 1 RInfi97 r2) I �I LDescription of item certified: m � CENTURY MATE EXPANDABLE MIDDLEru � --- iG1ASA:b ALR 13°}3lTL YftiYL 5 Flame Retardant Process Used Will Not Be Removed ey ID 1 N Washing And is Effective For The Life Of The Fabric 5 C621 S IS– TENT DEPARTMENT-ANCHOR INDUSTRIES INC. Z, ftnrjrJ��Pcl�cicPr.JcPJcPrJr�cPr.Pc��.f7R10iJW ELTJr5rJ�rTcPrT.-rIrr j cPcJ 3c.I�rJ��PsPcPr.PcPcPcPrJc�.��PIrJ�ePrJrP'�rJc 4 ,AORTH own of over No. 77 31 0 L A III E over, Mass., ' CoCMIc MEC ADRATED BOARD OF HEALTH Food/Kitchen PERMIT D Septic System THIS CERTIFIES THAT........�. ........... BUILDING INSPECTOR ........................................................................ ..... . . . ..... .. Foundation has permission to erect.'N ........... buildings on . .lohfw ........... .. .........��...... Rough to be occupied as............�i�,D.X..64....../iDI�9. 7" ...................................................... Chimney provided that the person accepting this permit shall in every r pec t conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough t30%NWMC== PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRLJ Y., ST TS Rough ....... ..... Service BUI TOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Finalh No Lathing or Dry Wall To Be Done Until Inspected and Approved by the. Building Inspector. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE Smoke Det.