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HomeMy WebLinkAboutBuilding Permit # 11/10/2016 �oRTy BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO. Date Received " � Date Issued: � � �4SSZHUS IMPORTANT: Applicant must complete all items on this page LOCATION 3 E Winthr Ave. No.Andover A. (11845 Print PROPERTY OWNER d 7 w 1 E Jahn Mathews Print MAIC NCS: PARGEL. ZONING Dt$TR1CTT Historic C�istrict yes no Machine Shop Vll3age yes n+ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential E New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial (X Alteration No. of units: Ix Commercial ❑ Repair, replacement ❑Assessory Bldg 11 Others_ ? 11 Demolition ❑ Other ❑ .eptic C Will t Ffoot�oWn ❑If4letIant s V41ati +sh District l/ilaterlSewer Dental office construction as per Architect stamped pLans. To include non bearing metal stud walls/ Plumbing/ Electrical/ HVAC ducting/ Sprinkler head relocation. Identification Please Type or Print Clearly) OWNER: Name: Della MB. LLQ Phone: -0200 851-0200 Ext Address: 875 East St. Tewksbu MA. 01876 John Mathews CONTRACTOR Name P X790 hone fi�� Address: D . SUP elvIsOr S.n t7riStrtlt`.tIC1f1 LtenSe: Date CS- 611 a5l1 / [l1? Home lrnprouement License: Exp. Date. ARCHITECT/ENGINEER_ David A. Farmer Phone: Address: 1450 ramhrirJ��t ,.Camhridge.,MA.32J.11() ..., TReg. 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: $ 255 F p Check No.: 34- -Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent1OwnerL___,aff, J , .1� __ SIg rtature ©fcon t ractor Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. 2,672 Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No x DANGER ZONE LITERATURE: Yes No MGL Chapter 168 Section 21A—F and C min.$100-$1000 tine NOTES and DATA— (For department use) Ll Notified for pickup - Date I � �.. -- _ - ----...----- --..............------ Doe.Building Permit Revised.2012 Plans Submitted ® Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/.Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpstcr on Site ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED {� PLANNING & DEVELOPMENT ❑ �� .� KJ COMENTS 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/Sig na#ure_& ©ate _ _ Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENT Temp Dempster on site yes X ria I�oeated at X24 Main Strut fire rtment Depa41g taturelda#e f COMMENTS l .0 ,� �S?rl, t1ORTk own of :.:F . ndover O _ �► No. fN C,aLAK_ h ver, Mass, d Ir-Eo 7 V BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT .......O $.4tarjIf .... 1....... . . . . BUILDING INSPECTOR has permission to erect ... buildings on � � w� Foundation 00001PIMPOW, NOW Rough to be occupied as .� �'��........ T ............ Cn mney 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TION Rough Service . .,....... Final BUILDING FISP R GAS INSPECTOR OccupancyOecupancy Permit Required to 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 Approved by the Building Inspector. Burner Street No. Smoke Det. Merritt Construction Amu 15 Ha Road Deerfield, N.H. 03037 PROPOSAL Tel. (603)463-5790 Proposal,Subrnrued Co Work tv be Per formed at Proposal #: 92616 Name Gentle C,onnnunications Street. 350 Winthrop.Ave. Street: 200 Fifth Ave. Sheet#; 1 of4 City: No. Andover State: MA. 0 1845 City: Waltham Date of'Plans: 09/1.3/2,016 Date: 09/26/2016 State: Maass 02451 Architect: Paul Zbrua Tel: 781-647-0772 Fax: 781-895-9995 Plan # We her eby pr otiose to furnish till the materials curd perforin all the lrtl ±r nccessar y for tate contpletiort crf. Dental QIfice as per above Plan and attached�Sj)ecificatlons Uleets. If Information to bew. u apfi cl b Cieritle Dental-isnot received in a tiniplyY1.11nat�c�r we yaaa�cha c c�tra_{ate to caf sct c ost, Special Note: Items to be supplied by others and installed by Merritt Construction: PaperTowel Dispensers. Gentle Dental standard specs will override Dental Co. specs. Clean box letter dated 04/13/701.6 Architect to review and Stamp designers plan only. Not included in this Proposal : Licensed. Engineer, Lead, 1-1 V.A.C:. Unit, C)u(sitle of building, Storefront, Rear Door and entrance, Fire Alarms, Separation walls, Concrete Allowance cut to a maximum depth of 6", or existing code violations. All material is guaranteed to be as specified, and above work to be perlbrrned in accordance with the draawingv and specifications submitted,for,above work and coinpleted in a substantial iworlananlike tnanner for the surra of _._ .._....._. . __.. . _.... .._ Two Hundred and l{il'ty Five Thousand_Two,Hundred.........__.Dollars: $255,200.00 pctyrnenu to be made as follows: TBD Any alteration or deviation from above sj)eeifications,involving extra costs, will he executed only upon written orders and will become an extra charge over arta above the e}vtiniate, hi the event that o pgvineni is not made when due and we commence awith legal proceedings to collect rnonics owed, you agree to be responsible fi)r all casts of collection, including attornelrfees andeosu. lit addition, any unpaid amount will bear interest at the rate(?flc e'c,from due date. Resl)eq/ully subrrntted.. liernalct" C; Merritt Note This proj)osal may be withdraawn if not accepted within 10 days. Accepton e (g/7'roPosal 7'lte c'ibove pr,icev, sl)eciliccrtiaris arad conditions crr•e her,elry(tecc�ptecl. You are authorized to do work as s1pecyied Ac:,-celrted by Signature: Date: � � �� � w,�, Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the 8'h edition of the u� Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Gental Dental of New England Date: 10/3116 Property Address: 350 Winthrop Avenue,North Andover, MA Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: interior fit-out of an existing building for dental office including interior partitions, MEP, finishes, etc. I David A. farmer, AIA MA Registration Number: 8333 Expiration date: 8131/17 ,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 X Mechanical Fire Protection X 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. 1 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. 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, 1 shall submit to the building official a `Final Construction Control Document'. .�r,plD AA,Chy Enter in the space to the right a"wet"or electronic signature and seal: �4; !1 0 No.B333 � o CAME- Hi DG E. J 2 MA Phone number: 617-529-3875 Email: d—farmer@comeast.net -M 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 11 2013 October 7,2016 Zonina/Code Analysis—350 Winthrop Avenue, North Andover,MA Project: Gentle Dental of New England Zoning: Property address: 350 Winthrop Avenue,North Andover, MA(existing building) Zoning District: B-3 Use: Dental Clinic Parking Requirement: existing Code Anal Applicable Codes: - 2009 International Building Code w/Massachusetts Amendments 780 CMR - 2009 International Existing Building Code - 2012 International Mechanical Code - Fire Prevention and Electrical Regulations 521 CMR Incorporating NFPA 1 - Massachusetts Accessibility Regulations 521 CMR - Massachusetts Plumbing Regulations CMR Building Use/Occupancy: B (Business)per IBC 304.1 ���ED A� Q �r Construction Type: Type III (IBC 602.3) c7 No.83',13 Life Safety Systems: CA Supervised Automatic Sprinkler System Fire alarm system q lH OF 1,A Use Group Separation: None Occupancy Load: Use Group B; project SF=2,267; 100 SF/person=22 Exit Access Common Path&Travel Distance— 100' allowable (Business)—maximum travel distance 62' Travel Distance Allowed Per TBC Table 1016.1 —300' Allowable Business Corridor Width—Allowable per IBC Section 1005.1, CMR Exception 2: 0.15"/per person— Provided: '/z occupant load of 22 people= 1 I people per egress route=2.4" (44"ruin. per IBC 1018.2); 5 '-7"minimum provided Corridor rating—None required for Use Group B per IBC Table 1018.1 Stair Enclosure Ratting—N/A w The Commonwealth of Massachilsettts Department of Fire Services Office of the State Fire Marshal P.O.Brno 1025 State Road,Sta%MA 01775 AV A I/ PERIT bate: r� ` PexxnToy o£ ovi) (If pplicable) Dig Safe Number ,a accordance-with theprovisionsofmaL. Chapter 1aasprovidedinsection 527 CMR 34 This Permit is granted to: Start Date Full name of person,Fkm or Corporat=ion permission to locate dumpster for construction/renovation/demolition of structure Comments: dum sten he 25 ' from structure or covered with tarp or plywood Restrictions- at end of workday (Give location by street and no.,or describe in such manner as to provied adequate identification of location) Fee paid$ ..�_.. _ This Permit-will ox (Signa o e granting permit) Offi granting permit (Title) TWl!g WMttltl'i' bltl IAT AF: f'"f1NG31('.1!!')l fql V Pt)-gTr:n t iPnKi TW;= PP9;utpgl=q The Commonwealth of Massachusetts Department of Industrial Accidents X Congress Street,Suite 100 Boston,MA 02114-2017 < Wwww.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/PIumbers. TO BE TILED WITH THE PERMIT'T`ING AUTUORITY. Applicant Information Please Print Lezibly NaMe(Business/Organization/Individual): Ronald Merritt Address: 15 Haynes Rd. City/State/Zip: Deerfield NH 03037 Phone#: (603)463.5790 Are you an employer?Check the appropriate box: Type of project(required): : 1.❑1 am a employer with employees(full and/or part-time).* 7. ❑New construction 2.01 am a solo proprietor or partnership and have no employees working for me in 8. ®Remodeling any capacity.[No Workers'comp,insurance required.] 3.0 I am a homeowner doing all work myself[No workers'comp,insurance required.] 9. El Demolition 10[]Building addition 4.Q I am a homcownor and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are solo 11,0 Electrical repairs or additions proprietors with no employees. 12.n Plumbing repairs or additions S.®I am a general contractor and I have hired the subcontractors listed on the attached sheet. I3.�]Roof repairs 'Moso sub-contractors have employees and have workers'comp,insumnce.t 6.[:]We are a corporation and its officers have exercised their right of'exemption per MGl,c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Arry applicant that checks box t/1 must also fill out the section below showing theirworkers'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. #Contractors 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. X ant alt employer that is providing ivotlrers'conipertsation iltsurattce for itiy employees. Below is the policy and job site inforlltation. Insurance Company Name: Policy#or Self-ins.Lie.##: Expiration Date: Job Site Address: _360 Winthrop Ave. City/State/Zip: No Andover MAA1845 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisomnent,as well as civil penalties in the form of a STOP WORT{ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. i Ido hereby certify under the pains and penalties of pmt jttty that the info►nation provided above is true and correct. Signature: Date: 11/2/2016 Phone#: 603 463-5790 Qf_jlcdal use only. Do not write in this area,to be completed by city or totplt official City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Coutnet Person: Phone#: Massachusetts -Department of Public Safety Board of Building Regulations and Standards S o"Ntructi6ft.�xFi? rYiSf)i' - UcerFsv CS-061160 RONALD C MER T 15 HAYNES RD DEERFIELD lVFftt3F r ' 91 �.3F Expiration Commissioner €1511512017