Loading...
HomeMy WebLinkAboutBuilding Permit #223 - 1 HIGH STREET 9/21/2007 tsuiwirvv rcr�m� � - ,• -, TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0:010,3 Date Received pq,Ttp�•p' �� 4SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page c ,,Pa"..r 7qr . v n ��:', tt ,x t f �. x`ya,,a e : ` S12n �t *' ¢y '� ,.°`„;,`�wry 3"A dd`" ^^r'° w +t;.� e• � 5"11"' �ry q -�" ss3 '�� j-� uEfl•�e � Iw ;�+�,f> tier de. .,- 912 W101 � IN g h � � 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 0 Others: ❑ Demolition Other DESCRIPTION OF WORK TO BE PREFORMED: se iyc dew o + 0-nv23truct1Q6x- ':4-"0AS I*" L-17 oTTi 5 face- Identification Please Type or Print Clearly) OWNER: Name: Co HVc Y Se �oY+ . Cate r oo Phone: 6l7- 777.7/x3 Address O.s. t x,s. e "+xv �'es _ �' r a • �v,Fje"#".t rYr5 s � Si. +r,.�;� rre `' <5Y1 a ��'`�`•cy?�^ u ;�x: ._Mar :. n� � q � rq � x•`„� r�4^ �r'y;'��'s` "` amk�a-<ra t ' �„, rris i��"^� #app F �.-.E�, a-."-vret.� fi `r a' WWI rvrT ASA s9 a � xwv�F`x WERE � Z`11-11MW W"s-a v 540 t :.." i, €gr ��',�(� s`�� � ;„�.�,'� {y+,a -�- ✓ w+,r`x- ,.,�.� ... �" '�-s M'Os z ak i ;� :fit " k fg 1 ARCHITE=CT/ENGINEER 5inmasISe 'f Verbr;ctp Phone: 97,?- V7— 374L, Address: lad &aGG Sf Ae -cr-/U A?h 0/1/ 'Reg. No. 1`' 6Oa8 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:, $ 4. �a?I FEE: $ Check No.. • # -7l Receipt No.: (;2o NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund �cr 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified 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 Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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:BPFORM07 Revised 2.2007 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 Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING &-DEVELOPMENT ❑ ❑ 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 P,el,dnning Board Decision: Comments Conservation Decision: Comments ' Water& Sewer Connection/Signature sate Located at 384 Osgood Street77 RA Driveway Permit > � 7717 zr: """�k.,e g ORM: r w-hae. 1„...r ;., � ... '. .✓a<"t rti `' d-"�� k rid, �k S d c+ t Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.s100-s1000 fine NOTES and DATA— For department use 0 Notified for pickup - Date Doc.Building Permit Revised 2007 I- 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application i ❑ Certified 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 Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit f 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:BPFORM07 Revised 2.2007 I i Location Dr No. Date NQRTIy TOWN OF NORTH ANDOVER Of� . • ;,1't.G 3? • OL F A Certificate of Occupancy $ r yes�+cHus ACH E<� Building/Frame Permit Fee $ s Foundation Permit Fee $ Other Permit Fee $ ,. TOTAL $ t Check # 20642 Building Inspector OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER ` CONSTRUCTION CONTROL a=M�ge PROJECT NUMBER: PROJECT TITLE: PROJECT LOCATION: NAME OF BUILDING: NATURE OF PROJECT: IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, 1, REGISTRATION NO. BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ❑ ARCHITECTURAL ❑ STRUCTURAL ❑ MECHANICAL ❑ FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept,shop drawings, samples and other submittals which are submitted by the contractor In accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become,generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF 19 NOTARY PUBLIC MY COMMISSION EXPIRES Siemasko +Verbridge Architecture / Interior Design CONSTRUCTION CONTROL AFFIDAVIT PROJECT LOCATION: One High Street,North Andover MA PROJECT NAME: Renovations to Converse 2nd and 3rd Floors NATURE OF PROJECT: Interior Renovations ARCHITECT: Siemasko+Verbridge,Inc. ADDRESS: 126 Dodge Street,Beverly,MA 01915 TELEPHONE: 978-927-3745 In accordance with Section 110 and 116.0 of the Massachusetts State Building Code, 1,Thaddeus S Siemasko,Registration No. 6028,being a registered professional Architect,hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning, ARCHITECTURAL,for the above named project and that,to the best of my knowledge,such plans,computations and specifications meet the applicable provisions of the Massachusetts State Building Code,all accepted engineering practices and applicable laws and ordinances for the proposed use and occupancy. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2. 1. Review of shop drawings,samples and other submittals of the contractor as required by the construction contract documents as submitted for the building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code www.svdesign.com required controlled materials. 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix G. Pursuant to Section 116.2.2,I shall submit an affidavit at final inspection together with pertinent comments to the Town of North Andover Building Department. 126 Dodge Street Beverly,Massachusetts 01915 t 978.927.3745 f 978.927.6365 P:\Commercial,Current\Converse 200'\Second and Third Floors\02-General Correspondence and Proiect Info\Construction Control Affidavit.duc Upon completion of the work,Architect,and/or Engineers,shall submit final affidavits as to the satisfactory completion and readiness of the project for occupancy. zignalure Then personally appeared the above named and made oath that the above statement by him is true. Oit"I Before Me � W 'Ir"urA'...E'M. R, rY Public OF ,,.• .3 t�pED A No.6028 BEVERLY, O o MA soy# �ay� or 0As�� P:\Commercial,Cun ent\Converse 200'\Second and Third Floors\02-General Correspondence and Proiect Info\Construction Control Affidavit.doc i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Mass. 0211.1 Workers' Compensation Tnsurance Affidavit Name: Vantage Builders, Inc, Location: 281 Winter St, Suite 340 City: Waltham, MA 02451 Phone: 781-895-3270 _ I am a homeowner performing all work myself I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company Name: Vantage Builders, Inc. Address: 281 Winter St, Suite 340 City Waltham, MA 02451 Phone: 781-895-3270 Insurancecompany:Americal International Policy ll WC 897-53-90 Group I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation policies: Company Name: Wall Tech Systems Address: 94 River Rd d Huson, NH City: Phone: 603-886-8797 Insurance Company: Travlers Ins. Policy# WC731S225190024 Company Name: Plunkett Painting. Address: 11 Jackson St City: Hopkintbn, MA 01748 Phone: 508-435-5234 Insurance ComCompany: Policy# Travlers Ins. VB-7528A77-5-04 Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fma up to $1,500.00 and/or one years'imprisonment * s well as civil penalties in the form ofs STOP WORK ORDER and a fine of$100.00 a day against me.I understand that a copy of this statement may be forwarded to the Office of Imestigatioa of the DIA for coverage verification. I do hereby certify under the pain and penalties ofperjury that the information provided above is true and correct Signator . Date: Print Name: !ul Phone# Official Use Onlyl Do not write in this area,to be completed by City or Town Offmcial City or Town: PermitfLicense# Contact Person:BUILDING,PLWBNG,ELECTRICAL INSPECTOR Phone 4 781—794—8071 1 s�rc3 o��'a'rd —ffguiaridns any�a s a`a d� i Construction Supervisor License I' E, Licodhke: CS 79454 Bi!jt- ate 2/26/1977 xpiraon j2T2009 Tr# 12181 l t_.;, 'Re<str!ct10 PATRICK M YARNE-LLQ 3 BEAVER BROOIRD BURLINGTON,MA OT6b3:1'" Commissioner t _ AG BUILDERS,, INC. Job Budget For: Ron Caterino Procurement Manager Converse One High Street North Andover Job Name: Converse 2nd and 3rd floor work One High Street North Andover Date: Revised 6/12/2007 Revised 7/24 Revised 7/31 Revised 8/9 Division 1:General Requirements Permit 1lot 536 Supervision 3 week 6,600 Dumpster 2lot 1,300 Misc. material/protection 1 lot 150 Final cleaning 1 lot 300 General Requirements sub-total $8,886 Division 2:Demo Cost to demo 2nd floor wall Cost to demo 2nd floor office partition 1lot 1,260 Demo sub-total $1,260 Division 9:Drywall Cost to build a GWB wall to the deck to separate the coating room from the actual work space on the 2nd floor and relocate door to the outside Cost to build a GWB partition to the deck to separate the two existing offices on the second floor on the parking lot side and Move existing door and frame 1lot 3,120 Cost to add a new wall to the an existing office to make two separate offices. 3rd floor 1 lot 1 500 P , Drywall sub-total $4,620 Division 8:Glass and Doors and Hardware Cost to take the glass out of the area that the wall will be demo'd on the 5th floor. Misc glass work on the 2nd floor at office near the parking lot 1lot 900 Cost to add(1)3070 with knock-down frame(new office) 1lot 325 Cost for the door hardware(new office) Page 1 i Cost to install door(new office) 1 lot 120 1 lot 135 Cost to cut a full lite into the exsisting door being relocated 1 lot 150 Glass and Doors and Hardware sub-total $1,630 Division 9: Painting Paint all new walls as well as touch up area's of Demo wall Paint abutting walls as needed 1lot 830 Cost to paint the new wall on the 3rd floor and touch up existing walls that abutt it.Along with painting the extended duct work 11ot 325 Painting sub-total $1,155 Division 9: Flooring Patch and Match existing Vinyl Base on new walls 180 Supply only VCT for Mold room 200 Labor only Allowance 600 Flooring sub-total $980 Division 15: Mechanical Cost to Furnish and Install(1)motorized Damper Cost to furnish and install(1)"T"YWE run of Duct work Tapping Into the existing Duct from the Gym Provide switch for the Motorized Damper(wiring by others) Provide Flexable Exhaust Tubing 1lot 8,485 Cost to extend the supply into the new office to accommodate the new layout 1lot 250 Mechanical sub-total $8,735 Division 15: Plumbing Price to furnish and install a bradley eye wash station 1lot 6,640 Plumbing Sub-total $6,640 Division 16: Electrical Provide Demo as needed Electrical fee Re-locate Three(3)switches Re-locate Three(4)Receptacles Re-locate Three(3)Lights j Rewire(2)two lights Wire a switch and interlock wiring for the new exhaust fan and motorized damper two electrical inspections 1lot 4,560 Add to run electrical power from the switch to the top floor exhaust. 1 lot 0 Misc relocation or removal of any receptacles for the new office on the 3rd floor Ilot 400 Electrical sub-total _ $4,960 Sub total $38,866 Fee $1,555 Total Job $40,421 C Qualifications: 1. No money has been allocated for architectural or engineering 2. No money has been allocated for hazardous materials Page 2 3. No money has been allocated for building shut downs,tie-in,reconnects or testing for sprinkler or Electrical work 4. No money has been allocated for sprinkler work or relocation of T-stats 5. No money has been allocated for new ballasts for any existing light fixtures, it is assumed they are all in good working order. 6. No money has been allocated for Fire alarm work 7.Add/Alternate-Please add$1400 for 50 yards of matching carpet. You will not need 50 yards for this job,but it would cost just as much to by what is needed and I figured that you could keep the balance in stock for the next time. 8.Converse to confirm before construction that the Existing Cube Fan is on continuously or there will be an add to intergate the Damper Switch PLEASE NATE: It is assumed that all substances that will be vented through the new system have been approved to be combined in any way shape or form with the existing product currently being vented through the existing system and are in no way hazardous to a human and or the environment alone or when mixed together and to your knowledge will not corrode the metal,new or old. Page 3 NORTH 0 0 6Andover 2 23 q_ LA odover, Mass., • COCMICMEWICK y�. ADRA'rE D `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT..........C, r. .............................................................................................................. Foundation has permission to erect... ................................... buildings on .......co ..Vfs ..N......S..�............*.............. Rough ............ to be occupied as.......... %^Aa.... , s.....�!!.... ...���. ....... Chimney provided that the person accepting this permit shall in every respect nform to thof theVii -fitafio"nonlile.--ini. Final 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 UNLESS CONSTRU ON T T ELECTRICAL INSPECTOR Rough .......................:.........................:: Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det.