Loading...
HomeMy WebLinkAboutBuilding Permit #231 - 1009 OSGOOD STREET 9/30/2008 BUILDING PERMITc* NORTkf i0-��bt `' ♦e O� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:ow Date Received �SSACH►f�+Y� Date Issued: a IMPORTANT:Applicant must complete all items on this page LOCATION 4- /009 Q S G 0 0 fl Sl- Print PROPERTY OWNER_ [;-/t i2`i iso tO n C Q6_SS I a G kk,C Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Iteration No. offbpits;� Commercial --Repair, replacement Assessory Bldg •' Others: Demolition Other Septic Well Floodplain Wetlands Watershed District ater/Sewer U;L( ©U-r DESCRIPTION OF WORK TO BE PREFORMED: U( 'Fi"i u iJ t i c(�tflfZAT 1009 OSGOon sir" Fo R r)t2 Identification Please Type or Print Clearly) Y) p OWNER: Name: AT R� ���� /(NC ��, L Phone: f7g- FF-W7 Address: 'TJ R n) 'P dC- CONTRACTOR Name: - �ASe59 6z44Sy gn 4dL Phone: Address: c/���l y('� 5,/ A&;1' A)DO a Supervisor's Construction License: E Q �� Exp. Date: J J 3 O Home Improvement License: f 3 1 3 Exp. Date: S a ARCHITECT/ENGINEER L,3 %D Phone: Address: Reg. No. X333 FEE SCHEDULE:SULDING PERMI 12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ g&.80© FEE: $��, D Check No.: 3 y � !� Receipt No.: ..2 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ignature of Agent/Owner Signature of contracto 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 4 DATE REJECTED DATE APPROVED I PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on d" Signature COMMENTSD6— HEALTH Reviewed on Signature COMMENTS I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes L7 Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street .FIRE DEPARTMENT .- Temp Dumpster on site yes no Located at 124 MainStreet` Fire Department signature/date COMMENTS 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.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 2.2008 Location No. Date MORTN TOWN OF NORTH ANDOVER F D • ; : Certificate of Occupancy $ U �'s'"•°•t1� Building/Frame Permit Fee $ Z 7 AC NUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Z d� 7 ^ Check # ?9 2154 ) Building Inspector Date. . !'. ,©� r�. 0i, • 03? y`.-(`i tip� p TOWN OF NORTH OVER PERMIT FOR GAS INSTALLATION SACHUS 7 This certifies that .. . . . . . . . . has permission for gas install io4.� . . . . . . . . � •e in the buildings o .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at ./©©.� . . . . .^��. . I North Andover, Mass. Fee Zyn . . . Lic. Nol r�. 9y'. . . . . . . . . . . . AS I oR Check# 6188 MASSACHUSETTS UNIFORM APPLICATON FOR PERMPT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER`,MASSACHUSETTS Building Locations l0© 7 , 0--�,760 c! S' 41 Permit# is .-- C �/ Amount$ U /?�+�,7'I iB2 ra Owner's Name 11617 2 s New Ic"I Renovation Replacement Plans Submitted w � CA x A 009 C7 Wa W O OU m E+ x 7y Ga z V w x rn z E- a 4 a F>+ w Z d w Q F F w O > z o z o x x o > a a0, H o SUB-BASEMENT B A S E M ENT 1ST.' FLOOR 2ND. FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR or type) jQ� n��n �jJ C� Check one: Certificate Installing Company +� NameCorp. Address PC ©� �� �� Partner. - 424 usmess 1 a ep one El Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: 1 have a current liability Insurance,policy or it's substantial equivalent. Yes ® No If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity D Bond ❑ Owner's Insurance Waiver: l am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State G dean Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber ` 3 6 C?-q City/Town Gas Fitter License Number 8 Master APPROVED(OFFICE USE ONLY) .Ioumeyman �.10RTH '9 TONM of over No. ......... 2j2m _ � ,. -7 LA ©L �` dover, Mass., COCMICMEWICK y�. ORATED `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT............................................:.........................:.... ...............:.................... ............................. Foundation ©syhas permission to erect........................................ buildings on . ./.. !°.7..../............ ............................................................ Rough c�i+lr�t74 �R�E C, !�E/' Chimney to be occupied as......... ........... `......................... .. ................... .. . . .. . .. . . . . . . . . . . . .. . . . . . . . . provided that the person accepting this permit shall in every respect conform to the terms of the application on file in 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 ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough ........ ..................... ............. Service BUILD G 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. S EE REVERSE SIDE Smoke Det. 09/29/2008 21:16 FAX 978 685 0049 GRASSO CONST fib001 —10- i C� Consr' . Sp, err Y&le �pwc-xt/CAM- 46ft - �o�t�p CS 22588 81hbr11 a;10a111943 _ 1!2009. Tr# 5235 JOHN GRASSO-' 9 685TURNPIKE s NO ANDOVER,MA 0`I$i$ Commissioner tfloi�oieon� n�,.�a�b Bomrd Of#uildie6 ReSutationa and Standards HOME IMPROVEMENT CONTRACTOR R9916tWioo: 113130 Expiration: 5i18a009 Tt11 129587 Type: Pq.wate corporation (wso coNstRucTION•COo.,.ke. JOHN GRASSO 865 TURNPIKE ST N.ANDOVER.AAA 01845 Adminfarater CONSTRUCTION CONTROL PROJECT NAME:Buildout of Dental Offices for Dr. Peter Devlin PROJECT OWNER: Dr. Peter Devlin PROJECT LOCATION: 1009 Chickering Road — Lower Level ARCHITECT: DAVID A.FARMER OF KING DESIGN ASSOC.,INC.,10 HIGH ST,MEDFORD,MA IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING CODE, SIXTH EDITION,1, DAVID A.FARMER REGISTRATION NO. 8333 BEING A REGISTERED PROFESSIONAL ARCHITECT HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT XXX ARCHITECTURAL STRUCTURAL MECHANICAL FIRE PROTECTION_ELECTRICAL OTHER(Specify) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF KNOWLEDGE,SUC1I PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE 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 116.2.2: 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 material. 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,in general,if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.4.,I SHALL SUBMIT PERIODICALLY A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE North Andover BUILDING COMMISSIONER UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. 4�4tED A nC No.8333 NCORD. DAVID A.FARMER PERSONALLY APPEARED BEFORE ME AND SUBSCRIBED AND SWORN TO BEFORE ME THIS 1 5th DAY OF September, - 2008 'Y OFFICIAL SEAL .: -JEFFREY F'...KING' _ -NOTARY,PU[SLIC COMMONWEALTH OF MhSWHU8 M 9'myr.,omni"Expires Mai.8,2013